Seesam health insurance

Seesam health insurance covers unexpected expenses of employees for medical aid in case of an illness.

If an employee gets ill, it may affect not only the employee, his or her family but also the interests of an employer. By purchasing the health insurance for the employee the employer ensures receiving of good quality treatment services, possibility to get well and return to work faster.

Why to purchase 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.

That is because we provide:

  • very cost-effective premiums,
  • wide range of diversification of insurance coverage, limits, and other conditions,
  • an individual approach for each company by offering health insurance tailored to the needs and capabilities of each particular company,
  • a broad range of health insurance partners,
  • a prompt review of claims - within 48 hours,
  • customer support. In case of questions, you may contact both your service manager or consult the 24-hour support phone line 8888,
  • convenient digital solutions. We invest significant resources in technological development every year, so that, equipped with a smartphone, tablet or computer, insured persons can take advantage of both the digital health card and a number of other options. More and more customers are taking advantage of the convenience provided by Seesam's Health Insurance app. Many of these advantages are not yet being offered by our competitors. 

When purchasing health insurance, the employer is entitled to take advantage of tax incentives.

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Useful links

Login to Seesam portal

Report claim

List of contract organizations

Price list for health care services

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More on Seesam Health Insurance


More on reasons to buy Seesam Health Insurance
  • The offer is prepared according to wishes and needs of each company
    In various companies employees require different insurance support. Thereby “Seesam” offers quick preparing of the offer for each employer taking into account the area of operation and employer’s wishes according to the goals set by the company and staff motivation policy.

  • Tax discounts for a company
    The employer is eligible to decrease the company’s profit for the amount spent on health insurance policies – this amount is an exempt of corporate income tax. If the insurance premium does not exceed 10 % of the insured person’s gross income and also does not exceed EUR 426.86 then it is an exempt of personal income tax and is not included in the object of compulsory social insurance contributions.

  • The employee health insurance facilitates continuous operation of the company
    The employee health insurance facilitates faster return of employees back to work after they have been ill. Possibilities of health insurance policy help to discover serious health problems at an early stage and faster recovery decreasing employer’s costs for covering of sick leaves. Shorter periods of sick leave also decrease costs related to replacing of employees.
  • Reputation of a socially responsible employer
    Employee health insurance is an expression of the employer’s good will as well as care and in its turn it motivates employees and increases their loyalty to the company.

  • We do not apply an extra payment for split payments
    The insurance premium for the policy can be paid in several payments and no extra expenses are applied.

  • We offer an open policy
    Open policy offers a possibility to pay for services that are not included in an insurance contract. Insurance holder sets insured sum of an open policy and it can be increased during the entire insurance period for an unlimited amount.

  • We also insure employees of small companies
    Seesam health insurance offers a possibility for every employer to insure employees without envisaging any restriction like minimum number of insured employees.

  • Beneficial and flexible policy purchase for new employees
    During the entire insurance period it is possible for the employer to insure new company’s employees who can be added to the selected insurance program under the same conditions as the initial contract was concluded. In case the number of insured individuals is increased the insured amount for each employee will not be decreased.

  • Discounts for other kinds of Compensa services
    The company as a legal entity and insured company’s employees as individuals have possibility to receive discounts for other Compensa services. 

  • For convenience of clients – health insurance self-service site 
    For the convenience of clients Compensa has created insurance self-service site ensuring clients not only with digital health insurance card and access to its data but also much more comfortable and faster service.

  • Seesam health insurance now is also available on the phone! Mobile app is available for both Apple iOS (iPhone, iPad) and Google Android smart devices.

    Benefits: 
    1. Simple and convenient use
    In the initial version of the app two essential sections are available – a digital card and an application of insurance indemnity.

    2. Information is easy to review
    All information on the policy, insurance risks, limits, programs and history will be at the same place and client will be able to access it through the phone. It will be easy to review it at any time and place.

    3.Eco-friendly solution
    Mobile app is nature friendly as no waste is created.

About health insurance programs

Out-patient paid-services

Paid-services are services not covered from the state budget:

  • Consulting of a family doctor, general medical practitioner, internist or paediatrician.
  • Home visit of a family doctor.
  • Consulting of a competent doctor. 
  • Consulting of a highly qualified specialist (assistant professor, professor).
  • Consulting of physical therapy doctor, physiotherapist, rehabilitologist
  • Treatments (injections, infusions, blockades).
  • Manipulations made by a specialist, laboratory and diagnostics examinations prescribed by a treating doctor, including expensive examinations.
  • Medical expenses related to pregnancy within the service framework set in this program.
  • Physiotherapy treatments as prescribed by the treating doctor (short wave therapy, electrophoresis, ultrasound, magnetic therapy, laser therapy, light therapy, etc.). 
  • Medical certificates (for weapon acquisition permit, driver’s commission) and inspections related to them.
  • Mandatory health inspections related to work specifics, including an individual’s medical record  in the amount and procedure of the legislations enactments of the Republic of Latvia.
  • State emergency medical treatment.
  • Paid emergency medical treatment at “ARS” in Riga and Riga area.

Out-patient rehabilitation

Out-patient rehabilitation – massages, manual therapy, water treatments, medically prescribed corrective gymnastics in a group or individually (also medically prescribed corrective gymnastics training packages are covered within the limits). Out-patient rehabilitation can be received only at a medical institution in case of justified indications. Out-patient rehabilitation has a limit for each treatment and number of treatments during the period.

Paid in-patient services

Staying at a hospital and day-care for a fee:
•    Treatment in a hospital
•    Treatment and diagnostics manipulations
•    Laboratory inspections
•    Surgeries
•    With/without treatment in advanced service conditions


Before receiving of the service, i.e. 5 working days before, at the hospital offering services for a fee, including paid days at the hospital outside the insurer’s contract organizations as well as if the in-patient service is not agreed position, it is necessary to have a written consent of the insurer – Guarantee Letter regarding the cover of the services. To make the refund according to the insurer’s guarantee letter then for preparing of the letter, it is necessary to submit to the insurer a treating doctor’s designation and possible cost estimate of services provided.

Paid childbirth assistance services

This coverage in the insurance program can be included only if cover for “paid in-patient services” is selected. Service is covered if the card is effective for a full insurance year and only with Guarantee Letter of the insurer.

Paid childbirth assistance services:

  • Service room;
  • Contract with a doctor or midwife;
  • Analgesia.

In-patient rehabilitation

This coverage in the insurance program can be included only if cover for “paid in-patient services” is selected. Services are paid with the insurer’s guarantee letter.

Paid in-patient rehabilitation

Treatment at a sanatorium and specialized rehabilitation institutions only after acute health problem, i.e. accident, injury or surgery that have taken place during an insurance period. The in-patient rehabilitation services are agreed with the insurer in prior based on a treating doctor’s designation for a medical rehabilitation according to a diagnosis and medical indications and recommendations.

Dental services

Program covers various kinds of dental services and dental hygiene services. The indemnity is limited by the insured amount per year and ratio (%) discount as set in the program.

Medication

Program ensures cover of the medications required for the treatment process if this medication is registered in the Drug Register of the Republic of Latvia. The indemnity is limited by the insured amount per year and ratio (%) discount as set in the program.

Sports

Sports program covers:

  • Sports classes (gym, pool, tennis, squash, aerobics classes).
  • Indemnity is limited by the insured amount per class in one day and number of classes per month as set in the program.
  • Sports classes also cover one-month memberships (packages) within the limit set in the insured person’s program.
  • Sports classes also cover two-month and three-month memberships (packages) within the limit set for the program, by paying 100 % from personal assets.

Optics

Program covers based on the doctor’s prescription. Optics items can be acquired once a year:

  • Contact lenses, including one-day or month contact lenses.
  • Optical lenses of eye-glasses (including services of optometrist) based on the doctor’s prescription.

The indemnity is limited by the insured amount per year and ratio (%) discount as set in the program.

Open policy

Open policy covers unforeseen out-patient and in-patient costs not covered by acquired basic program. Payments of an insurance indemnity from the open policy the insurer makes only to the insured persons included in the insurance policy (employees only) with a written confirmation of the policy holder.

Policy holder determines insured amount of the open policy. Insurer withholds administrative costs. 

Association of Health Centres

The outpatient clinics of the Association of Health Centres (hereinafter referred to as the VCA) employ the best doctors equipped with modern technologies, offering patients the highest level of medical care. VCA has twelve health centres throughout Latvia, and it is the largest network of outpatient clinics in the country.

A wide range of treatments and examinations performed by highly specialised and experienced medics are available in VCA’s outpatient clinics. The aim of the company is to provide patients with an individualised approach, necessary consultations, professional diagnostics, medical treatment, rehabilitation and prevention in one place. This significantly reduces the time required for treatment, which is the greatest value of our century.

VCA employs about 600 highly qualified doctors in more than 40 specialties who use the most advanced hardware and novelties available in the field of medicine. Each outpatient clinic is equipped with the latest generation equipment for conducting magnetic resonance imaging, computed tomography, ultrasonography and X-ray imaging. VCA provides both the most extensive range of State-paid healthcare services and offers paid services at competitive prices provided by the best professionals in the field, who will give each patient the time and attention they need. VCA evaluates the loyalty of its patients – having the Patient Card makes it possible to receive discounts for diagnostic examinations and medical manipulations.

List of VCA’s Outpatient Clinics

What to do if an insurance card is lost or needs to be changed?
If personal data/surname changes or health insurance card is lost:
  • It is necessary to send a request to e-mail info@compensa.lv nrom the insured person asking to change a health insurance card adding passport or ID card copy (if personal information has changed).
  • Indicate address where the new card needs to be sent.
  • Payment for making a new card is EUR 4.00. (Policy may have a condition that new HI card is made for free at any case).

If health insurance card has been stolen:

  • It is necessary to send a request to e-mail  info@compensa.lv from the insured person asking to change a health insurance card adding police statement regarding theft of documents.
  • Indicate address where the new card needs to be sent.
How to receive health insurance indemnity?

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 assessment of claims.
    We process the claims registered in the portal or app within 1-2 working days.
  • You'll save time.
  • Only information on the incident must be filled out. The information known to us will be filled in automatically from the data available in the system.
  • All documents submitted by you are compiled in a single platform.
  • Easy tracking of claim cases, their status, decisions.

2. In one of Compensa's customer service centers.

3.By filling out the application form.

List of contracting organisations and Price lists of services

One of the recommendations to the insured persons is not to rush to use medical services for a fee in cases when services covered by the state budget are available. It is essential to maintain sufficient insurance support resource for possible acute situations when the most often operative help can be received only by means of services for a fee. As well as to maintain positive balance at the moment when policy is renewed and not to create necessity to increase the insurance premium due to the fact that previously services for a fee have been used often. 


By searching help of a specializing doctor the insured person should always make sure about the possibility to receive health care services covered by the state. To receive information on medical institutions ensuring government covered medical care please contact with the National Health Service by calling to number 80 00 12 34 or look for the information on NHS website.

Customer support and purchase of insurance policy
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