Download student health insurance

Survey
yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project

Document related concepts

Dental emergency wikipedia , lookup

Transcript
INSURANCE PLAN «STUDENT-2016»
FOR INTERNATIONAL STUDENTS OF HSE
SK VEKTOR (license SL#2664 dated June 25, 2015) shall cover the following
medical expenses associated with an acute disease, injury, poisoning or
exacerbation of chronic conditions throughout the entire duration of the
Insurance Agreement:
1. Outpatient care at the following locations:
- “Medsanchast 03” Medical Centre (Sushchevskiy val 5, bld.9, Savyolovskaya
metro station), reception: 8-495-664-20-03;
- Moscow Outpatient Clinic No.68 (Malaya Yakimanka 22, Polyanka metro station)
- “Altamed+”, Odintsovo, Soyuznaya Str., 32Б
- “Veramed”, Odintsovo, L.Novoselovoy boulevard, 17
to receive medical treatment at these facilities, contact the 24-hour call centre
of SK VEKTOR: 8-925-011-48-82, 8-916-141-36-80
Outpatient services include the following:

Physician office visits for consultation, diagnosis or treatment by a general
practitioner (GP), surgeon, cardiologist, infectious disease specialist, trauma surgeon,
urologist, ear, nose and throat specialist, ophthalmologist, neurologist, dermatologist,
specialist for sexually transmitted diseases, obstetrician, gynaecologist and, upon
referral, a kidney specialist, proctologist, oncologist (until an oncological disorder is
diagnosed), neuropsychiatrist (initial appointment)

Issuing medical documents requested by the student

Issuing a certificate of fitness for studies and dormitory accommodation based
on medical examination (GP, chest X-ray, HIV test and Wassermann test) conducted at
Medsanchast 03 (Sushchevskiy val 5, bld.9, Savyolovskaya metro station) no more than
once per the coverage period.
Function tests:

ECG, EEG, echocardiography, pulmonary function testing

Holter monitoring and 24-hour blood pressure monitoring, if indicated – once
per the coverage period and upon the Insurer’s consent
Laboratory tests and instrumental procedures:

General laboratory tests, biochemistry, bacteriology, serology and immunologic
tests for total IgE levels (if indicated by the allergist)

Cytology and histology, biopsy for medical emergencies

Full array of radiographic procedures

Ultrasound testing

CT and MRI scan as a part of emergency treatment and upon the Insurer’s
consent

Gastrointestinal and pulmonary endoscopy under a local anaesthetic;
colonoscopy in emergencies (upon the Insurer’s consent)

Minor surgical procedures performed on an outpatient basis in emergencies
(upon the Insurer’s consent)
Rehabilitation therapy (upon the Insurer’s consent):

Therapeutic exercises, group classes (up to 10 classes per the coverage period);
rehabilitation treatment options: physical therapy, electrotherapy, light therapy, heat
therapy, therapeutic ultrasound, magnet and laser therapy (except intravenous),
inhalations – up to two options per one occurrence during the treatment period.
2. Dental treatment (up to 4 teeth).
To arrange for dental treatment, call the 24-hour call centre of SK VEKTOR:
8-925-011-48-82, 8-916-141-36-80
Emergency dental treatment and pain relief:
Dental therapy and surgery, all means of local anaesthesia, diagnostic X-rays and
physical therapy to the extent needed to provide pain relief and prevent any
complications (excluding treatment of periodontitis, congenital conditions and
developmental anomalies).
3. House calls (within MKAD and in Odintsovo):
House calls are made to international students whose state or nature of illness
requires bed rest and prevents them from attending a healthcare institution. Requests
for house calls should be made before 14.00 of the same day, and the student’s
contact phone number should be provided.
A house call involves the following procedures:

Initial or follow-up examination by a GP (a second follow-up examination
requires laboratory testing or determining whether the patient should be admitted to
a hospital).
4. Emergency care (within MKAD and in Odintsovo):
Emergency care includes the following:
dispatch of an ambulance service team; emergency diagnosis; emergency treatment
and acute care; emergency transportation to a hospital.
5. Inpatient care at the following locations:
- City Hospital No.36 (Fortunatovskaya 1, Partizanskaya metro station)
- City Hospital No.64 (Vavilova 61, Akademicheskaya metro station)
- City Hospital No.13 (Velozavodskaya 1/1, Dubrovka metro station)
- City Hospital No.15 (Veshnyakovskaya 23, Vykhino metro station)
- N.A. Semashko Hospital of the Russian Railways (Sportivny proezd 3, Lyublino
metro station)
and other healthcare facilities selected by the insurance company.
Inpatient care involves admission to a healthcare facility (when outpatient treatment
is impossible or ineffective) in order to administer conservative or surgical treatment
for an acute condition or exacerbation of a chronic illness.
Emergency hospital admission:
Emergency admission (urgent, without any prior arrangements) to a hospital takes
place when there is an immediate threat to the student’s life and health, necessitating
emergency medical intervention.
Patients are admitted to the nearest hospital, including those assigned by the
emergency medical services of the city. Thereafter, if the patient’s condition permits,
the Insurer may transfer the patient to a healthcare facility included into the
Insurance Plan, subject to the patient’s consent.
Inpatient services include the following:

Diagnostic and laboratory tests and instrumental procedures for the illness
(condition) that has necessitated the hospital admission

Surgical and/or conservative treatment administered as per the approved
medical standards

Counselling and other professional services provided by physicians

Medications and other materials required for treatment

Physical therapy, classic massage, therapeutic exercises prescribed by a
physician to treat the condition that has necessitated the hospital admission

Placement in a 4-bed hospital room, meals and nursing care
Patients may be admitted on an emergency basis to hospitals that have vacant places
and that can provide the relevant medical services. Patients may subsequently be
transferred to a healthcare facility included into the Insurance Plan, if their condition
permits it.
6. Accident insurance.
Insurance policies lasting from 6 to 12 months include an accident insurance cover of
200,000 roubles.
Insurable risks:
Traumatic injuries caused by an accident — insurance cover of 100,000 roubles with
payments as per the payment table.
Accidental death — insurance cover of 100,000 roubles.
INSURANCE PLAN EXCLUSIONS
1. The following cases, conditions and their complications (once the diagnosis is
established) are not covered by this Insurance Plan:

Injuries, burns, frostbites, acute poisonings, injuries to internal organs
sustained by the student while under the influence of alcohol, drugs or intoxicative
inhalants, during a psychotic episode, while engaging in antisocial behaviour or as a
result of a terror attack

Deliberate self-harm, suicide attempts, deliberate violation of safety
requirements

Unauthorised rallies and demonstrations, public disorder, military
operations, disasters and gun handling

Oncological diseases and their complications, nervous system tumours, skin
cancer, keloids, photoallergic reaction of post-burn scars, paresis and paralysis

Neoplastic diseases of the blood, chronic blood disorders, thrombocytopenia
(until the diagnosis is established)

Inherited and congenital disorders, iatrogenic disorders

Degenerative and demyelinating diseases of the nervous system, epilepsy,
cerebral palsy, multiple sclerosis, sensorineural hearing loss

Systemic diseases, including connective tissue disorders, such as rheumatoid
arthritis and undifferentiated collagen diseases

Chronic diseases of the musculoskeletal system (advanced and requiring
joint replacement or osteoplasty)

Asthma (once the diagnosis is established), chronic skin disorders, psoriasis,
disseminated eczema, systemic mycosis, genital herpes, leukoplakia and interstitial
nephritis (once the diagnosis is established)

Cardiovascular and nervous system disorders requiring reconstructive
surgery, including high-tech procedures (angiography, stent insertion, prosthesis, etc.)

Sexually transmitted diseases (STD), HIV, confirmed immune deficiency,
highly infectious diseases, syphilis

Infectious diseases, acute and chronic hepatitis, including drug-induced
hepatitis

Tuberculosis, sarcoidosis, cystic fibrosis, fibrosing alveolitis regardless of the
clinical presentation and stage of progression

Type I and II diabetes and its complications (retinopathy, angioedema,
eczema, pyogenic skin disorders), gout, metabolic syndrome, obesity, impaired
glucose tolerance

Diseases accompanied by chronic heart failure and cardiopulmonary
insufficiency

Diseases accompanied by chronic kidney and liver insufficiency

Psychiatric disorders and their complications, behavioural disorders

Sleep disorders, snoring

Occupational diseases

Menstrual disorders

Family planning and pregnancy (except for life-threatening conditions during
the first 8 weeks of pregnancy)

Radiation disease and its complications

Disability of category I and II
2. SK VEKTOR does not cover the following medical services:

Medical services that were not prescribed by the physician in charge

Lipid, hormone, immunology (except for total IgE levels) and allergy profile
(including hyposensitization therapy), PCR-based diagnostics for sexually transmitted
diseases, genetic testing, DNA tests

Scheduled surgeries to treat disorders of refraction and accommodation
(short-sightedness, long-sightedness, astigmatism), retinal disorders, physical therapy
for eye disorders; medical devices to train the accommodative apparatus of the eye,
treat or prevent short-sightedness; complex lens and contact lens fitting

Surgical treatment of injuries sustained outside the coverage period

All types of prosthesis and endoprosthetic replacement, organ and tissue
replacement surgery

Diagnosis, treatment (including surgical) and procedures performed for
aesthetic and cosmetic purposes or to improve the patient’s psychological well-being,
including skin treatment (calluses, papillomas, nevuses, etc.), sclerotherapy for veins,
weight loss treatment, sex reassignment surgery

Injecting drugs into joints for interstitial fluid replacement

Heel spurs, valgus deformity, flat feet (including those presenting with pain)
without any signs of acute arthritis and/or bursitis

Vaccination (except for emergency tetanus shots), specialised allergen
immunotherapy

Costs associated with purchasing medications, dressing, medical equipment
and devices (eyeglasses, contact lenses, hearing aids, etc.) and with customizing
them; customized hardware for treatment of injury

Hardware removal after treatment of injury

Alternative diagnostic techniques: thermopunctural, electropunctural, pulse
methods, iridology, ear acupuncture, electroacupuncutre according to Voll, etc.; all
traditional and alternative medicine: chiropractic, phytotherapy and other natural
remedies
“Medsanchast 03” Medical Centre
(Sushchevskiy val 5, bld.9, Savyolovskaya metro station)
SK VEKTOR

Homeopathy, hirudotherapy, energy therapy, traditional healing techniques,
reflexology (except for standard acupuncture), etc., any other experimental or
alternative treatment

All types of massage (except for classic massage – up to 10 procedures per
the coverage period), physical therapy (over 10 procedures per one occurrence),
preventive procedures, shockwave therapy, training devices, sunbeds, swimming pool,
sauna, individual sessions of therapeutic gymnastics, colon hydrotherapy, etc.

Fertility treatment and contraception, including in vitro fertilization, IUD
insertion and removal, diagnosis and treatment of infertility or erectile dysfunction,
complications from any contraceptive methods

Orthopaedic surgery and other procedures

Medical examination to receive a certificate of fitness for a driving license,
gun license, travelling abroad, admission to educational institutions (except for a
certificate of fitness for studies and dormitory accommodation – only once per year),
purchasing bank and other insurance services

Vaccination for adults (except for tetanus shots after an injury)

Extracorporeal treatment, blood irradiation therapy (laser and ultraviolet),
normobaric and hyperbaric oxygen therapy, radio-wave therapy, haemodialysis

Procedures, examination or treatment that require hospital admission on a
day patient basis, if the insurance policy does not cover a scheduled hospital
admission; inpatient stay for nursing care and rehabilitation at early treatment
centres, health resorts, preventive healthcare facilities, rehabilitation centres and
other specialised healthcare institutions (unless otherwise provided for in the
Insurance Plan)

If the Insurance Agreement has expired but an acute condition still persists,
the Insurer will cover the cost of medical services as follows: supervision by the
physician in charge until an acute phase of the underlying condition is over (for
outpatient care) or until hospital discharge (for inpatient care). All scheduled hospital
admissions (if they are included into the Insurance Plan) must take place at least 14
days before the expiry of the Insurance Agreement. For conditions that were diagnosed
before conclusion of the Insurance Agreement and require a mandatory non-urgent
surgery, no hospital admission will be scheduled
3. SK VEKTOR does not cover the following dental services:

Treatment of periodontal diseases (periodontitis, periodontosis)

Services provided for preventive, aesthetic and curative purposes (cleaning
the oral cavity, counselling in oral hygiene, applying protective substances to the
teeth, determining oral hygiene indices, plaque removal, Air Flow teeth whitening)

Dental prosthesis insertion and preparation

Dental implants

Treating teeth fitted with orthopaedic and orthodontic appliances, teeth
under a crown and filled root canals

Panoramic radiograph

“Termofil”, parapulpar, anchor and fiberglass dental pins

Aesthetic and restorative dental surgery, restoration of over ½ of a tooth

Applying fluoride varnish to the teeth for preventive purposes

Orthodontic treatment

Surgical interventions aimed at salvaging the teeth: apicoectomy, dental
cyst removal, flap surgery, open flap debridement using biomembranes, osteotropic
materials, intradental splinting, wisdom tooth extraction, extraction of impacted and
misplaced teeth

Treatment of non-carious lesions, chipped teeth, fissure sealing

Removal of old dental fillings without digital imaging
4. If during the coverage period the student develops any of the conditions listed in
Section 1 of these Exclusions or has a disability of category I or II officially confirmed,
the Insurer will cover medical services provided to the student up to the point when
the diagnosis or disability of category I or II has been established (confirmed).
STUDENT HEALTH INSURANCE
Outpatient care can be obtained at the following locations:
- “Medsanchast 03” Medical Centre
(Sushchevskiy val 5, bld.9, Savyolovskaya metro station)
This Medical Centre is by appointment only. To book an appointment, call
8-495-664-20-03. Don’t forget to bring your passport, insurance policy and
insurance card to the appointment.
- Moscow Outpatient Clinic No.68
(Malaya Yakimanka 22, Polyanka metro station) – without medical
examination
- “Altamed+”, Odintsovo, Soyuznaya Str., 32Б
- “Veramed”, Odintsovo, L.Novoselovoy boulevard, 17
To book an appointment, contact the 24-hour call centre of SK VEKTOR:
8-925-011-48-82, 8-916-141-36-80. Don’t forget to bring your passport,
insurance policy and insurance card to the appointment.
Moscow Outpatient Clinic No.68
(Malaya Yakimanka 22, Polyanka metro station)
All requests for house calls should be made from 08.00 to 14.00 by
phone: 8-925-011-48-82, 8-916-141-36-80.
Your insurance plan includes 24-hour emergency services that can be
requested at the call centre of SK VEKTOR:
8-925-011-48-82, 8-916-141-36-80.
Your insurance plan also includes emergency dental treatment and
pain relief (up to 4 teeth), subject to referral from the physician of the
Insurer’s call centre and at selected facilities only. To arrange for
emergency dental treatment, contact the 24-hour call centre of SK
VEKTOR: 8-925-011-48-82, 8-916-141-36-80.
Apart from outpatient care, you are also entitled to ambulance services
and emergency hospital admission.
To request an ambulance or arrange for an emergency hospital
admission, contact the 24-hour call centre:
8-925-011-48-82, 8-916-141-36-80.
Tell the contact centre operator your name, insurance policy (card)
number, location and reason for phoning.
Passing your insurance policy and insurance card on to others is
prohibited. Failure to comply will result in termination of the
Insurance Agreement without any compensation.
CONTACT US IF YOU HAVE ANY FURTHER QUESTIONS
SK VEKTOR, Personal Insurance Department
Telephone: 8-925-011-48-82, 8-916-141-36-80