THE ESSENTIALS
Before you start
- Separate total expense, reimbursement received and remaining cost.
- Request evidence of the earlier reimbursement.
- An unpaid balance is not automatically an eligible balance.
A document explaining what was already paid
Clause 18 of Multicare General Conditions 34, September 2026, permits copies when originals were used with another entity, accompanied by a statement of the total expense and reimbursement. It also provides for an insurer’s statement for a subsequent submission. This is a specific contractual procedure; confirm both policies’ requirements.
Calculate the balance without predicting the answer
Fictional exercise: a €100 expense received €60 reimbursement. The arithmetic difference is €40. That describes the remaining cost; it does not calculate another insurer’s liability. Do not apply a second percentage to €100 while ignoring the €60 already received.
Marta records three separate fields: total expense, amount already reimbursed and balance. If the first request remains undecided, she writes “pending” rather than treating an estimate as a completed payment. The date and response reference let her update the account without erasing its history.
Have the treatment and documents assessed together
Before a further submission, ask how the policy treats the expense after the earlier reimbursement. Identify the treatment and date, available evidence and amount paid. Ask what documents remain necessary and which deadline applies, without transferring a deadline from another policy.
Two cards do not establish that both contracts include the treatment, that a sum insured remains available or that there are no costs for you to bear. Compare the answer with the conditions identified. Do not change an invoice’s recipient or amount to make it fit a request.
Keep one file for each expense
Our suggested file groups the invoice, proof of payment, first entity’s response, reimbursement statement and second request reference. Name files by date and reference, keeping diagnoses out of shared folders or links. Send clinical documents only through the appropriate channel.
The balance may matter to Marta’s budget, but it is not predicted income. Use the relevant process for an existing policy. To compare future protection, select Saúde in the RMACHADO request and explain that another policy exists; a new quotation does not retrospectively cover this expense.
KEEP THESE QUESTIONS
Your checklist for the next conversation
- Record the total expense, amount received and balance.
- Request the earlier reimbursement statement.
- Confirm the second policy’s rules, documents and deadline.
- Keep both responses in the same expense file.
FROM THE ARTICLE TO YOUR SITUATION
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Sources and transparency
Content updated on .
Consultation dates are stated in individual references when available.
Numerical examples are fictional and explain concepts. Editorial interpretations are identified in the text.
Information from RMACHADO GROUP. This is not an insurance offer or individual advice. Covers, acceptance, exclusions, sums insured and costs depend on the policy. The intermediary does not underwrite the risks.