United Health Insurance Fund "OZOF Doverie" Insurance Company is an insurance company licensed by the Financial Supervision Commission
"OZOF Doverie" Insurance Company is a Health Insurance Company that covers both the ordinary and the specific health needs of each insured. With the help of our fund, the unbearable in many cases treatment costs are converted into bearable current insurance instalment fees. The Fund is a leader in the field of health insurance by providing its clients with medical services at a modern level commensurate with the high standards in healthcare of developed countries. The Fund guarantees the necessary quality, volume and term medical services by highly qualified doctors, associate professors, professors from the healthcare establishments at national and regional level.
The subject of the health insurance is the provision of modern highly specialized diagnostic, consulting hospital care and rehabilitation for protection, restoration and improvement of the health of insured persons, as well as reimbursement of expenses for medicines and medical devices.
The health insurance in OZOF Doverie does not deprive you of the opportunity to be treated in the public healthcare facilities and to use the services of the obligatory health insurance.
The health insurance is active immediately after signing a medical insurance contract in accordance with Article 4 of the General Conditions
The health services offered by OZOF Doverie ZAD are divided in following six types of packages:
- HEALTH IMPROVEMENT AND PREVENTION OF DISEASE.
- Nonhospital medical care
- HOSPITAL MEDICAL ASSISTANCE.
- SERVICES CONNECTED WITH DOMESTIC AND OTHER ADDITIONAL CONDITIONS IN THE PROVISION OF MEDICAL ASSISTANCE.
- REIMBURSEMENT OF EXPENSES.
- dental treatment
Health services offer in "Improving health and preventing disease" package an opportunity for a wide range of promotional and prophylactic activities aimed at enhancing the health culture and insurance of individuals and their personal capital towards their own health on the one hand and early diagnosis of a socially significant disease - hypertension, diabetes mellitus, cardiovascular and cerebrovascular diseases and malignancies - on the other hand. This package of health services also identifies the risk factors for these diseases and offers insured individuals individual and group programs for primary prevention. The package provides the opportunity to send the survey results to the risk factors analysis at the workplace for group health insurance. It should be noted in your chosen insured medical institution on the list of the Insurer in accordance with the term. Upon completion of all the consultations and studies, the physician has identified the deviation in the state of health, which means that consultation, research and treatment should be done.
Package "Nonhospital medical care" offers health services at the level of specialized clinical medical care. The insured persons have the opportunity to directly use the services of specialists from the relevant medical profiles, as well as access to the full range of laboratory and functional researches, including highly specialized medical-diagnostic investigations (scanner, nuclear magnetic resonance, etc.), to the limits of the full level of coverage that we offer. The package also includes the fees for medical services, paid under the Health Insurance Act, regulated by the Health Insurance Act. Our goal with this package of health services is to shorten the diagnostic process (by providing it with specialized outpatient care), to save time for insured persons and to provide them with a wide choice of specialists and healthcare establishments, both at home and abroad regional and national level of the health system
In the case of subscription health insurance, insured persons choose a clinic from the list of the Insurer. If medical assistance is needed, the insured person addresses the coordinator of the chosen clinic, which is obliged to provide the full service with maximum time savings in the respective medical establishment. The insured person may also contact to the call center of "OZOF Doverie" by the telephones listed in the health insurance card in case that he / she needs advice or assistance on any problem subject to the voluntary health insurance. In front of the respective medical establishment, the insured person is legitimized by his / her health insurance coupon and identity card. The insured person does not need a direction from his general practitioner for access to any medical establishment on the Insurer's list.
The Hospital Hospitals Package provides an option for steady treatment and sanatorial rehabilitation at the choice of the insured person, depending on the nature of the disease requiring hospital treatment and regardless of where the insured person lives. With this package, in the case of subscription health insurance, waiting time is avoided for planned hospitalization and a right to choose a doctor during a fixed stay is offered. The services offered in the package include the statutory sickness insurance fees regulated by the Health Insurance Act. In the case of hospital treatment, the insured person turns to the coordinator of the hospital's chosen hospital, which is obliged, in case of urgent problem, to get him to be treated immediately, and at planned hospitalization - within 48 hours of the notification. At the basic level of cover, the insured person is entitled to 15 days of hospital treatment. Within 30 days a year, in the case of a full package, the insured person is entitled, both to hospital treatment, to sanitary treatment, appointed by a specialist doctor.
The package "Services related to domestic and other additional conditions in the provision of medical care" includes the activities of scolding and care of the sick, in case of hospital treatment. It allows for the use of household services during the stationary and sanatorium treatment that the hospital medical care package does not cover (single room, telephone, etc.).
The "Reimbursement" package allows you to use the healthcare (medical, glasses, etc.) offered within it to the appropriate limit, and, after submitting the required documents, you will be reimbursed the amounts due.
The Dental Assistance Package gives you the opportunity to use dental services up to the specified limit at a dentist you choose, then your expenses is refunded by us
The insurer guarantees the access to health care services, in case of need arising from acute illness outside his / her permanent residence.
Detailed information about what we offer you can obtain at our Head Office: Sofia, 5 Lachezar Stanchev Str., Sopharma Business Towers Building A, Floor 5, tel. / Fax : 943 48 50; 943 32 20 and 943 49 74. The applicant for individual, family or group insurance should consult the Health Services Packages, the General Conditions of Insurance and the Tariff in order to make proper choice about the type and volume of desired insurance. In addition, you will receive a list of our partner clinics with which OZOF "Doverie" has signed contracts throughout the country, where you can always contact for medical assistance.
The insurer will do the choice of health services, a doctor or a health care facility. An insurer can be you, the head of your family, or your employer.
After the selection of packages of health services, the Insurer will fill in the following documents: In case of individual, family and group insurance up to 50 persons - declaration of the health condition of the applicant. For group insurance over 50 persons - list of employees formated in predefined format.
For individual and family insurance.
Within five days of submission of the Health Statement, the Insurer notifies you that he is ready to sign an insurance contract or to appear with a doctor for review and medical certificate if you have any illness. The declaration and the medical certificate are valid for up to three months from the date of their compilation.
On the basis of the completed Declaration and the conclusion of the reviewing physician, the Insurer sign a health insurance contract with you or makes a motivated refusal.
The company offers special discounts that depend on the number of insured persons, the combination of packages of medical services and the duration of the health insurance contract.
For group insurance of 50 or more persons.
The Insurer prepares and submits to the Insurer a list of the insured persons in accordance with the approved form of OZOF "Doverie" AD.
The medical insurance contract shall be concluded in writing on the basis of the documents submitted. The contract enters into force from 00.00 h on the day after the premium is paid. The contracted health insurance contract is received personally by the Insurer against signature. The term of the health insurance contract is not less than one year.
From the day of the beginning of the health insurance contract the insured person is handed over against a signature health insurance plasic card. The card is your legitimacy when using medical services.
The insurance is personal and the rights can not be relinquished.
Health insurance under the Act is two types - health insurance with reimbursement of expenses and subscription health insurance. In the case of the first type, the insured person freely chooses the medical establishment and the doctor, pays for the medical assistance given to him and against the submitted documents under the General Conditions, the Insurer refunds the expenses up to a certain limit. In the case of the subscription health insurance, the insured person chooses a medical establishment from the list of the Insurer. Each clinic has a doctor - a coordinator who is committed to organizing the service in the hospital itself. The insured person does not pay any sums for his medical assistance within the package of healthcare services he has purchased.
Depending on the volume of services offered, each of the six types of packages is divided into two types - basic and full.