ABOUT THIS EDITION
Dear Insured Member,
We are delighted to present the May edition of the bi-monthly UNSMIS newsletter!
In this issue we will discuss the following:
- Annual enrollment campaign
- 24/7 Emergency helpline
- Cost Control
- Right to Practice
The newsletter will be sent to insured members via email, will be published on the website and will appear as a pop-up window on the eClaims Portal.
We hope you find this newsletter helpful.
Kind regards,
The UNSMIS Team
|
|
Annual enrollment campaign 1-30 June
The campaign, taking place between 1-30 June 2024, is the yearly opportunity for active staff members enrolled in our insurance plan to add or remove eligible dependents effective 1 July 2024.
Enrollment will be possible through your online HR portal (e.g. UMOJA Self-Service or Workday), or directly through your HR focal point.
|
|
|
Our Emergency Helpline ensures prompt hospital admission assistance for members and their dependents facing urgent medical situations.
This service is available exclusively for emergencies where immediate hospitalization is required within 72 hours.
What to do in case of an emergency?
In the event of an emergency, you should call our helpline at +1 819 569 8740. North American callers can use the toll-free number +1 833 569 8740.
Upon calling, you will be connected to a globally recognized assistance company that will verify your UNSMIS coverage and assess the emergency nature of the situation.
You will be asked for your name, insurance ID, insurer (UNSMIS), location and details of the event.
Expenses in a semi-private room will be settled directly by UNSMIS, and we will recover the member’s share of the expenses afterwards. If the hospital is out of network and declines the guarantee of payment issued, the emergency helpline agent may instruct you to cover expenses personally and then submit a claim for reimbursement. Please rest assured that UNSMIS will reimburse the costs of any authorized emergency admission in accordance with its internal rules.
Important:
- In case immediate assistance is needed, you are advised to first call the local emergency phone number to be taken to hospital by an ambulance, if needed.
- This 24/7 emergency number is purely for emergency admission to a hospital.
- This is not a Medevac number. All Medevacs must be approved in line with established procedures and obtain necessary clearance from the Organization you are working for.
- A physical insurance card will not be needed (in case you are asked for your card, the e-card available in the UNSMIS mobile app will suffice).
|
|
|
|
Click on the image to enlarge
|
|
Cost control
To avoid excessive billing practices to the detriment of the insured and the health insurance plan as a whole, UNSMIS applies the notion of reasonable and customary charges and care. We strongly encourage all insured members, before scheduling a surgery or a treatment, to request a quote and a detailed medical report in advance and to share this with the UNSMIS front office. This will allow UNSMIS to verify the amounts and inform you in advance of any amounts not covered that you may be liable for as well as propose alternatives, if needed.
- For individuals scheduling a surgery in one of the hospitals in Switzerland with whom we have a direct pay and tariff agreement (click HERE for more details), you only need to provide us with a quote for the surgeon, assistant surgeon(s), and anesthetist fees. There is no need for a quote from the hospital.
- For individuals requesting a direct payment for surgery through the portal, in this case you do not need to request anything. Our third-party administrator will take the necessary actions.
Please kindly send quotes and supporting medical reports to unsmis@un.org for confirmation. To maintain our rates at the current level, unchanged since 2016, and to ensure the long-term solvency and inter-generational solidarity of the plan, we are striving to keep costs under control.
Right to practice
In most jurisdictions, healthcare professionals must obtain the necessary authorizations to be able to legally exercise their profession.
A recognized doctor in country A, for example, is not automatically allowed to legally exercise their profession in country B. They may need to get their credentials officially recognized by the competent local authorities. If the practitioner is not recognized in the country where they practice, even if a valid prescription is available, your invoice will not be reimbursed.
We are raising this issue as we have witnessed, especially in the Canton of Geneva, some cases of qualified medical professional exercising their trade without having obtained the necessary recognition by the competent local authorities.
|
|
|
|
|
