It’s frustrating to get less money for a medical bill than expected. Let's check what happened and what you can do! Check the bill's status in your account and use our guide below.
1. It's Processing
It may take up to 3 weeks to process bills. If a bill needs a deeper check, we'll flag the ongoing assessment in your claims tab. If it's been more than 3 weeks, reach out to us!
2. It's Processed
Open the claim in your account. Download the bill statement for more information (and check our guide on how to read it). Here are some common reasons for missing payouts:
Missing information or documents
Bills must show the diagnosis, treatment list, costs, and all pages (even blank ones). A referral or pre-approved cost plan may be required for some treatments.
Reach out if you want to add any documents.
Cashbacks must be used like pocket money to cover your bills
Example: You’re on a plan with €100 monthly pocket money (€1200 per year). A €2000 bill in March is partly covered by €1200 yearly cashback. You get an additional €800 paid out for the remaining cost.
A deductible applies to your plan
Annual limits reached
Some plans have yearly limits for certain treatments, such as dental work or psychotherapy. You can find the details in your account.
Treatment not covered
Private health insurance doesn’t cover everything - even if prescribed. Common exclusions: Vitamins and supplements, contraceptives, cosmetic or skincare treatments, hair growth products, and travel or work-related vaccinations.
Doctor charged above the standard rate
This is not always justified. Ask your doctor for a detailed explanation or appeal the invoice if you think you've been overcharged.
If you just can't make sense of it, we're here to help you figure out what happened.