A private health policy will cover medical treatment which you pay for privately, rather than using state health facilities (such as polyclinics and hospitals). Private medical insurance covers the costs of private medical treatment for what is commonly known as an acute condition (a disease, illness or injury that is likely to respond quickly to treatment). In general, it will not cover the treatment of long-term and incurable illnesses. As a private patient you can:

• avoid waiting lists, cutting down on the time it takes you to get better
• choose where to receive treatment and who provides the treatment
• benefit from being treated in private hospital facilities, with a private room

Health insurance is there for what is unexpected and unknown, therefore any existing health condition will usually be excluded. When you decide to take out a health policy, you'll be asked to fill in an application form which includes questions regarding your current and past health. If necessary, we may seek further medical information from hospitals or doctors who have treated you.

Any disease, illness or injury (whether or not diagnosed) for which you have received medication, advice or treatment, or for which you have experienced symptoms before taking out your policy will be excluded from your cover along with any related conditions unless we agree to accept it. Some existing conditions may become insurable after a waiting period set by us, provided the condition does not reoccur during this period, and you must not receive treatment for this condition during this period.

For a more detailed explanation please read our position on pre-existing medical conditions.

Your answers to the 'medical history declaration' section in the application form will help us to understand your medical history (and that of any family member you may wish to include in your policy).

It is important that you consider the questions carefully, for each person to be covered, and answer them in full. We will review your details and decide the basis on which we can accept you for cover. If necessary, we will ask your medical practitioners or hospitals to help us compile the necessary information.

If you have a pre-existing condition that is likely to need treatment in the future, this is usually excluded from cover along with any conditions related to it. We will show any exclusions on the membership statement you receive from us when we have processed your application. (The same process will also apply for any members of your family included in your application.)

Of course, any unexpected acute medical conditions arising after the start of your policy will be covered immediately subject to the policy terms and conditions.It is your responsibility to ensure that you provide full and accurate information in answer to the medical history declaration. Failure to do so may mean that we cannot honour a claim or even that your policy is invalidated. If you are in any doubt whether we would want to know about a particular fact, please contact us for assistance.

In most cases, the application of any exclusion will make future claims for treatment to this particular knee ineligible for benefit. If further information is provided regarding the detail of the knee operation or a specific diagnosis is made, the exclusion may be made more specific. Sometimes the exclusion may also be reviewable after a period of time following the start of the policy.

You would be expected to disclose details of the symptoms, ie the fact you have been suffering from headaches, on the medical history declaration. Exclusions would be applied to the symptom (and any related medical condition). Further information from your doctors may be required and a more specific exclusion could be applied if this information is made available.

You can do so within 30 days from the date of acceptance of cover and receipt of your policy documents. We will cancel your policy and any money paid will be refunded as long as you haven’t made a claim.

Private Health Insurance is designed to cover new and unexpected medical conditions. As is common with most private health insurance products, you will not be covered on our International, Private Hospital and Private Clinic Plans for medical conditions you have already had or have at the time your cover starts.

• Treatment for recurrent, continuing or long-term medical conditions. Private medical insurance is designed to cover short term treatment of acute conditions which start after joining the policy.
• Follow-up consultations or tests and procedures when your disease, illness or injury is no longer considered to be an acute condition.
  
  Routine medical examinations unless you buy the Preventive Care or Preventive Care Plus extensions.
• Normal pregnancy and childbirth, although complications are covered provided the mother has been on the policy for at least ten months prior to delivery date of her baby. If you form part of a company paid group which has bought the routine maternity extension, then you will have cover for a routine delivery. In this case please refer to the Summary of Cover.
• Optical and dental treatment, except for specific oral surgical operations unless you buy the Preventive Care or Preventive Care Plus extensions.
• Treatment for alcohol and drug abuse
• HIV/AIDS related illnesses
• Treatment of sexually transmitted diseases
• Cosmetic surgery (to solely enhance appearance)

Premium for health insurance may rise because of medical inflation and because as you get older, you are more likely to need and receive medical treatment.

You will be asked to complete a medical history declaration on the application form and if necessary, we may ask your doctor or hospitals to provide us with further information.

Once cover is confirmed, we will send you a claim form, or you may download one from the link at the top of this page. When planning the following types of treatment, you must telephone/contact our Health Claims Department on 23265641 or submitting an online pre-authorisation form to check that you are covered for that particular treatment:

• In-patient or daycare treatment (this is treatment for which you are admitted to a hospital or clinic even if only for a few hours);
• A bone density scan
• A mammogram
• Home nursing of any kind (except that provided by MMDNA);
• Psychiatric treatment
• We will confirm your level of cover and how it applies to the doctors and hospitals providing the treatment
• You do not need to contact us before receiving outpatient treatment unless as detailed above, however if in doubt, please do contact our Health Claims Department on 23265641 or health@atlas.com.mt

Our range of plans are designed to suit your requirements. If your main concern is in-patient treatment, then you could opt for a Value Option which covers in-patient and daycare treatment but does not provide out-patient benefits.

Choosing a different method of payment may also mean that you could benefit from a discount on your annual premium.

With the best will in the world, concerns about some aspects of our service can occasionally arise. In such circumstances our staff have wide authority to settle problems and will do everything they can to help. This should be your first point of contact. If you are still not satisfied, please download the appropriate form. These documents guide you through our commitment to deal with your concerns promptly and fairly.