Health

Voluntary health insurance offers financial support and security, helping you feel cared for during unexpected health challenges. It provides peace of mind, knowing you have assistance for the medical treatment and care you need.

1. VOLUNTARY COLLECTIVE HEALTH INSURANCE IN CASE OF CRITICAL ILLNESS

Critical illness insurance cover provides security and protection against financial difficulty at unexpected and most undesirable moments, in the event of a first-time diagnosis of one of the following 14 serious illnesses, defined in the Terms and Conditions for Insurance:

1. Malignant tumors;
2. Stroke;
3. myocardial infarction;
4. Coronary artery bypass graft;
5. Surgical treatment of aorta;
6. Surgical treatment of heart valves;
7. Organ transplantation;
8. HIV caused by blood transfusions;
9. HIV infection contracted during professional exposure;
10. Multiple sclerosis;
11. Alzheimer’s disease;
12. Parkinson’s disease;
13. Encephalitis;
14. Chronic kidney disease

2. VOLUNTARY COLLECTIVE HEALTH INSURANCE IN CASE OF SURGICAL TREATMENT

This insurance provides coverage for surgeries (i.e., surgical interventions or other procedures) resulting from illness or accident during the period of insurance that were not indicated before the start of coverage.

We offer two packages that differ in the number of operations covered:

• Short Package – List of Operations shown in Table 1 of the Insurance Terms and Conditions;
• Extended Package – List of Operations shown in Table 2 of the Insurance Terms and Conditions;

3. PRIVATE HEALTH INSURANCE FOR OUTPATIENT AND INPATIENT TREATMENT

Private health insurance for outpatient and inpatient treatment covers expenses for specialist health services, diagnosis and treatment in private health care institutions. This coverage shall protect against:  

• Main risks (mandatory)
• Additional risks (optional) 

Main risks covered by insurance:

OUTPATIENT TREATMENT

• Consultations and examinations and/or diagnosis;
• Expenses incurred for domiciliary treatment/diagnosis;
• Medical services indicated by certified specialist/subspecialist medical practitioner in relation to mental health treatment for patients in acute psychiatric crisis;
• Urgent dental treatment consequential to accidental injury (acute traumatic injury);
• Necessary ambulance transportation.

INPATIENT HOSPITALISATION

• Accommodation in a standard hospital room and medically approved diets;
• Medical treatment proved by certified specialist medical practitioner for the respective heath condition of the insured person following the relevant medical indications, and medical examinations and analysis taken during the hospitalisation;
• Surgery or surgical procedure/other procedures;
• Therapy during inpatient hospitalisation and day care center;

• Daily cash for accompanying an insured child aged up to 14 years by a parent during the inpatient hospitalisation.

 MATERNITY COVER

• Ordinary/regular gynaecological and ultrasound examinations during pregnancy;
• One advanced ultrasound examination;
• One prenatal biochemical screening;

• Prenatal therapy is covered if prescribed by a certified specialist/subspecialist   medical practitioner of certain competence;
• Normal delivery;
• Caesarean delivery only medically indicated.

Additional risks covered by insurance:

1. EXPENSES FOR PRESCRIPTION MEDICATION
2. PHYSIOTHERAPY AND MEDICAL REHABILITATION
3. OPHTHALMOLOGY SERVICES

The Health Institutions that we have signed cooperation agreements with for covering expenses for medical services

• PZU CLINICAL HOSPITAL ACIBADEM SISTINA SKOPJE
• PZU CLINICAL HOSPITAL ZHAN MITREV SKOPJE
• PZU RE-MEDIKA
• PZU BIOTEK LABORATORY SKOPJE
• PZU POLYCLINIC AT PRIMARY LEVEL BIOTEK SKOPJE
• PZU ZHAN MITREV DIAGNOSTICS STRUMICA
• NEUROMEDICA HOSPITAL SKOPJE – PZU – General Surgery Facilities
• NEUROMEDICA SKOPJE – PZU – Polyclinic offering medical consultations to specialized services
• PZU CARDIOART STIP
• PZU PRIM. DR. ACO NIKOLOV STIP
• PZU PRIM. DR. ACO NIKOLOV VIDAFI STIP,
• PZU DR. ORGANDŽISKI STIP
• PZU PRIM. DR. SAMARDŽISKI STIP
• PZU Specialist consulting clinic for services in internal medicine and biochemical laboratory DR. SHUPERLISKI – KOCANI
• MEDICA Skopje -PZU – polyclinic offering primary health care services and biochemical laboratory SKOPJE
• SINLAB – PZU – Diagnostic Laboratory with Biochemical and Microbiological Laboratory SKOPJE
• ELI MEDIKA POLYCLINIC – STRUMICA
• GYNECOLOGY AND OBSTETRICS OUTPATIENT FACILITY FERTILAB – SKOPJE
• HEALTHCARE INSTITUTION AD CAR SAMUIL
• PZU PROMEDIKA MEDICAL CENTER
• PZU PROMEDICA PRIMA
• PZU-Specialised Ophthalmology Hospital PROMEDICA OPHTHALMOLOGY Skopje
• JZU CITY GENERAL HOSPITAL “8TH SEPTEMBER”
• JZU UNIVERSITY CLINIC OF SURGICAL TREATMENT “ST. NAUM OHRIDSKI”
• POLYCLINIC DR. DONEVSKI – KOCANI
• PZU DR. TAMARA MANCHEVA DZHORDZHIEVSKA
• PZU RAMUS

We are at your disposal to clarify any questions about the method of concluding this type of insurance that you are interested in, including what indemnity we can pay for any claim related to each product. Our experienced agents are here to support you and provide guidance. For all the details, read the  Terms and Conditions for  Insurance.