This Product is manufactured by MAPFRE Middlesea p.l.c.
MAPFRE Middlesea p.l.c. (C-5553) is authorised by the Malta Financial Services Authority (MFSA) to carry on both long term and general business under the Insurance Business Act, Cap. 403 of the Laws of Malta. MAPFRE Middlesea p.l.c. is regulated by the MFSA.
Health insurance – Quick Facts
Refer to the Tables of Benefits and Health Insurance Policy for full details of cover
Our Range of Scheme Options
International: covers treatment received worldwide, excluding in the U.S. and Canada (in this case cover is applicable for emergencies only)
Hospital: covers the full cost of reasonable in-patient treatment received in Malta with direct settlement facility; and limited cover for treatment outside of Malta.
Basic: covers part of your treatment costs up to specified limits worldwide.
Each scheme can be taken as:
- in-patient only (cover for hospital admissions), or
- in- and out-patient (this will add on cover for consultations, diagnostic tests, therapies and other medical services.
Additional benefits (extensions) can be purchased to complement the Scheme of your choice.
Ways to manage your premium
MMS Health Schemes give you the flexibility to manage your premium in a way that suits your budget and lifestyle. You can opt to add or remove these options at any policy renewal:
- Apply an excess for your claims (the first part of any claim which you must pay yourself, against a reduction in your annual premium)
- Pay in monthly / quarterly / half-yearly by instalments
Scheme for Work/Residence Permit Applicants
The Europa scheme has been designed specifically for work and residence permit applicants; and complies with the requirements of the respective authority.
The scheme covers the full cost of reasonable in-patient treatment received in Malta; and anywhere in Europe when the same / similar treatment is not available in any hospital in Malta.
Benefits up to specified limits also apply for:
- Cancer treatment
- Out-patient treatment
- Emergency dental treatment
- Funeral expenses
Dental Cover Extension
Cover for routine and restorative dental treatment up to a specified amount.
This extension can be added to any In- and Out-patient Scheme at an additional premium.
Routine and Preventive Care Extension
Optional cover to help you maintain a good state of health.
Benefits include eye tests, skin and cervical cancer screening, breast and prostate examinations, blood tests, stress ECG, bone density scans and monitoring of chronic conditions.
This extension can be added to any In- and Out-patient Scheme at an additional premium.
Some benefits may be age-specific.
Loss of Income Extension
Financial assistance up to a specified amount in the event of being diagnosed with a long-term condition that results in loss of your employment.
This extension is automatically included with the International In- and Out-patient Scheme.
It can be added to the Hospital In- and Out-patient Scheme at an additional premium.
Waiver of Standard Exclusions Extension
Cover for vaccinations, clinic fees and allergies otherwise excluded from cover on the standard Schemes.
This benefit can be added to the International and Hospital In- and Out-patient Schemes at an additional premium.
247 International Emergency helpline
Available free of charge to all MMS health insurance clients.
Second Medical Opinion
Access to a network of acknowledged international medical experts for a second opinion relating to the diagnosis of a condition and recommended treatment.
This extension is automatically included with the International and Hospital schemes.
It can be added to the Basic Scheme at an additional premium.
Oncology treatment
We understand oncology treatment is challenging.
Our health schemes cover the cost of treatment at different phases, including diagnosis; cancer drugs, radiotherapy, tests and scans; genetic tests carried out to confirm a patient’s eligibility for certain treatment; and follow-up consultations and tests when in remission. Out-patient treatment is also covered when you opt for in-patient only cover.
Funeral Expenses
All schemes include cover for funeral expenses, giving the ones you leave behind the financial support to make the necessary arrangements.
Insurance at your Fingertips
Download the MyInsurance app for secure access to all your MAPFRE policies.
You can view documents, renew your policies and submit claims at any time.
Insure and Save with MAPFRE
We value your custom! Contact us on marketing@middlesea.com to get your Insure&Save loyalty card and benefit from discounts in your favourite stores.
FAQs Health Insurance
What am I covered for?
The purpose of the policy is to provide cover for any medically necessary surgical or medical service (such as consultations, diagnostic tests or investigations) needed to diagnose, relieve or cure a disease, illness or injury.
Treatment can be received as an in-patient or day-patient; or as an out-patient (this depends on your choice of scheme).
Full terms and conditions are detailed on the Health Policy; and the Table of Benefits of your chosen scheme.
Where am I covered?
This depends on the scheme you choose, and is detailed on the Table of Benefits:
- Basic Scheme covers treatment worldwide
- Europa Scheme covers treatment in Malta on full refund of maximum payable fees; and in Europe if the same / similar treatment is not available in any hospital in Malta
- Hospital Scheme covers treatment in Malta on full refund of maximum payable fees; and limited cover worldwide
- International Scheme covers treatment worldwide on full refund of maximum payable fees. In the USA and Canada limited cover applies for emergency treatment only.
If you are insured on a group policy, the list of benefits and cover limits may be different from the ones available on this website. Please refer to the Table of Benefits available from your group administrator.
Can I include my dependants in my policy?
Yes, you may include your spouse / partner and children on your policy, by including their details on the application form. Premium is charged for each individual according to their age and chosen cover.
Parents or siblings are not considered as dependants, and will be quoted for separately.
As a policyholder you may include a new born child free of charge until the policy period expiry date. You will need to send a copy of the birth certificate within three months of the baby’s birth date.
If you are insured on a group policy that allows for inclusion of dependents, this must be arranged through your group administrator.
Can I pay my policy by instalments?
Your premium is due at the start of the policy period and must be paid for a full year, irrespective of your chosen frequency of payment.
We accept half yearly, quarterly or monthly instalment payments from the second year of cover. Instalment charges (calculated as a percentage of your annual premium) will apply.
Instalment payments must be arranged through direct debit.
Am I covered immediately?
You are covered from the policy start date detailed on your Schedule, subject to premium being paid.
Some conditions are subject to a waiting period (detailed on the Health Policy and the Table of Benefits) – this means that medical expenses related to these conditions or procedures are covered only after the completion of the defined waiting period.
Will I be able to change my plan after I purchase the policy?
Your policy contract is for one year. You can request changes to your plan, such as an upgrade or downgrade, or adding / removing optional extension at policy renewal by writing to us.
You will need to complete an application form for a plan upgrade, declaring any symptoms or medical conditions you have (whether you have been diagnosed or not, and irrespective whether you have made claimed for on your policy or not). These conditions may be restricted from your upgraded cover, however, will continue to be covered up the limits of your previous cover. Any cover limitations will be communicated to you in writing.
No application form will be needed in the case of inclusion of optional extensions or plan downgrades.
Can I have health insurance if I already suffer from an illness?
Our health insurance policies do not cover pre-existing medical conditions. These are conditions for which you had symptoms, consultations, medication, surgery or other treatment in the past.
You will be asked to disclose these in your application form. These conditions may be excluded from your cover, in which case we will advise you in writing.
Exclusions may be permanent or for a specified period of time.
How do I claim?
Out-patient treatment (such as consultations with doctors, therapists and specialists; and tests) are on a pay and claim basis.
Ask your doctor/medical professional to complete the relevant section of your claim form. A completed form, together with receipts and itemised invoices must be received by us within 3 months of the initial date of treatment.
Submit your claims for reimbursement here. When this is not possible, the original documentation can be sent to us by post.
You will need to contact us for pre-authorisation before receiving any of the following treatment:
Any type of surgery
- Hospitalisation
- MRI/CT/PET scans
- Home nursing
- Mental health treatment
When do I need GP or specialist referral?
You need referral from your family doctor or specialist for:
- Physiotherapy
- Diagnostic tests
A referral from a specialist is mandatory in case of:
- Admission to hospital
- Alternative treatment
- Consultations with psychologists or psychotherapists
- MRI / CT / PET scans
- Home nursing
How are claims paid?
Claims for out-patient expenses are paid by direct credit to your bank account or by cheque. Cheque payments below €20 cannot be issued.
Invoices for pre-approved in-patient treatment or MRI/CT scans are paid directly to the provider of your choice.
What is not covered?
The full list of exclusions is detailed on the Health Policy, available in the Downloads section.