Claim

The procedure to follow depends on the event, chosen insurance model and supplementary insurance.

Customers who have taken out the standard model with Sanitas can go directly to a doctor or go to a specialist without a referral.

Customers who have taken out a telemedicine model with Sanitas, such as CallMed or Compact One, are obliged to seek initial medical advice from Medgate before going to a doctor. This does not apply in case of emergency.

If you are employed for at least 8 hours a week with the same employer, accidents are processed directly via the employer’s accident insurance. If you are not in employment, your health insurance is responsible, provided that you have included the risk of accident in your basic insurance.

In each case, you have to complete an accident report and send it to the accident insurance company.

Health insurance covers maternity benefits from the 13th week of pregnancy until 8 weeks after the birth without applying the deductible or copayment. To benefit from this rule, it is important that you inform Sanitas of your pregnancy as early as possible.

You can find more information about pregnancy here.

For the reimbursement of costs, it depends on which system the health insurance company uses to settle costs with the  healthcare provider.