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All about health insurance

All about health insurance

There are many concepts and definitions that come up in a health insurance trial that we’ve probably heard before but it doesn’t hurt to know them exactly, because they’re sure to come back in the contract. We have gathered the most important concepts that appear in a health insurance contract.


A measure with legal effect, in which the contracting company initiates the extension of the contract with the Health Insurance Company in writing regarding the employees to be insured. By entry we mean that the offer for the insured employee has been accepted by the Health Insurance and the risk bearing for the insured can start.

Healthcare service

The set of health activities that can be performed with a health care operating license, which is aimed at preserving the patient’s health, treating him / her, improving the condition caused by the disease, and processing the patient’s examination materials.

Healthcare provider

An organization licensed to provide healthcare under current legislation.

Risk assessment

An appraisal process in which the insurer decides whether to assume the risk specified in the offer and for what premium. In the case of corporate health insurance for example, a pre-contractual health assessment is included. At Medicover, we do not examine the health status of employees prior to entering into a contract, nor do we request a health declaration.

Call Center

a telephone service available by calling the announced telephone number(s) during the announced periods of time (business day, extended working hours), intended to check or make an appointment of health services that can be scheduled or are programmed.

Hot Line

A direct telephone number is available to the company’s insured employees, which is available to insured persons 24 hours a day, 7 days a week with health advice and service organization. Medicover’s employees are experienced, English-speaking professionals with a medical degree, to whom our clients can turn for medical advice and information.

Basic service

Betegség vagy baleset következményeként szükségessé vált egészségügyi szolgáltatás, ami az alapellátásra és a háziorvosok által végzett ellátásokra vonatkozó hatályos jogszabályokban foglaltaknak megfelelően történik. Alapellátásnak minősül továbbá az első vizit belgyógyászaton, nőgyógyászaton, gyerekgyógyászaton valamint az ennek keretében történő orvosi konzultáció, kivizsgálás.

Screening examinations

A series of medical examinations aimed at protecting health, increasing an individual’s quality of life and longevity, and identifying latent, latent or asymptomatic diseases, pre-existing conditions and predisposing risk factors.

Outpatient care

single or occasional care or diagnostic or medical care or specialist consultation, all performed by a specialist based on referral from the patient’s regular care physician or at the patient’s request, in line with the effective provisions of law concerning specialist outpatient care, provided that such are not considered inpatient care or one-day surgery or health care or service requiring continuous specialist inpatient care by a specialist for chronic disease.

Inpatient care

Health service with diagnostic or medical treatment purposes provided on the basis of a referral by a regular care physician, treating physician or another person authorized to issue a
referral, or at the patient’s request, at an inpatient medical institution or hospital complying with the provisions of the effective laws relating to specialist inpatient care to a hospitalized person, or at certain times of the day, or a single procedure or a procedure performed as a course of treatment after which observation for a certain period is needed and during which immediate health care is available as needed.

Family member extension

The insurer offers the company’s employees the opportunity to extend the insurance to their own family members for a premium. A family member is the spouse, partner and children of the Insured or his / her spouse / partner, including adopted and foster children.


A measure with legal effect, in the course of which the policyholder initiates the termination of the contract in writing with the Health Insurance Company in respect of the insured. By withdrawal we mean that the claim concerning the insured has been accepted by the insurer and the Health Insurance bears the risk bearing of the insured.

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All about health insurance - Medicover Health Insurance