Self service
- Health insurance
- Compensa Seesam health insurance
Compensa Seesam health insurance
Compensa Seesam health insurance
Seesam health insurance protects employees against unexpected medical expenses in case of illness.
Illnesses can affect not only the employee and their family but also the employer’s interests. By providing health insurance, employers ensure their employees have access to quality medical care, recover faster, and return to work sooner.
Why choose Seesam Health Insurance?
We are the fastest growing health insurance company - over the past 3 years, the number of companies that choose Seesam insurance has been growing by 30% per year.
This is because we provide:
- Highly competitive premiums,
- Wide options to customize insurance coverage, limits, and other conditions,
- An individual approach for each company, offering health insurance tailored to the company’s needs and capabilities,
- A broad network of health insurance partners,
- Fast claims handling – within 48 hours,
- Customer support – clients can contact their dedicated account manager or receive assistance via the 24/7 support line at 8888,
- Convenient digital solutions, including a health insurance app with features many competitors do not provide,
- Family doctor and specialist consultations via chat or video in the Seesam app, including evenings, weekends, and public holidays.
By providing health insurance, employers can benefit from tax incentives.
More about Seesam health insurance
-
Offers tailored to each company’s needs
Different companies require different levels of health insurance support for their employees. Seesam provides quick, customized offers for each employer, taking into account the company’s field of activity and the employer’s goals and staff motivation policy. -
Tax benefits for the company
Employers can reduce the company’s taxable profit by the amount spent on employee health insurance policies – this amount is exempt from corporate income tax. If the premium does not exceed 10% of the insured person’s annual gross salary and €750.00, it is not subject to personal income tax and is not included in mandatory social insurance contributions. -
Employee health insurance supports business continuity
Health insurance helps employees return to work faster after illness. Policies also enable early detection and treatment of serious illnesses, reducing sick leave costs and the expense of temporary replacements. -
Reputation as a socially responsible employer
Providing health insurance demonstrates care for employees, motivating them and increasing loyalty to the company. -
No extra fees for installment payments
Policy premiums can be paid in multiple installments without any additional charges. -
Open policy option
An open policy allows coverage for services not initially included in the insurance contract. The policyholder sets the sum insured and can increase it at any time during the policy period. -
Coverage available for small business employees
Employers can insure all employees without restrictions such as a minimum number of insured staff. -
Flexible insurance for new employees
Employers can add new employees to the chosen program at the same terms as the original contract throughout the insurance period. Adding employees does not reduce the sum insured for existing staff. -
Discounts on other Compensa services
Companies and insured employees may receive discounts on other Compensa products, if agreed with Compensa. Contact us at 8888 for details. -
Self-service health insurance portal
Compensa provides a digital self-service portal giving clients access to digital health cards and faster, more convenient service. Learn more -
Seesam health insurance is now available on mobile
The mobile app is available for Apple iOS (iPhone, iPad) and Android devices.1. Simple and convenient
The app provides two main sections – digital insurance card and claims submission.2. Easy-to-access information
All policy details, insured risks, limits, programs, and history are in one place, available anytime, anywhere on a mobile device.3. Eco-friendly solution
The app helps protect the environment by reducing paper usage.
Outpatient Paid Services
Services not covered by the state budget are considered paid services:
- Family doctor, therapist, internist, and pediatrician consultations.
- Home visits by family doctors.
- Specialist doctor consultations.
- Consultations with highly qualified specialists (associate professors, professors).
- Consultations with physiatrists, physiotherapists, and rehabilitation doctors.
- Procedures (injections, infusions, nerve blocks).
- Specialist-performed procedures, laboratory and diagnostic tests prescribed by the treating doctor, including high-cost examinations.
- Pregnancy-related medical expenses within the scope of this program.
- Physiotherapy procedures prescribed by the treating doctor (UV therapy, electrophoresis, ultrasound, magnetotherapy, laser therapy, light therapy, etc.).
- Medical certificates (for weapon permits, driver’s medical exams) and related check-ups.
- Mandatory occupational health checks, including sanitary books, as required by Latvian regulations.
- State emergency medical care.
- Paid emergency medical care at “ARS” in Riga and Riga district.
Outpatient Rehabilitation
Outpatient rehabilitation includes massages, manual therapy, hydrotherapy, and therapeutic exercises in groups or individually (including therapeutic exercise subscriptions within program limits). Outpatient rehabilitation is only available in medical institutions with justified medical indications. Limits are set per procedure and per number of sessions during the insurance period.
Inpatient Paid Services
Hospital and day-hospital stays for a fee, including:
- Hospital treatment
- Therapeutic and diagnostic procedures
- Laboratory tests
- Operations
- With or without enhanced service conditions
Before receiving services in paid inpatient facilities (including day hospitals) outside insurer network, or in cases where inpatient services are not pre-approved, written confirmation from the insurer (“Guarantee Letter”) is required at least 5 business days in advance. To claim reimbursement, the Guarantee Letter requires submission of a doctor’s referral and estimated service cost.
Paid Maternity Care
This coverage can only be included if the “Inpatient Paid Services” coverage is selected. Services are paid if the insurance card has been valid for a full year and only with the insurer’s Guarantee Letter.
Paid maternity services include:
- Private maternity ward
- Contract with a doctor or midwife
- Pain relief
Inpatient Rehabilitation
This coverage can only be included with “Inpatient Paid Services.” Services are paid with the insurer’s Guarantee Letter.
Inpatient rehabilitation includes treatment in sanatoriums and specialized rehabilitation facilities following acute illness, accidents, injuries, or operations occurring during the insurance period. Services require prior approval from the insurer based on the treating doctor’s referral, diagnosis, and medical indications.
Dental Care
The program covers various dental treatments and oral hygiene services. Compensation is limited to the annual sum insured and a percentage (%) discount specified in the program.
Medications
The program covers medications registered in the Republic of Latvia required for treatment. Compensation is limited to the annual sum insured and a percentage (%) discount specified in the program.
Sports
The sports program covers:
- Fitness classes (gym, swimming pool, tennis, squash, aerobics).
- Compensation is limited per class visit and the number of visits per month as defined in the program.
- One-month sport subscriptions within program limits.
- Two- and three-month sport subscriptions within program limits, paid 100% from personal funds.
Optical Care
Coverage is provided based on a doctor’s prescription. Once a year, the following optical items can be purchased:
- Contact lenses, including daily or monthly lenses.
- Eyeglass lenses and frames (including optical services) based on a doctor’s prescription.
Compensation is limited to the annual sum insured and a percentage (%) discount specified in the program.
The open policy covers unforeseen outpatient and inpatient expenses that are not included in the purchased base program. Payments from the open policy are made by the insurer only for insured persons listed in the policy (employees) and require written approval from the policyholder.
The policyholder sets the sum insured for the open policy. The insurer deducts administrative fees from the payment.
Why use remote mediacal consultations?
CONVENIENT: Consult with a doctor from anywhere in the world via video or chat.
FAST AND NO WAITING: Book a video or chat consultation at a time that suits you. Save time by avoiding travel to a medical facility and waiting in line at the doctor’s office.
SIMPLE: Receive doctor’s recommendations, referrals for additional tests, and necessary documents, such as e-prescriptions, referrals.
SAFE AND PRIVATE: Consultations are conducted securely in cooperation with MyEmerg.
SOCIAL DISTANCING GUARANTEED: No need to be in the same room with other patients at a medical facility.
PAYMENT WITH SEESAM HEALTH CARD: According to the terms of the policy.
- You need to send a request by email to info@compensa.lv from the insured person, asking to replace the health insurance card, and attach a copy of your passport or ID card (if personal details have changed).
- You must indicate the address where the new card should be sent.
- The fee for issuing a new card is €4.00. (The policy may state that issuing a new card is free of charge in all cases.)
If the health insurance card has been stolen:
- You need to send a request by email to info@compensa.lv from the insured person, asking to replace the health insurance card, and attach a police report regarding the stolen document.
- You must indicate the address where the new card should be sent.
It is possible to apply for insurance indemnity in the most convenient of the following ways:
1. Portal or app
Download the mobile app
Benefits:
- Faster claim processing.
Claims submitted via the portal or mobile app are processed within 1–2 business days. - Time-saving.
Only incident information needs to be filled in. Any known data in our system will be automatically pre-filled. - All submitted documents are stored in a single platform.
- Convenient tracking of claims, their status, and decisions.
2. At one of the Compensa customer service centers.
To help residents better understand health insurance and what to pay attention to in a policy, the Latvian Insurers Association has prepared an educational roadmap. View the roadmap here.
