Vzajemna zdravstvena zavarovalnica d.d.
Vzajemna
Vzajemna is a travel insurance for the Slovenia market with online purchase and 24/7 assistance.
Direct payment
In cases of serious illness, injury, hospitalization or need for repatriation you must immediately notify the 24/7 assistance center, which verifies the contract and arranges and organizes the necessary treatment or transport; in minor cases no call is required and you pay the costs yourself and then claim reimbursement, although direct settlement with the provider can also be agreed
Geographic scope
Worldwide, or Croatia only if that option is selected; a separate inbound variant covers Slovenia and its neighboring countries for foreigners visiting Slovenia
Coverage applies abroad and does not apply in Slovenia or in the country where the insured has official permanent residence; this record describes the outbound travel product from Slovenia, while a distinct inbound product exists for foreigners in Slovenia valid in Slovenia and its neighboring countries (Croatia, Italy, Austria, Hungary)
Unique selling points
- 24/7 Dr. Posvet chat or video consultation with a Slovenian-speaking doctor is included at no extra cost.
- Coverage extends to private healthcare facilities outside the public health system, going beyond what the European Health Insurance Card provides.
- Family Multitrip policies allow up to two adults and their children to be insured together even when they travel separately.
- Multitrip annual cover allows an unlimited number of trips abroad within the insurance year, each covered up to 90 days.
- An optional liability add-on can be attached to cover third-party claims for injury or property damage caused abroad.
Coverage limits
Medical expenses
Covered
Only in TUJINA - nujne zdravstvene storitve, TUJINA - nujne in potrebne zdravstvene storitve
Covers necessary emergency medical care abroad including prescribed medicines and medical aids, and treatment costs until you are fit to return home; the insured sum applicable is stated on the individual policy and not in the general terms
Emergency medical treatment
Covered
Only in TUJINA - nujne zdravstvene storitve
Core benefit covering emergency medical care that cannot be postponed without endangering life or health, including acute exacerbation of chronic disease
Hospitalization
Covered
Only in TUJINA - nujne zdravstvene storitve
Costs of hospital treatment abroad are covered as part of emergency medical costs until the insured can return home to continue treatment; if hospitalized and unable to return as planned, accommodation costs for the insured and an accompanying family member are also covered
Outpatient treatment
Conditional
Only in TUJINA - nujne zdravstvene storitve, TUJINA - nujne in potrebne zdravstvene storitve
Under the basic 'nujne zdravstvene storitve' module only emergency outpatient care is covered; if the 'nujne in potrebne zdravstvene storitve' module is agreed, coverage extends to non-urgent diagnostics, treatment, rehabilitation (physiotherapy), standard optics, preventive check-ups and vaccinations as foreseen under Slovenia's public health scheme
Emergency dental care
Covered
Only in TUJINA - nujne zdravstvene storitve
Covers emergency dental care needed to relieve acute pain from disease or fresh injury to teeth, including tooth extraction and simple denture repairs where eating would otherwise be impossible; crowns, bridges, implants and other prosthetics are excluded
Medical transport
Covered
Only in TUJINA - nujne zdravstvene storitve
Covers transport costs to the nearest hospital or clinic and back to the place of stay abroad as part of emergency treatment
Medical evacuation / transport home
Covered
Only in TUJINA - iskanje in reševanje, hotelska namestitev in strošek prevoza v domovino
Covers organization and cost of transport to your home or a hospital in your home country if this is not otherwise possible for health reasons, including a medical escort if required by your condition; prior consent from the insurer is required
Repatriation of remains
Covered
In case of death during the trip, transport costs of the mortal remains to the home country are covered
Search and rescue
Covered
Covers search and rescue costs in case of illness or accident in a hard-to-reach area (mountains, sea, lakes, caves, deserts), covering both search while officially reported missing and rescue and transport once located; prior consent from the assistance center is required where possible
COVID-19 treatment
No limit stated
No COVID-19-specific provision is stated; general exclusions list epidemics/pandemics among excluded causes, while separately hotel accommodation is covered if quarantine or isolation due to illness is ordered, so exact treatment of COVID-19 costs is not clarified
Pre-existing conditions
Excluded
Excluded are costs arising from diseases, health conditions and injuries that existed before departure abroad, or that appeared before departure and were not fully resolved by the time of departure; acute exacerbation of a chronic disease is however covered under emergency treatment
Winter sports cover
Optional
Accidents or illness suffered while performing high-risk activities or extreme sports (including on a recreational level) are covered only if specially agreed in the contract and an appropriately higher premium has been paid; the list of sports requiring a surcharge is published on the insurer's website. Activities above 6,000 m altitude are always excluded
Adventure / extreme sports cover
Optional
High-risk activities and extreme sports, professional or recreational, are covered only when specifically agreed and an additional premium is paid; a surcharge sports list is published online, and activities above 6,000 m altitude are excluded regardless
Pregnancy complications
Conditional
Only in TUJINA - nujne in potrebne zdravstvene storitve
Under the basic 'nujne zdravstvene storitve' module, pregnancy-related costs (checkups, complications, childbirth) are excluded except to save the life of the mother or child. Under the 'nujne in potrebne zdravstvene storitve' module, if pregnancy did not exist at policy inception, routine checkups, treatment and childbirth are covered after a 6-month waiting period from the start of the insurance; if pregnancy existed at inception, acute complications, miscarriage, medically indicated abortion and premature birth up to the end of week 36 are covered
Personal liability abroad
Optional
Only in DODATNO KRITJE ODGOVORNOST V TUJINI
Optional add-on (DODATNO KRITJE ODGOVORNOST V TUJINI) covering civil liability claims from third parties for bodily injury or property damage caused abroad, including legal defense costs, up to the sum insured stated on the policy; the insured bears part of the cost themselves (co-payment) as specified on the policy
Legal assistance
Conditional
Only in TUJINA - pravna pomoč
Covers organization of legal assistance, telephone translator costs and bail deposit (repayable within 30 days), but only when triggered by an illness or accident abroad that required emergency medical assistance and led to criminal or civil liability proceedings against you; damages/compensation are not covered, and this is not part of the standard 24/7 assistance services
24/7 assistance
Covered
A 24/7 assistance center provides reachability by phone (with reimbursement of call costs), organization of emergency medical help and transport, and notification of family, plus a chat/video doctor consultation service if agreed
Key conditions
Assistance call deadline
In case of serious illness, injury, need for hospital treatment or repatriation, the assistance center must be notified immediately or as soon as possible (no fixed hour limit is stated); for minor acute issues, no call is required and costs are paid by the insured and later reimbursed
Unauthorized treatment
The insurer's obligations cease if the insured refuses proposed emergency treatment, transport home or other organized services; reimbursement of transport costs and search and rescue costs also generally requires prior consent obtained via a call to the assistance center
Purchase while abroad
The insurance must generally be concluded before departure abroad while the insured is in Slovenia or their country of permanent residence; by agreement with the insurer, it can also be concluded on the day of departure or while already abroad, provided the insured event has not yet occurred
Chronic conditions
Treatment of chronic diseases is excluded, except for costs arising from an acute exacerbation with sudden, severe symptoms typical of that chronic disease, which is covered under emergency treatment
Pregnancy
Pregnancy-related costs are excluded under the basic emergency module except to save the life of mother or child; under the extended 'nujne in potrebne' module, routine care and childbirth are covered after a 6-month waiting period if pregnancy did not exist at inception, or acute complications/miscarriage/medically indicated abortion/premature birth to week 36 if it did exist at inception
Pre-existing condition exclusions
Costs are excluded for diseases, health conditions and injuries that existed before departure abroad or appeared before departure and were not fully resolved by the time of departure
Coverage duration limit
For annual Multitrip insurance, coverage allows an unlimited number of trips abroad within one insurance year, but each individual trip is covered for a maximum of the first 90 days; single-trip insurance has the fixed duration stated on the policy
Policy specifics
Maximum trip duration
For Multitrip annual insurance, coverage for each individual trip abroad is limited to 90 days maximum
SourceMedical expenses and repatriation
Coverage includes emergency medical care, necessary medical treatment, emergency medical transport to hospital, and repatriation to Slovenia
SourceSearch and rescue services
Coverage for costs related to search and rescue operations in case of accident abroad
SourceLegal assistance and translator services
Coverage for legal assistance costs and telephone translator services in case of legal disputes abroad
SourceFamily coverage
Multitrip insurance can be purchased for families with up to two adults (under 75 years, in family relationship) and their children up to 26 years old
SourceAge surcharge for persons 75 and older
Persons aged 75 years or more are charged 50% additional premium on the base premium
SourceGeographical exclusions
Coverage is not available for travel to Russia, Belarus, Ukraine, Palestine, Israel, Lebanon, Iran, and Syria
SourceCo-payment (deductible)
Insured person covers part of the claim cost; typically 10% with minimum of 50 EUR per insurance case
SourceOptional liability coverage abroad
Optional add-on coverage for third-party liability claims, including legal and other costs related to compensation claims against the insured
Source24/7 Assistance Center
24-hour assistance center available for emergency medical support and coordination, with Slovenian language support
SourceDoctor consultation service
Dr. Posvet service offering chat or video consultation with Slovenian doctor available 24/7 (included in standard package)
SourcePrivate healthcare facility access
Coverage includes access to private healthcare facilities not part of the public health system in the visited country
SourceRight of withdrawal
Insured can withdraw from remotely concluded insurance (via internet, mail) for periods of one month or longer within 15 days of contract conclusion
SourceCoverage exclusion for Slovenia
Coverage does not apply in Slovenia or in the country where the insured person has registered permanent residence
SourceCoverage start condition
Coverage begins at 00:00 hours on the stated start date on the insurance contract, provided premium has been paid by that time
Source