Whonsi Info Descrcover Consult en

WORLD HEALTH ORGANIZATION NON
STAFF INSURANCE FOR CONSULTANTS,

TEMPORARY ADVISORS, EXECUTIVE
BOARD MEMBERS AND EXPERTS
DETAILED COVERAGE
DESCRIPTION FOR THE MEDICAL
EXPENSES
Version 01/01/2018
CONTENT
This document contains a general description of the medical cover provided for WHO’s Consultants,
Temporary Advisors, Executive Board Members and Experts. Should you have any questions about an
item that is not listed below or want additional information, please contact Cigna or consult your
personal webpages which are accessible through www.cignahealthbenefits.com.
Your coverage.................................................................................................................................................4
1. In general...............................................................................................................................3
2. Summary of benefits..............................................................................................................5
2.1. In the hospital .................................................................................................5
2.2. Ambulance and transportation expenses .............................................................7
2.3. At the General Practitioner’s 8
2.4. At the specialist’s 9
2.5. At the licensed qualified health care provider’s (other than doctor) ........................ 10
2.6. At the optician’s 11
2.7. At the dentist’s .............................................................................................. 12
2.8. At the pharmacist’s ........................................................................................ 13
2.9. At the specialised supplier’s office .................................................................... 15
2.10. In the laboratory/medical imaging facility ........................................................... 17
3. Exclusions............................................................................................................................18
Cigna – Medical expenses coverage description for WHO Non Staff 2/18
Consultants, Temporary Advisors, Executive Board Members and Experts 1 January 2018
YOUR COVERAGE
1. In general
All amounts are expressed in USD.

PA indicates that pre-authorisation is required by Cigna.
Benefits Description
Overall maximum Maximum of 50,000 USD per event per 12 months of incurrence of medical
expenses based on your initial start date of coverage under this contract.
Reasonable and This indicates a specific threshold for a specific treatment in a specific
customary geographical area where adequate quality medical care is available for that
amount or less. This means that when the fees charged for medical care
exceed the reasonable and customary level, the coverage is only applied to
the amount up to the reasonable and customary threshold. The part
exceeding the reasonable and customary level is completely at the expense
of the patient.
Reimbursements effected under this insurance plan may only relate to
treatments, supplies or other services that are generally recognised as
medically necessary and appropriate for the condition being treated, and
when such treatment, supplies or other services are prescribed or provided
by a licensed, qualified medical professional.
Currency of By default USD, by cheque or by electronic transfer directly to the insured.

reimbursement Exceptionally, the WHO can agree to have the reimbursement paid to the
WHO c/o the insured
Validity of prescriptions One year (even for prescriptions mentioning ‘permanent use’)
Outpatient Treatment given on an outpatient basis, where the date of admission is the
treatment/outpatient same as the date of discharge.
surgery/day case
Inpatient treatment/ Treatment given on an inpatient basis, where the date of admission differs
hospitalisation from the date of discharge.
Type of expenses Compulsory coverage: only expenses related to accidents and emergency
illnesses are covered
covered
Voluntary coverage complementary coverage: only the expenses related
to non-emergency illnesses are covered. This coverage is only applicable if
the insured has applied for it, and that the application has been confirmed by
Cigna
Emergency: a life threatening situation where the patient must start
treatment within 48 hours and for whom travel is not possible for medical
reasons
Accident: impairment of physical integrity through the sudden action of an
external force
Benefits Description
Territorial limits Coverage is excluded for expenses incurred in:

• North America;
• Singapore;
• Republic of South Africa;
• Switzerland.
For these countries/regions, coverage shall only be provided under one of

the following conditions:
• in case the insured person’s duty station is located in one of these
countries/regions;
• for urgent (non-planned) medical attention, if the insured person is on
duty travel in one of these countries/regions;
• for North America: if the insured’s duty station is located within the
Americas
• for the Republic of South Africa: if the insured person’s duty station is
located in one of the following countries: Mozambique, Angola,
Zimbabwe, Lesotho, Swaziland, Malawi, Zambia and Madagascar;
• after prior approval by the Insurer’s medical advisor: if no adequate
treatment can be found elsewhere.
Moreover, for hospitalisation in the USA, accommodation in a USA hospital

and for all related inpatient costs incurred, prior approval from the Insurers is
always required. Where prior approval has not been obtained from the
Insurers for hospitalisation in the USA, the normal reimbursement calculated
will be reduced by 25%.
Exchange rate UN operational rate of exchange, in force on the date the claim is processed
2. Summary of benefits
2.1. In the hospital
GENERAL RULE
Coverage is 100% unless stipulated differently below.
Items marked with* - see type of expenses covered above
Please note that prior approval for hospital treatment is advisable to set up direct payment
and to verify whether all expenses are reasonable and customary.
Item Compulsory coverage Voluntary coverage
Second opinion Covered* Covered*

Stay (bed and board expenses) Covered* Covered*
Maximum rate applicable for a Maximum rate applicable for a
semi-private room or a ward. semi-private room or a ward.
Or in case the hospital of choice Or in case the hospital of choice
only has private room, the only has private room, the
maximum rate applicable for a maximum rate applicable for a
semi-private room or a ward in an semi-private room or a ward in an
alternative comparable hospital in alternative comparable hospital in
the same area. the same area.
All-in hospitalisation Covered* Covered*
Fees surgeon and/or costs Covered* Covered*
incurred during the surgery
Fees treating physician Covered* Covered*
Other hospital expenses Covered* Covered*
Accompanying person Not covered Not covered
Private nurse during Not covered Not covered
hospitalisation
Psychiatric admission Covered* Covered*
Transplantation: registration Covered* Covered*
expenses
Transplantation: expenses Covered* Covered*
donor in case the insured is the
recipient
Transplantation: expenses Not covered Not covered
donor in case the insured is the
donor
Outpatient surgery (operating Covered* Covered*
theatre required)
Day case (i.e. less than 24 Covered* Covered*

hours but room charged)
Minor surgery in doctor’s cabine t Covered* Covered*
Specific admissions/surgeries Compulsory coverage Voluntary coverage
Outpatient chemotherapy Not covered Covered*

PA needed
Outpatient radiotherapy Not covered Covered*

PA needed
Outpatient haemodialysis Not covered Covered*

PA needed
Rehabilitation/convalescence Covered* Covered*

after surgery
Maximum rate applicable for a Maximum rate applicable for a
semi-private room or a ward. semi-private room or a ward.
Or in case the hospital of choice Or in case the hospital of choice
only has private room, the only has private room, the
maximum rate applicable for a maximum rate applicable for a
semi-private room or a ward in an semi-private room or a ward in an
alternative comparable hospital in alternative comparable hospital in
the same area. the same area.
Home for the elderly/nursing Not covered Not covered

home
Institution for the disabled Not covered Not covered
Cure Not covered Not covered
Drug and alcohol abuse Not covered Not covered
Corrective eye surgery to Not covered Not covered

change the dioptre/LASIK
Cures Not covered Not covered
Cosmetic surgery Not covered Not covered
Reconstructive surgery Covered* Covered*

PA needed PA needed
Infertility treatment Not covered Not covered
Pregnancy and childbirth Not covered Not covered
2.2. Ambulance and transportation expenses
GENERAL RULE
Ambulance Covered* Covered*

Only charges for professional Only charges for professional
ambulance service used to ambulance service used to transpor t
transport the insured between the the insured between the place
place where the insured is injured where the insured is injured by an
by an accident or stricken by a accident or stricken by a disease
disease and the nearest hospital and the nearest hospital where
where treatment can be given or treatment can be given or
repatriation of patient to home repatriation of patient to home
country or medical evacuation of country or medical evacuation of
patient to country where care can patient to country where care can be
be given are covered; given are covered;
In case of emergency or major In case of emergency or major
disability, special transport of the disability, special transport of the
insured, including costs of insured, including costs of
accompanying person or attendan t accompanying person or attendant
is allowed. is allowed.
The allowable transportation costs The allowable transportation costs
are reimbursable up to a maximum are reimbursable up to a maximum
of 10,000 USD of 10,000 USD
Medical transport (no ambulance) See ambulance See ambulance
by professional services
Helicopter ambulance See ambulance See ambulance
Search & rescue (e.g. in case of Not covered Not covered
ski-accident)
Repatriation patient to his/her See ambulance See ambulance
home country
Medical evacuation of patient to See ambulance See ambulance
country where care can be given
Taxi Not covered Not covered
Own transportation Not covered Not covered
Public transportation Not covered Not covered
2.3. At the General Practitioner’s
GENERAL RULE
Consultation Covered* Covered*
Annual subscription fees Not covered Not covered
Minor surgical intervention Covered* Covered*
Not covered Not covered

Vaccination

Routine physical exam
Cigna –
Medical
expenses
coverage
description
for WHO
Non Staff
8/18
2.4. At the specialist’s
GENERAL RULE
All treatments and medicines must be prescribed by a qualified and registered medical doctor.
Consultation Covered* Covered*
Treatment Covered* Covered*
Second surgical opinion Covered* Covered*
Outpatient mental health care: Covered* Covered*

psychiatrist

Outpatient mental health care:
psychologist
Immunotherapy Not covered Not covered
IUD (intrauterine device) Not covered Not covered
Check-ups (mammography, Pap Not covered Not covered

smear etc)
Hearing test Not covered Not covered
Eye test to determine the dioptre Not covered Not covered

by an ophthalmologist, optometris t
or optician
Eye examination due to a medica l Covered* Covered*

condition (i.e. not routine or to
determine the dioptre)
Cigna – Medical expenses coverage description for WHO Non Staff
9/18
2.5. At the licensed qualified health care provider’s (other than doctor)
GENERAL RULE
A doctor’s prescription is required for care given by a person holding a paramedical degree
(e.g. nurse, physiotherapist).
Medical act (e.g. dressing Covered* Covered*

wounds, giving injections) and
supervision by a nurse
Nursing assistance for activities o f Not covered Not covered

daily living (e.g. dressing, feeding,
supervision)
Custodial care (i.e. assistance Not covered Not covered

with activities of daily living) by a
person other than a nurse (e.g.
garde-malade, home health aide)
Not covered
Dietician, nutritional counselling Not covered
Physiotherapy Covered* Covered*

Pre- and postnatal exercises
Other treatments not provided by Covered* PA needed Covered* PA needed

a doctor (and no physiotherapy) Ayurveda not covered Ayurveda not covered
Acupuncture Covered* Covered*
Chiropractic treatment Covered* Covered*

Psychological treatment given by:
• a licensed psychologist;
• a licensed psychoanalyst;
• a licensed psychiatric social
worker.

Custodial care

Hospice care for the terminally ill

Relationship therapy

Outpatient treatment for alcohol
and drug abuse
2.6. At the optician’s
GENERAL RULE
All treatments and medicines must be prescribed by a qualified and registered medical
doctor. Items marked with* - see type of expenses covered above
Eye test to determine the dioptre Not covered Not covered

by an ophthalmologist, optometris t
or optician
Corrective glasses and contact Not covered Not covered

lenses
Frames Not covered Not covered
Fluid for contact lenses Not covered Not covered
2.7. At the dentist’s
GENERAL RULE
General cover for dental care Covered* if related to an accident Not covered
Half-yearly dental exam Not covered Not covered
Dental x-rays Covered* if related to an accident Not covered
Prostheses (including bridges, Covered* if related to an accident Not covered

implants, dentures)
Orthodontic care (including the Covered* if related to an accident Not covered

orthodontic device)
Dental surgery performed in Covered* if related to an accident Not covered

hospital for which a hospital
The doctor’s fees and the cost of
theatre is required
the dental items are included in
(e.g. surgical tooth extraction)
the General cover for dental care.
For other expenses (e.g. use of an

operating theatre, bed and board
for an inpatient admission): see In
the hospital
Toothbrush, toothpaste, Not covered Not covered

mouthwash
Tooth whitening Not covered Not covered

Cigna – Medical expenses coverage description for WHO Non Staff
12/18
2.8. At the pharmacist’s
GENERAL RULE
General cover of prescribed Covered* Covered*

pharmaceutical products:
For claiming purposes, please For claiming purposes, please
• containing active medical
provide us with the following provide us with the following
components;
documents together with your documents together with your Claim
• generally medically recognised
Claim form: form:
and fully approved by the
relevant legislation in force; • doctor’s prescription stating: • doctor’s prescription stating:
• required as a result of illness,
• the name of the patient; • the name of the patient;
accident or maternity.
• the diagnosis; • the diagnosis;
• the name of the medication; • the name of the medication;
• the dosage; • the dosage;
• the official original invoice • the official original invoice clearly
clearly mentioning: mentioning:
• the date of purchase; • the date of purchase;
• the name(s) of the • the name(s) of the
medication; medication;
• the price paid for each • the price paid for each
product. product.
Over-the-counter (OTC) drugs Not covered Not covered
Food/nutritional supplements Not covered Not covered
Vitamins and minerals Not covered Covered*

Please note: vitamins that are taken
for preventive reasons are not
covered.
Only reimbursable in case of
treatment for a vitamin deficiency.
Multivitamins Not covered Not covered
Homeopathy Covered* Covered*

Phytotherapy, herbal products

Chinese medication

Appetite inhibitors aimed at weigh t
loss / dietary products

Drugs for obesity management
(Xenical, Meridia and Reductil)

Products aimed at quitting
smoking
Bifosfonates/Medication to treat Not covered Covered* if certain conditions are

fulfilled.
osteoporosis (Fosamax, Evista
etc.) PA needed on the basis of the
results of a Bone Mass
Measurement
HIV/AIDS medication Covered* Covered*
Daily care products (soap, Not covered Not covered

shampoo etc.)
Contraceptives Not covered Not covered
Glucosamine, chondroitin sulfate Not covered Not covered
Hair and nail growth stimulating Not covered Not covered

products
Medication to (temporarily) treat Not covered Not covered

impotence (e.g. Viagra, Levitra)
Malaria prophylaxis (= prevention Not covered Not covered

of malaria)
Vaccines Not covered Not covered
Tamiflu Not covered Not covered
Hormonal treatment to stimulate Not covered Not covered

fertility
Dressings/bandages Covered* Covered*

2.9. At the specialised supplier’s office
GENERAL RULE
The plan covers 100% unless stipulated differently below of the rental (or the purchase thereof
when purchase of the appliance is more economical than rental or when it is impossible to rent
the appliance in question), if considered medically necessary by Cigna’s medical consultant.
Orthopaedic devices in general Covered* Covered*

PA needed PA needed
Repair of orthopaedic devices Covered* Covered*

PA needed PA needed
Orthopaedic shoes Not covered Covered*
PA needed
Inlay soles
Hearing aids Not covered Not covered
Rental of an aerosol/nebulizer Not covered Covered*

PA needed
Rental of a CPAP appliance Not covered Covered*

PA needed
Rental of sphygmomanometer (= Not covered Not covered

a blood pressure meter) or blood
pressure gauge
Wheelchair Covered* Covered*

PA needed PA needed
Crutches Covered* Covered*
PA needed PA needed
Rollator
Standing frame
Support stockings for varicose Covered* Covered*
veins PA needed PA needed
Anti-allergic eiderdown cover, Not covered Not covered

mattress cover, pillow cover
Adaptations to the house (e.g. Not covered Not covered

shower, elevator, special lavatory)
Hospital bed Covered* Covered*

PA needed PA needed
Home trainer Not covered Not covered
Infrared lamp Not covered Not covered
Incontinence material Covered* Covered*

PA needed PA needed
Wig Not covered Covered*

PA needed
Special bathing suit after breast Not covered Not covered

amputation
Special bra after breast Not covered Covered*

amputation
PA needed
Humidifier Not covered Not covered
Air cleaner Not covered Not covered
(Baby) food in case of allergy Not covered Not covered

(cow milk, gluten etc.)
(Baby) food in case of serious Not covered Not covered

metabolic disorder (e.g. Amino
acid deficiency)
Cigna –
Medical
expenses
coverage
description for
WHO Non
Staff
16/18
2.10. In the laboratory/medical imaging facility
GENERAL RULE
X-rays Covered* Covered*
Magnetic Resonance Imaging Covered* Covered*

(MRI)
Ultrasound Covered* Covered*
Electrocardiogram (ECG) Covered* Covered*
Preventive routine mammography Not covered Not covered
Preventive routine mammography Not covered Not covered

for persons with a prior history of
breast cancer or whose mother or
sister has had a prior history of
breast cancer
Mammography for diagnostic Covered* Covered*

purposes
Laboratory tests Covered* Covered*
Amniocentesis Not covered Not covered
Preventive HIV testing Not covered Not covered
PSA testing Not covered Not covered
Pap smear Not covered Not covered
3. Exclusions
The coverage does not extend to:
• the consequences of illnesses or accidents resulting from voluntary and intentional action on
the part of the beneficiary or the insured, e.g. attempted suicide, voluntary mutilation;
• the insurance is suspended in time of war for insured who are mobilised or who volunteer for
naval, air or military service;
• the results of wounds or injuries resulting from motor vehicle racing and dangerous
competitions in respect of which betting is allowed; normal sports competitions are covered;
• the consequences of insurrections or riots, if by taking part the insured has broken the
applicable laws; the consequences of brawls, except in cases of self-defence;
• the direct or indirect results of explosions, heat release or irradiation produced by transmutation of
the atomic nucleus or by radioactivity or resulting from radiations produced by the
artificial acceleration of nuclear particles;
• aircraft accidents are only covered if the insured is on board an aircraft with a valid certificate of air-
worthiness, piloted by a person in possession of a valid licence for the type of aircraft in question.
• periodic, preventive health examinations;
• rejuvenation cures and cosmetic treatment. However, cosmetic surgery is covered when it is
necessary as the result of an accident for which coverage is provided;
• expenses for or in connection with travel or transportation whether by ambulance or otherwise,
except that charges for professional ambulance service used to transport the insured between the
place where the insured is injured by an accident or stricken by a disease and the nearest hospital
where treatment can be given or repatriation of patient to home country or medical evacuation of
patient to country where care can be given is not be excluded hereunder. In case of emergency or
major disability, special transport of the insured, including costs of accompanying person
or attendant is allowed. The allowable transportation costs are reimbursable up to a
maximum of 10,000 USD within the overall medical expenses ceiling of 50,000 USD.
• medical expenses incurred in relation to dental (except when as a consequence of a covered
accident), optical (lenses, glasses and frames as well as fees for eye examination),
maternity, delivery, hearing aids and spa cures.
• funeral expenses, repatriation of mortal remains, etc.

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WORLD HEALTH ORGANIZATION NON

STAFF INSURANCE FOR CONSULTANTS,

2.1. In the hospital .................................................................................................5

2.2. Ambulance and transportation expenses .............................................................7

2.3. At the General Practitioner’s 8

2.4. At the specialist’s 9

2.6. At the optician’s 11

2.7. At the dentist’s .............................................................................................. 12

2.8. At the pharmacist’s ........................................................................................ 13

2.9. At the specialised supplier’s office .................................................................... 15

2.10. In the laboratory/medical imaging facility ........................................................... 17

All amounts are expressed in USD.

Currency of By default USD, by cheque or by electronic transfer directly to the insured.

Territorial limits Coverage is excluded for expenses incurred in:

For these countries/regions, coverage shall only be provided under one of

Moreover, for hospitalisation in the USA, accommodation in a USA hospital

2.1. In the hospital

Item Compulsory coverage Voluntary coverage

Second opinion Covered* Covered*

Day case (i.e. less than 24 Covered* Covered*

Specific admissions/surgeries Compulsory coverage Voluntary coverage

Outpatient chemotherapy Not covered Covered*

Outpatient radiotherapy Not covered Covered*

Outpatient haemodialysis Not covered Covered*

Rehabilitation/convalescence Covered* Covered*

Home for the elderly/nursing Not covered Not covered

Institution for the disabled Not covered Not covered

Cure Not covered Not covered

Drug and alcohol abuse Not covered Not covered

Corrective eye surgery to Not covered Not covered

Cures Not covered Not covered

Cosmetic surgery Not covered Not covered

Reconstructive surgery Covered* Covered*

Pregnancy and childbirth Not covered Not covered

Item Compulsory coverage Voluntary coverage

Ambulance Covered* Covered*

Item Compulsory coverage Voluntary coverage

Consultation Covered* Covered*

Annual subscription fees Not covered Not covered

Minor surgical intervention Covered* Covered*

Not covered Not covered

Not covered Not covered

Item Compulsory coverage Voluntary coverage

Consultation Covered* Covered*

Treatment Covered* Covered*

Second surgical opinion Covered* Covered*

Outpatient mental health care: Covered* Covered*

Not covered Not covered

Immunotherapy Not covered Not covered

IUD (intrauterine device) Not covered Not covered

Check-ups (mammography, Pap Not covered Not covered

Hearing test Not covered Not covered

Eye test to determine the dioptre Not covered Not covered

Eye examination due to a medica l Covered* Covered*

Item Compulsory coverage Voluntary coverage

Medical act (e.g. dressing Covered* Covered*

Nursing assistance for activities o f Not covered Not covered

Custodial care (i.e. assistance Not covered Not covered

Physiotherapy Covered* Covered*

Not covered Not covered

Other treatments not provided by Covered* PA needed Covered* PA needed

Acupuncture Covered* Covered*