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What should I do?
Follow the steps
1. Check beforehand whether it is a hospitalisation or outpatient care
Hospitalisation or outpatient care?
Nowadays, large numbers of patients are being referred for one-day clinic for exploratory and minor procedures. If you are admitted as day case, you will spend just one day in the hospital. If your day case is invoiced as a hospital admission, your hospital plan will cover the costs.
As a general rule, your treatment and procedure(s) will qualify as a hospital admission:
- if you have had general anaesthesia
- if you have stayed in a regular hospital room
A trip to the emergency room to apply a cast to a broken arm, for example, will not count as a hospital admission but as outpatient (ambulatory) care. In this case, you will usually not be able to claim a refund through your hospitalisation insurance.
If you're unsure as to whether the costs will be covered, it's best to check with your attending physician or the hospital directly.
2. Notify AG in advance
It's best to report a hospital stay in advance, although this isn't always possible. So, you can also report it using your smartphone while you're in hospital or after you've been discharged.
3. Save all receipts for medical expenses
Remember to keep copies of all your medical expenses receipts related to your hospital stay: not just costs during your hospital stay, but also before and after (known as outpatient costs).
Before
Your hospitalisation insurance will reimburse you for medical services, such as pharmacy and doctor's fees, within a certain period of time before you're admitted. The period covered is 1 or 2 months, depending on your policy; this can be found under the special terms of your insurance. IIf you cannot find this and you are insured through your employer, you can also log in to MyAG Employee Benefits or check with your HR department.
During
Your hospitalisation insurance will reimburse your hospital bill. If you have the Medi-Assistance third-party payer agreement, AG will receive the admission bill and pay it directly to the hospital. However, it is still important for you to report your hospital stay to AG in advance.
In other cases, the bill will be sent to you and you may submit it along with your other medical expenses. Please still submit the declaration in advance, and we'll open a case. This makes it easier to process the expenses if you send them later.
After
You may receive treatment after, just like before, your hospital stay to help you get better as quickly as possible. Your hospitalisation insurance will reimburse you for these medical services within a certain period of time after you're discharged. This is 3 or 6 months, depending on your policy.
Keep all invoices and receipts from your hospital, doctor(s), pharmacy, etc. safe. !
Tip: You can get a handy overview of your medical benefits from your sickness fund.
4. Send in your expenses
Got all your medical expenses together? Send them to us!
Scan or take a clear photo of your expenses and submit them to us online. Be sure to include your correct account number and your contract number or customer reference.
5. Collect your refund
Your account statement
Once your medical expenses have been processed, your account administrator will issue you an account statement. This is a written statement that shows in a simple and transparant way which costs are covered and which are not.