State-funded medical services strive to make quality healthcare available to all. However, various elements are creating high demands on this service, and you may find that you have to wait longer than you are comfortable with to receive medical treatment. Having private medical insurance cover complements the services provided by the national health service. It is a way of making sure you receive prompt access to private medical treatment, giving you one less thing to worry about when you’re ill. Having private health insurance means you will receive treatment in a comfortable environment, by professionals of your choice.

Private health insurance provides cover for short term medical care given by authorised medical practitioners, which is provided with a reasonable expectation to restore you to the same or possibly even better health than you enjoyed before having the medical treatment.

Full details are available in the General Exclusions section of the Policy

• Medical conditions that occurred prior to the policy start date;
• Regular monitoring of chronic conditions;
• Cosmetic treatment;
• Injuries arising from participation in professional or dangerous sports;
• Treatment of conditions resulting from addiction, self-inflicted injury or criminal activity;
• Treatment of conditions resulting from developmental delay or behavioural problems;
• Dentistry and short or long-sightedness;
• Experimental treatment;
• Infertility and birth control;
• Sexually transmitted infections;
• Uncomplicated pregnancy and childbirth;
• Palliative care;
• Travel expenses;
• Treatment of pandemic illness.
• Semi professional sport

Any disease, illness or injury for which you have already received medication, advice or medical treatment; or which you have experienced symptoms of before the start of your cover (whether the condition has been diagnosed or not).

We will usually not cover treatment for pre-existing conditions and conditions associated with them. Excluded conditions will be identified on your member certificate.

Don’t forget though, even if you do have a pre-existing condition it could still be worthwhile buying private health insurance as you will have cover for treatment of other unrelated conditions.

A Chronic condition is defined as a medical condition that keeps coming back or is likely to continue, and/or need regular or periodic monitoring, treatment, medication or medical advice. Private health insurance is designed to cover acute (short-term) medical episodes.

Since treatment for a chronic medical condition is likely to be a series of predictable, rather than unexpected events, we will not pay for the ongoing management/treatment of such conditions.

We will however pay for treatment required for the diagnosis and stabilisation of a new chronic condition; and for acute episodes of the condition which may occur in the future.

Examples of chronic conditions include irritable bowel syndrome, diabetes, hypertension (high blood pressure), hyperlipidaemia (high cholesterol), psychiatric problems, allergies and certain skin disorders.

Complete online proposal form this site.

Alternatively you may email your completed form to health@citadelplc.com or mail it to: Citadel Insurance plc, Casa Borgo, 26, Market Street, Floriana FRN 1082, Malta.

Please attach the following:

• copies of medical reports;
• evidence of previous insurance cover;
• claims experience from your previous insurers where applicable.

The proposal form contains questions relating to your medical history.

If in doubt, please contact us so we can answer any queries or concerns you may have.

When applying for a new health policy you will be required to answer a series of questions relating to the medical history for each applicant listed on the proposal form.

Pre-existing conditions (any disease, illness or injury of which you have experienced symptoms; or for which you have received medication, advice, treatment or diagnostic tests for before applying for the policy, even if you were not diagnosed at the time).

We may also need your permission to get further information from your medical advisors. We don’t usually cover pre-existing conditions, however once we have assessed your questionnaire and any information from your doctor, we will let you know in your policy documents which symptoms or conditions will not be covered by your policy.

It is important you answer our questions accurately and fully.

Having a complete picture of your health at the beginning means we can be clear about what you are and are not covered for at the start. It can also speed up the claims process, as we are already aware of your medical history.

Premium is payable annually in advance. Payment can be made by internet banking, bank transfer or by cheque addressed to Citadel Insurance p.l.c. Internal note to include new online payment facility once live.

We review premiums regularly and try our best to keep increases to a minimum, while making sure we have enough funds to cover the cost of our clients’ claims.

Advances in medical treatment technology are made all the time, and more and more people are reaping the benefits of such treatment, which can save or transform lives.

This all comes at a price – and the more customers use their health insurance to claim for them, the bigger the fund we would need to pay health care bills. We strive to ensure that our private health insurance policies continue to offer good value for money.

The premium you pay will depend on your age, and will increase when you move into a higher age band at renewal.

You must visit a family doctor or general practitioner (GP) for each new medical condition. Specialist treatment must be referred by a GP. Treatment by therapists must be GP or specialist referred. MRI, CT and PET scans must be referred by a specialist.  If the condition persists for more than 3 months, another referral is required.

You would be required to pay bills for out-patient treatment, and submit a completed claim form with bills, copies of test results and other relevant documentation within 2 months of the initial treatment date.

You must inform Citadel in advance when you are planning in-patient or day-patient treatment; CT, MRI and PET scans; psychiatric treatment and home nursing. In this case we will confirm your cover in writing, and where applicable will liaise with the service provider to settle your bill directly, allowing you to concentrate on your treatment and recovery.

In case of an emergency always seek medical care immediately. It is important that we are informed as soon as possible of your treatment so that we can confirm eligibility for insurance cover, and where possible settle bills directly with your service provider.

We will reimburse charges that are considered to be fair and reasonable, subject to the specific terms of your policy and the policy being in force.

The maximum benefits payable towards the fees charged are determined by us based on what the majority of medical service providers charge, after consulting widely with all branches of the medical profession.

In the event that you are charged in excess of these guidelines, then in all likelihood you will be personally responsible for the difference, known as a “shortfall”.

If your treatment proves to be more complicated than the procedure described, then we will be happy to consider paying further benefit provided that your specialist writes to us and explains the circumstances.

You may claim as often as you need, and we will continue to pay claims as long as your benefit is not exhausted and your cover is still in force.

You are covered when we have processed your proposal form, received your premium and issued your member certificate which shows the cover start date. You can claim immediately for any new eligible medical conditions that arise after the cover start date. Treatment of psychiatric conditions; complicated pregnancy and childbirth; and specified dental procedures are covered after a waiting period (moratorium). Please refer to the Policy for details.

We reassure you that we comply with current data protection and professional secrecy regulations, and take such matters very seriously. We do not share any sensitive data, including that relating to your medical history, with third parties unless this is justifiable by the relevant laws. More details are included in the Privacy Policy.