What does Health Insurance cover?

At its most extensive scope, Health Insurance by Pohjola Insurance covers treatment expenses for illnesses and injuries as well as the costs of pharmaceutical products and rehabilitation. Read examples of coverage situations to see what the insurance covers and which losses or damage remain your responsibility.

What Health Insurance covers

Below are examples of loss situations involving Health Insurance for a newborn, child and adult. We describe the situation and whether the loss is generally covered by the insurance. Please note that we handle every claim individually, and the nature of the event may determine whether we can pay compensation.

 

Will Health Insurance cover: My child fell ill

It is early autumn, and Claire is preparing for the coming school year with her 8-year-old son Oliver. A few weeks before school is set to begin, Oliver starts to complain of a tummy ache. Claire first attempts a few home remedies and keeps a closer eye on the boy’s diet. As Oliver’s stomach pains worsen, however, Claire decides it is best that they see a doctor. Claire calls Pohjola Health Advisor, who evaluates the boy’s symptoms and schedules an appointment with a suitable specialist. The doctor prescribes Oliver medication, and the boy gets better in just a matter of days. Thanks to the quick treatment, he is healthy to start the new school year.

 

Will Health Insurance cover: Sprained ankle while running

Chris is passionate about fitness. He goes to the gym several times a week and runs the year round. The damp and dark autumn nights play a trick on him, however, as Chris missteps clumsily while on an evening run on a bumpy forest trail. His left ankle is sprained badly. Chris is able to limp on, but as he gets back home, he notices that the ankle has become swollen up and is looking serious. Without further hesitation, Chris calls Pohjola Health Advisor. The Health Advisor evaluates the ankle’s condition, gives Chris home care instructions, and schedules an appointment with a specialist. The doctor examines the ankle, which was in perfect health until the accident, and refers Chris for a more detailed MRI scan. The MRI scan reveals a bone fracture that will require surgery to fix. After the surgery, Chris rehabilitates the ankle with exercises and is back up and running the following autumn.

 

Will Health Insurance cover: Treatment during pregnancy

Becky is six months pregnant and eagerly expecting her baby as she enters her third trimester. Preparations for the birth have already been made, and Becky has taken out Health Insurance for the newborn after the structural ultrasound scan. As the pregnancy nears its end, however, Becky is admitted to the maternity ward for intensive monitoring and prescribed medication for high blood pressure until the birth. The medication and rest are successful in treating her, and Becky delivers a healthy full-term baby boy. 

 

Will Health Insurance cover: Accidental tooth fracture

Matt is enjoying the winter weather while practising his new hobby, ice skating in the wilds. The sun shines in the cloudless sky as Matt hurtles ahead on his skates, backpack on his back and sunglasses on his head. Out of carelessness, Matt hits the tip of his skate against the ice at too steep an angle. The skate gets caught, tripping Matt on his nose against the ice with just enough time to soften the landing with his arms. His lower jaw hits the ice, and as he tries to collect himself, Matt quickly realises that his bottom teeth have come out worse for wear from the fall. The two front teeth are chipped. Matt uses the Pohjola Health Advisor app to message Pohjola Health Advisor. The Health Advisor schedules a dental examination for him. The dentist recommends that Matt’s front teeth are repaired with implant-supported dental prostheses.

 

Will Health Insurance cover: Falling ill while travelling

Kenneth is an avid backpacker. As spring arrives, he sets out on another trip, this time to southern Europe. While travelling across Europe by train, however, Kenneth falls ill. Battling against a rising fever, Kenneth seeks out a local doctor who examines him and prescribes a medication. After a few days’ rest and medication, Kenneth is able to get back on the move. He returns home in good health and is already making plans for his next trip.