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
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
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.
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.
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.
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.
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 direct debit instalments
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 approved 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 approved fees; and limited cover worldwide.
- International Scheme covers treatment worldwide on full refund of approved fees. In the USA and Canada limited cover applies for emergency treatment only.
If you are insured on a group policy, the Table of Benefits may differ from those 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 proposal 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?
We accept half yearly, quarterly or monthly instalment payments. Payments must be arranged through direct debit. Charges will apply, these are calculated as a percentage of your annual premium.
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 a proposal 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 proposal 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 proposal 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 to complete the relevant section of your claim form.
Send us your completed form with receipts and itemised invoices within 3 months of your first treatment date here. When this is not possible, the original documentation can be sent to us by post.
Contact us for pre-authorisation before receiving any of the following treatment:
- Surgery
- Hospitalisation
- MRI/CT/PET scans
- Home nursing
- Mental health treatment
When do I need GP or specialist referral?
GP referral is needed for any treatment. The following are only covered when referred by a specialist:
- Alternative treatment
- Hospital in-patient and day-case admissions
- Any procedure
- 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.
We can settle hospital bills directly for pre-approved treatment (hospital admissions, CT/MRI/PET scans).
What is not covered?
The full list of exclusions is detailed on the Health Policy, available in the Downloads section.