ABOUT THIS EDITION
Dear Insured Member,
We are delighted to present the September edition of the bi-monthly UNSMIS newsletter!
In this issue we will discuss the following:
- Everything you should know about prescriptions
- The importance of updating your banking details registered with UNSMIS
- Options for extending your health insurance coverage during Special Leave Without Pay or after separation from service
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
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TIPS & TRICKS - DO I NEED A PRESCRIPTION?
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UNSMIS requires a valid written prescription for any treatment or purchase requested by a medical doctor.
This includes (but may not be limited to) all medication and medical or optical appliances, as well as any services provided by radiologists, laboratories, nurses and home care practitioners, physical therapists, occupational therapists and osteopaths, podiatrists, speech therapists, psychotherapists, and ASD therapists. Post-natal care by a midwife, non-emergency transportation and thermal cures also require a prescription from a medical doctor.
To be sure that all of your expenses are eligible for reimbursement, you will need to verify that you have a valid prescription in-hand prior to the beginning of any treatment or the date of any purchase and that the correct, valid prescription (original document) is attached to the same reimbursement request as the invoice to be reimbursed (even if it has been submitted previously).
What is a valid prescription?
To check if your prescription is valid, you should verify that you can see on the prescription:
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- a visible first and last NAME of the person receiving care
- a visible Prescription Date
- the prescription must be written prior to the purchase / treatment date
- a non-renewable prescription is valid for 6 months maximum from the prescription date unless otherwise indicated
- a renewable prescription is valid for up to 12 months from the date it is issued. The doctor should clearly indicate whether the prescription is renewable and specify the duration of its validity (up to a maximum of 12 months)
- prescriptions over 12 months are not accepted
- no prescription can be accepted for treatment / purchase prior to the prescription date, even if the doctor indicates a retroactive validity
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- the Name and Amount or Duration of each treatment or medication prescribed
- If renewable, the number of renewals or the period of renewal (for example: “for 12 months”, “until 01.12.24”) must be stated
- All prescriptions for physical rehabilitation (physiotherapy, osteopathy, podiatry, etc.) should indicate the number of sessions prescribed by the doctor
- the Signature, Name and Title of the person writing the prescription
It is important to note that once you have submitted an invoice with a prescription for reimbursement, no change or modification of that prescription by you or the doctor can be accepted.
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TIPS & TRICKS - BANKING DETAILS
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Are your bank details up-to-date?
To ensure that all reimbursements are paid to your bank account in a timely manner, please make sure you always keep your bank details updated in our system. If you have any changes in your details, please complete, sign (by hand or by adding a certified digital signature) and send the Banking Instructions Form to unsmisaffiliations@un.org, in order that we can register the changes in our system. Please click to access the form in English or in French.
Please note: Updating your banking details for payroll will not automatically update them in your medical insurance records. Therefore, we kindly ask our Insured Members to share their updated details with us separately via email.
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You have the flexibility to choose one of the following currencies to receive your reimbursements in: USD, CHF, EUR, GBP, AUD, CAD, DKK, HUF, JPY, MXN, NOK, NZD, PLN, SEK, SGD, THB, or ZAR.
If you do not have an account in any of these currencies, you may still register your account. In that case, please choose a currency from the above list, regardless of your account’s currency. The chosen currency will be the one in which your reimbursements will be transferred to your bank account. Please note that you may only register one bank account.
Please be aware: Banks may impose additional fees (for various reasons, such as currency conversion), which they charge to the account holder. Please note that UNSMIS will never bill their insured members any fees. If the amount on your bank statement differs from the one in your reimbursement advice, we recommend contacting your bank to address and potentially minimize these extra costs.
Important considerations: In case you are considering registering an account at a digital/online bank (e.g. WISE, Revolut or Monzo), please be informed that as per our experience with these platforms, most transfers are returned/delayed, and they may also incur substantial bank and investigation fees. We do not recommend using these banks for your medical claim reimbursements.
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TIPS & TRICKS - EXTENSION OF COVERAGE (SLWOP/SEPARATION)
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Certain changes in your staff member status, such as Special Leave Without Pay (SLWOP) and separation, will end your health insurance coverage. However, as a paying member, you have the option to extend your medical coverage, including for your currently enrolled family members, under specific conditions.
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If you go on Special Leave Without Pay (SLWOP), you can opt to retain your insurance coverage for the entire period. This is not automatic: once HR approves your SLWOP, you need to contact UNSMIS (unsmisaffiliations@un.org) before commencing your SLWOP to request the extension of your coverage. UNSMIS will calculate the monhtly premium amount based on your last payslip deduction, and you will have to pay both your share and the Organization’s share during SLWOP. Payment in monthly instalments is not allowed; therefore, you must pay the full contribution amount at once and in advance, before leaving the Organization.
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Important to note:
- The extension applies to you and your currently enrolled family members and is only available as a direct continuation of your existing coverage. An additional extension beyond the initially requested period is possible only in case your SLWOP is further extended beyond its original end date.
- Failure to secure health insurance coverage during SLWOP automatically forfeits the possibility to apply for coverage in the event SLWOP is extended. Coverage is only available to insured individuals and insured family members as a direct continuation of their existing coverage.
- Upon your return to work following your SLWOP re-enrollment is not automatic. If your organization uses UMOJA, you have 31 days from your return to do the necessary in UMOJA ESS. For insured members of member Organizations that do not utilize UMOJA, it is necessary to request re-enrollment by submitting the standard affiliation form to your HR focal point within 31 days of your return. If you do not comply with the 31 day deadline, you may take action to cover yourself and any eligible family members during the annual enrollment campaign. If you are employed by UNHCR, your re-enrollment will be automatic upon returning to work, requiring no further action on your part.
- If you are retiring at the end of your SWLOP, an extension of your coverage during SLWOP will be a prerequisite to be eligible for After Service Health Insurance (ASHI) during retirement. ASHI is only available as a continuation of your previous active-service coverage in a United Nations contributory health insurance plan, without any interruption between your active service and retirement status.
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If you separate from the Organization and are not yet retiring (or taking early retirement), you will be allowed to extend your coverage for a period of maximum 3 months beyond your separation date, provided that you have been a member for six consecutive months. In this case, you will have to pay the full premium (i.e., your share and the Organization’s share) to UNSMIS prior to your separation date. To request such a coverage extension, please reach out to UNSMIS via email before your separation date via unsmisaffiliations@un.org. UNSMIS will calculate the premium amount based on your current contribution, and you must pay the full amount at once and in advance, before leaving the Organization.
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Important to note:
- The extension will automatically apply to you and your currently enrolled family members and is only available as a direct continuation of your existing coverage. An additional extension beyond the initially requested period is not possible.
- The 3-month extension does not count towards the ASHI vesting period.
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For comprehensive information on coverage extensions, please refer to Rule V of the UNSMIS Internal Rules, available by clicking the box below:
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