“Swiss Life Medica Bolivar” provides access to services through its medical network of over 5,000 providers and/or through out-of-network providers. Primary care services are delivered by its own medical centres. Second medical opinions are available, as well as travel insurance and 24/7 medical guidance through its Telefono Verde contact centre.
Access to services
For primary care, plan members may self-refer to a specialist, either in-network or out-of-network, at full benefit, without first obtaining a referral from a primary care provider. For basic coverages, insureds may visit a doctor in the Seguros Bolivar medical network, or an out-of-network provider, in which case reimbursement applies. A clause outlining reasonable and customary charges* applies to all medical procedures that are reimbursed.
* Charges determined to be normal for a particular medical procedure in a specific geographic area. If charges are higher than what the insurer considers normal, the full amount will not be paid by the insurer and the balance is the responsibility of the insured.
Basic coverage includes medical assistance with a maximum benefit amount ranging from COP 150 million to COP 500 million per person, per annual medical event. This benefit covers all expenses related to: hospitalisation, intensive care, physicians’ fees, maternity care, new-born baby care, special diagnostic tests and ambulatory care. It covers cancer, HIV, transplants, prostheses, home care, medical emergencies abroad and outpatient treatment.
Additional coverages include: primary care, basic dental care, ambulatory medicines, travel insurance for medical emergencies abroad, emergencies in Colombia, and home health care.
“Swiss Life Medica Bolivar” is ISO 9001:2000 certified. Its many satisfied policyholders include a large number of major international corporations from a wide variety of industry sectors.
Please ask for information on how your employees in Colombia can enjoy better medical coverage.