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Joining Médis

Subscribe a Médis Health Plan and discover all the advantages of a Personal Health Service.

Depending on which option you take out, you'll have access to the following covers:

  • Inpatient
  • Birth
  • Outpatient (access to Primary Health Care Physicians and Specialists and Additional Diagnostic Exams)
  • Dental
  • SeriousIllness
  • International Coverage

Consult the Options, Covers and Capitals that Médis offers.

The Insurer's risk analysis may imply a change to the premium, or the exclusion of certain covers.

 

Procedure Checklist

Before using Médis services, you must consider:

  • Policy covers;
  • The maximum annual capital available per insured person;
  • Procedures for accessing each Healthcare Service;
  • The co-payment you must pay for each medical intervention or healthcare service;
  • The procedures for reimbursement of expenses made outside the Médis network;
  • Choosing a Médis Physician or Service from Médis Guide, which is organized by geographical area;
  • Scheduling medical appointments, exams or treatments that do not require pre-authorisation directly with the Medical Office or Diagnostic Centre, identifying yourself as a Médis client;
  • If the healthcare service require pre-authorisation from Médis Clinical Director, you must ensure:
    • If the doctor belongs to Médis Network, the doctor will ask the pre-authorisation to Médis; you as a Client do not have to do anything else;
    • If the doctor does not belong to Médis Network, you need to download the document “Impresso de Informação Clínica” at www.medis.pt/area-de-cliente/documentos or call to 218 458 888 (Médis Line).

Please note:

  • Prescribed exams or x-rays must be scheduled directly with the respective centers, since they may need to inform you of how the harvest or how to prepare for a particular examination.
 

The Médis Card

The Médis Card is a personal card that identifies you and grants the holder access to Médis network professionals and health services.

You must present it whenever you need to visit a Médis network healthcare provider and you only need to pay the co-payments or deductibles.

Here is a breakdown of the procedure:

  • The Provider/Médis Assistant asks for your Médis card;
  • The Provider/Médis Assistant enters your Médis card number into the terminal to check your eligibility, covers and limits;
  • After your appointment or exam, the Provider/Médis Assistant enters the codes of the medical interventions that have been carried out and that information is sent to Médis for payment;
  • After that, you'll be informed of the co-payment you must pay and whether you've reached the sum insured limit established for your cover. Finally, you must ask for a receipt of the payments you've made, since you can deduct these from your income tax.
 

Médis Guide

Médis Guide is available on the Médis Website and includes a list of all Healthcare Providers (Physicians, Hospitals and Clinics, Diagnostic centers) and the Health and Well-Being network.

To consult the Médis Guide please follow these steps:

  • Go to www.medis.pt;
  • Select the type of healthcare provider or service (medical appointment, exams, treatments, surgeries…);
  • Select the most adequate Specialist, Service or Hospital;
  • Call the Healthcare Provider directly to schedule the appointment;
  • If you have any difficulty using the Médis Guide, do not hesitate to contact the Médis Line, which is available for any question ou doubt about your health insurance from 8h00 to 20h00 (working days).
 

Pre-Authorisation

It is through this process that Médis Clinical Services grant its clients access to certain covers (e.g.Inpatient) and certain therapeutic interventions, diagnostic examinations and assistance.

Pre-authorisation results in issuing an authorisation document (financing guarantee/liability agreement) that are sent to:

  • the physician that has suggested the surgery/examination;
  • the hospital or Clinical Center, when requested;
  • the client.

The following clinical interventions are subject to pre-authorisation:

  • Medical or Surgical Hospitalisation
  • Outpatient surgical intervention (at hospital or medical office)
  • Chemotherapy and Radiotherapy
  • Ophthalmology procedures using laser technique
  • Special Otorhinolaryngologist services (Audiometru of evoked electrical responses, Vestulametry, Videonystagmograpgy, Endoscopy Services)
  • Special Neurophysiology Services (Electroencephalography, evoked Potentials)
  • Sleep studies
  • Complementary means of diagnosis performed under anesthesia
  • Complementary means of invasive vascular diagnosis and therapy
  • Interventional Cardiology
  • Lithotripsy, Echocardiography (Transeophageal, Fetal)
  • Nuclear Diagnostic and Therapeutic Medicine (eg. Scintigraphy, PET)
  • Nuclear Magnetic Resonance
  • Angio TAC
  • Flexible urological endoscopy
  • Bronchoscopy
  • Genetic Exams
  • Childbirth
  • Amniocentesis
  • Dental Implants and corrective apparatus

Pre-Authorisation results from a clinical dialogue between the Physician and the Médis Clinical Services, and allows clients carry out a given exam or treatment at a Médis-network Provider. Excluding emergencies, you must request this authorisation before carrying out the exam or treatment to guarantee that Médis pays its portion of the cost.

For detailed information on pre-authorisations process, contact the Médis Line.

 

Scheduling Appointments

You have to schedule the appointments directly with the medical office.

Médis