What is covered?
PFA Health Insurance – what is covered?
What is covered?
PFA Health Insurance covers (not exhaustive):
- Expenses for pre-examinations, treatments and re-examinations at hospitals, clinics or by specialists
- Treatment of abuse of alcohol, medicine and other intoxicants (up to DKK 132,000)
- Treatment by psychiatrists (needs-based)
- Rehabilitation (up to 6 months)
- Recuperation stay (up to 3 months)
- Medicine (up to 6 months)
- Chiropractor and physiotherapist (needs-based)
- Dietician (up to 12 consultations in case of BMI belov 18 or above 30)
- Acupuncturist and reflexologist (up to 12 treatments in total)
- Psychologist including emergency counselling (needs-based)
- Temporary home help and home nursing care (up to 3 months)
You can use the examination and treatment options, etc. right from the day when you become covered by the health insurance plan; however, the need for treatment must have occurred during the insurance period.
Quick help in connection with stress symptoms
If you are experiencing any symptoms of stress, it is important that you seek help promptly. The faster you get help, the greater the possibility of preventing stress symptoms from turning into a serious health problem. Therefore, you do not need a doctor's referral. You simply need to contact PFA and then we will refer you to a business psychologist specialised in stress. If necessary, we also offer tripartite dialogue, where you, your employer and the psychologist together plan your recovery programme in order to prevent relapse.
PFA Health Insurance does not cover (not exhaustive):
- Chronic illnesses that occurred before you became covered by PFA Health Insurance
- Cosmetic surgery
- Glasses, contact lenses, hearing aids or dental treatment
- Infertility treatment
- Emergency treatments (for instance in relation to situations that require doctors from the emergency service and casualty ward)
- Treatment needs that occurred before you became covered by PFA Health Insurance
Log on to My PFA and see which terms apply to you
Your children have the same cover as you do
Your children between the age of 0 and 21 are automatically covered by your Health Insurance and are therefore ensured the same access to quick treatment. The same applies to your cohabiting partner’s resident children.
Read more about PFA Health Insurance at pfa.dk and at My PFA in your terms and conditions in the section "Special terms and conditions of pension for PFA Health Insurance", where the detailed terms and conditions of your PFA Health Insurance are described.
Take out PFA Health Insurance for your partner
If you have PFA Health Insurance, it will be possible for you to take out a Health Insurance plan for your spouse or cohabiting partner. Your partner’s Health Insurance must be paid annually through Betalingsservice.
You can only take out Health Insurance for your spouse or cohabiting partner if the agreement between your employer and PFA allows for it.
As part of PFA Health Insurance, you can now get medical advice from a general practitioner via video, phone or email all weekdays from 8:00 - 22:00 and during weekends/holidays from 8:00 - 18:00. The medical advice is provided by Hejdoktor and any spouse/domestic partner as well as children under the age of 24 will also have access.
For example, Online Doctor can:
- Provide you with professional medical advice and treatment by phone or video
- Answer questions via email within one hour during opening hours
- Issue and renew prescriptions for you.
How to contact an Online Doctor
- Log on to My PFA (mitpfa.dk)
- Select Online Doctor under Your insurance cover
- Choose if you want a consultation by phone, video or email
- If you choose a consultation by phone or video, you can decide if you want to make an appointment for later or wait in the queue and get an appointment within 15 minutes or sooner
- The doctor will then call you
- The doctor will send any required prescriptions, etc.
Generally, you can get the same advice and treatment at the Online Doctor as at your own doctor to the extent physical examinations or laboratory tests, etc. are not required. In addition, Online Doctor cannot issue prescriptions for addictive drugs etc.