Quick examination and treatment

PFA Health Insurance

Not everyone is covered by PFA Health Insurance – it depends on the individual employer’s agreement with PFA. You can see whether you are covered by PFA Health Insurance in the insurance overview at My PFA.

 

How to use PFA Health Insurance

1. Contact your doctor

You always need to start by contacting your own doctor, who must assess your need for treatment and give you a referral or recommendation*. This ensures that you will get the correct pre-examination and/or receive the correct treatment.

*for instance, you need a recommendation if your doctor assesses that you need to see a reflexologist or acupuncturist as you cannot get a traditional doctor's referral for these types of treatment.

2. Call PFA's Health Centre at
(+45) 70 24 50 01

Once you have seen your doctor, we need to approve the examination and/or treatment that your doctor has recommended* or referred you to. Usually, you will receive immediate approval. Examination and treatment must be approved by PFA before initiated. Additionally, you will receive a letter with the approval either by post or in your e-Boks. However, this does not apply to treatment from a psychologist, in which case the psychologist will contact you to arrange a time for the consultation.

3. Get started with examination and treatment

We will, as a rule, direct you to a treatment facility within PFA’s quality-assured network.

Normally, PFA will settle the payment directly with the treatment facility so that you do not need to pay upfront and claim the payment back later.

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)
- Transportation.

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.