Limited cover
A hospitalisation insurance always takes your medical history into account. Insurance companies may apply a limitation or possibly an exclusion as a result. Read all about it below.
What is a limitation of cover?
A limitation of cover means that your insurance company will not grant you full cover. For example, they may limit your cover for a pre-existing condition. Some insurance companies also apply an exclusion for pre-existing conditions. Helan does not apply an exclusion in such cases.
Our advice: Take out a good-quality hospitalisation insurance policy as early as possible to avoid any future limitation of your cover.
Might Helan limit my hospitalisation insurance cover?
With Helan, limitations for a pre-existing conditions are possible, but exclusions are not.
When you purchase a hospitalisation insurance policy, you fill in a medical questionnaire. Afterwards, a medical report will be requested if there is a pre-existing medical condition. You can obtain this report from your GP or consulting physician, and submit it to the health insurance fund. The decision about whether you will receive a cover limitation for the insurance due to your pre-existing medical condition will depend on this report.
We recommend that you always fill in this list truthfully. If it the medical questionnaire contains inaccuracies or is incomplete, reimbursement will be refused.
What exactly does a limitation mean?
Have you received a limitation for a pre-existing condition and are you being hospitalised for that same pre-existing condition?
- Double or multi-occupancy room: no limitations in cover will apply
- Single room: cover limitations will apply. You will not receive reimbursement for room- and doctor surcharges.
When admitted for a diagnosis that is independent of the pre-existing condition for which you received a limitation, the cover will apply without limitation. The reimbursement you receive depends on the type of hospitalisation insurance you took out.
Pregnancy limitations
If you want to take out hospitalisation insurance when you are already pregnant, specific rules and restrictions apply. Inform yourself well in advance to avoid high costs.
Our advice: Buy good-quality hospitalisation insurance as early as possible in your life, and well before you start expanding your family. That way, you can avoid any future limitation of your cover
Helan Independent Health Insurance Fund is the insurance agent (n° CDZ 5006c) for ‘MLOZ Insurance’, the VMOB of Independent Health Insurance Funds, (Register of Legal Entities in Brussels, 422.189.629, recognised under no. CDZ 750/01 for branches 2 and 18). View the data sheet and the General Terms and Conditions. Belgian law applies to the insurance contract. The term of the contract is whole life. In the event of any complaint, contact the complaints department of Helan Health Insurance Fund or the insurance ombudsman. For more information about purchasing this/these product(s), please contact Helan Health Insurance Fund. Helan Onafhankelijk ziekenfonds, Boomsesteenweg 5, 2610 Wilrijk, 0411.696.011, RPR Antwerpen, www.helan.be.