1. What are reasonable and customary expenses?

Expenses will be considered reasonable and customary if they correspond to the normal charge made by the health care provider for a similar service or supply and if they do not exceed the normal charge made under the best prevailing conditions for such service or supply in the locality where the service or supply is received (subject to the limits specified in the contract and taking into consideration the nature and the severity of the accident or illness treated).

2. What happens if I take a leave of absence?

If you are on sabbatical or other leave of absence for a maximum of three years, you may continue your insurance, provided the premium is paid through AUC.

3. Can I switch from one plan to the other?

A switch from one plan to the other is possible only once and has to take place at the annual renewal date of the contract.

The move from the Regional Coverage Plan to the World Wide Coverage Plan is subject to a waiting period of two years. Three months before the move would become effective, a certificate of good health is required. Affections diagnosed before that date are excluded from the extended territorial coverage.

4. Is Infertility treatment covered?

In those cases where infertility is considered a sickness, all medical treatment (whether through pills and/or other procedures) in order to cure that condition are covered.

Procedures such as artificial insemination, in-vitro fertilization,… or charges related to the pregnancy of a surrogate mother,… are not covered.

Fertility pills are reimbursable.

5. What happens if I can also benefit from another medical insurance?

If you enjoy multiple coverage, you will be reimbursed based on the difference between the eligible medical expenses and the reimbursement obtained from the other medical insurance or social security system.

First submit your claim to the other insurer or social security institution. Then, attach the original statement of benefits (with details of the amounts reimbursed) issued by the other insurer or social security institution to your claim form together with a copy of the medical bills concerned.This way, Vanbreda International can calculate and pay you the amount of the additional reimbursement you are entitled to.

6- Is participation compulsory?

Participation to the Group Insurance Contract is compulsory for the foreign administrators and the foreign hired Faculty, unless they provide proof of other medical insurance already in effect at the time of their appointment.

For all other categories of staff, coverage is optional.

If a staff member joins the Group Insurance Contract, coverage of his/her dependants is compulsory unless proof of an alternative existing coverage is provided.

7- How do I fill out the claim forms?

  • State your name in the same way on all claims.
  • Clearly mention your Vanbreda International insurance number on each claim form.
  • Submit a separate claim form for each patient.
  • In case the expenses are covered by another insurance, this should be indicated, as well as the amount reimbursed by the other insurance or social security institution.
  • Use one line per medical treatment.
  • Give a detailed description of the nature of the expenses incurred. For example: general practitioners' and specialists' fees, costs for prescription drugs, x-rays, care given by physiotherapist, etc.
  • Indicate the currency in which the expenses have been incurred.
  • In case of hospitalization, please indicate the date of hospitalization, the diagnosis and the treatment received or the surgical intervention undergone.

You must first meet the annual deductible of 250 USD per insured person up to 750 USD per family before you receive any reimbursement of medical expenses under the Group Insurance Contract.

You should submit your claims with the least possible delay, and not more than two years after the date the expenses were incurred.

8- Is direct billing system works in the States?

In case of hospitalization in the USA, for Worldwide memberspre-notification to Vanbreda International is mandatory and has to be given at least 14 days beforehand. Where this pre-notification has not been given to Vanbreda International, the normal reimbursement calculated will be reduced by 25%.

In case of hospitalization, hospitals may send their invoices for in-patient treatments directly to Vanbreda International for settlement according to the provisions of the AUC Group Insurance Contract. This way advance payment can be avoided.

In order to make the directpayment possible, Vanbreda International should be informed before the hospitalization takes place.

To this end, please ask the hospital administration or your doctor to send all information to (or to contact Vanbreda Internationalby telephone or regular mail). When they inform Vanbreda International on the diagnosis and medical procedure to be performed (as well as on the estimated period of hospitalization), Vanbreda International will confirm them your coverage and arrange for a direct payment of the hospital bill (excluding personal expenses and any not covered expenses).

Before hospitalization, please check with the hospital if the above mentioned procedure was followed. If not, please take care yourself of providing Vanbreda International with the information required.

Direct settlement of bills does not exempt the insured from paying to the hospital any amount not reimbursed by the AUC Group Insurance Contract.

9- Is there Direct payment in case of a hospitalization in Egypt

If you are hospitalized in one of the Egyptian hospitals that Vanbreda had a direct agreement with them; mentioned hereunder,Vanbreda International will firstpay the full bill directly to the hospital. Afterwards, you will be asked to pay any non covered expenses to Vanbreda International.

The hospitals for which this procedure is followed are:

  • Misr International Hospital;
  • Alsalam Hospital;
  • As-Salam International Hospital;
  • Cleopatra Hospital;
  • Dar Al Fouad Hospital;
  • Shaalan Surgicenter Clinics;
  • The Behman Hospital and
  • Nile Badrawi Hospital.

A letter of guarantee will be issued annually adressing the above list to provide you with guarantee of payment for inpatient treatment or out patient surgery. Otherwise for any other medical services like doctors visits, Lab exams. X rays , etc……..you will pay in advance and then claim for reimbursement later from Vanbreda .