Whonsi Info Descrcover Consult en

WORLD HEALTH ORGANIZATION
NON STAFF INSURANCE FOR

CONSULTANTS, TEMPORARY ADVISORS,
EXECUTIVE BOARD M EMBERS AND
EXPERTS
DETAILED COVERAGE DESCRIPTION

FOR THE MEDICAL EXPENSES
Version 01/08/2020
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 .....................................................................................................6
2.1. In the hospital.................................................................................................6
2.2. Ambulance and transportation expenses ...........................................................9
2.3. At the General Practitioner’s ........................................................................... 10
2.4. At the specialist’s .......................................................................................... 11
2.5. At the licensed qualified health care provider’s (other than doctor) ....................... 12
2.6. At the optician’s ........................................................................................... 13
2.7. At the dentist’s................................................................................................ 14
2.8. At the pharmacist’s ........................................................................................ 15
2.9. At the specialised supplier’s office .................................................................... 17
2.10. In the laboratory/medical imaging facility ........................................................... 19
3. Exclusions ................................................................................................................. 20
Cigna – Medical expenses coverage description for WHO Non Staff 2/20
Consultants, Temporary Advisors, Executive Board Members and Experts 01/08/2020
YOUR COVERAGE
1. In general
All amounts are expressed in USD.

Prior Approval indicates that pre-authorization 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 The default currency for the reimbursements of claims is USD. Upon request
reimbursement of the claimant during the claiming process, reimbursements of claims can
be made:
• in EUR or
• in CHF or
• in the local currency in which the medical expenses are incurred
provided the payment is being requested on an in country bank
account for that local currency and provided the local currency is a
freely convertible currency for which payment in local currency is
technically / legally possible, economical and efficient for the Insurer.
Current currencies are : AUD, CAD, CLP, DKK, EGP, ETB, GBP,
HKD, IDR, INR, JOD, KES, MAD, MYR, NGN, PHP, PKR, SEK,
SGD, TND, XOF, XAF, ZAR
The conversion of medical expenses incurred in a currency other than USD
is made at the U.N operational rate of exchange in force on the date of
processing of the claim. Any other local currency payment request, not yet
on the available local currency list, will be assessed. This might result into
adding the local currency on the list of available local currencies.
Exceptionally, the WHO can agree to have the reimbursement paid to the
WHO c/o the insured
Impact social security If you are covered by a social security system or another group/individual
system or another insurance contract which intervenes as your ‘primary insurer’, you must first
group/individual obtain the reimbursement to which you are entitled under that scheme.
insurance coverage Please send their original settlement note to us together with copies of all
supporting documents in order to obtain an additional reimbursement.
Validity of prescriptions One year (even for prescriptions mentioning ‘permanent use’)
Submission of invoices 1 year after date of service for medical expenses
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
covered illnesses are covered
Voluntary 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
Automatically granted complementary coverage extension: only the
expenses related to non-emergency illnesses are covered. This coverage is
identical to the Voluntary complementary coverage, though it is
automatically granted by the WHO to the Interns covered by the compulsory
coverage.
The Voluntary complementary coverage and Automatically granted
complementary coverage extension are both referred to as Complementary
coverage in the below.
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
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 as this will allow us to set
up direct payment with your healthcare provider as well as verifying whether all expenses
are reasonable and customary, therefore you should inform Cigna of any planned
hospitalisation at least one week prior to the admission date.
Item Compulsory coverage Complementary coverage

Second opinion Covered* Covered*
Stay (bed and board Covered* Covered*
expenses) Maximum rate applicable for a Maximum rate applicable for a semi-
semi-private room or a ward. private room or a ward.
Or in case the hospital of Or in case the hospital of choice only
choice only has private room, has private room, the maximum rate
the maximum rate applicable applicable for a semi-private room or
for a semi-private room or a a ward in an alternative comparable
ward in an alternative hospital in the same area.
comparable hospital in 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: Covered* Covered*

registration 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 Covered* Covered*
(operating theatre required)
Day case (i.e. less than 24 Covered* Covered*

hours but room charged)
Minor surgery in doctor’s Covered* Covered*

cabinet
Specific Compulsory coverage Complementary coverage

admissions/surgeries
Outpatient chemotherapy Not covered Covered*

Prior Approval needed
Outpatient radiotherapy Not covered Covered*
Outpatient haemodialysis Not covered Covered*
Rehabilitation/convalescence Covered* Covered*
after surgery Maximum rate applicable for Maximum rate applicable for a semi-
a semi-private room or a private room or a ward.
ward. Or in case the hospital of choice only
Or in case the hospital of has private room, the maximum rate
choice only has private room, applicable for a semi-private room or
the maximum rate applicable a ward in an alternative comparable
for a semi-private room or a hospital in the same area.
ward in an alternative
comparable hospital in 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
Specific Compulsory coverage Complementary coverage
admissions/surgeries
Cures Not covered Not covered
Cosmetic surgery Not covered Not covered
Reconstructive surgery Covered* Covered*

Prior Approval needed Prior Approval 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 transport ambulance service used to
the insured between the place where transport the insured between
the insured is injured by an accident the place where the insured is
or stricken by a disease and the injured by an accident or
nearest hospital where treatment can stricken by a disease and the
be given or repatriation of patient to nearest hospital where
home country or medical evacuation treatment can be given or
of patient to country where care can repatriation of patient to home
be given are covered; country or medical evacuation of
In case of emergency or major patient to country where care
disability, special transport of the can be given are covered;
insured, including costs of In case of emergency or major
accompanying person or attendant is disability, special transport of
allowed. the insured, including costs of
The allowable transportation costs accompanying person or
are reimbursable up to a maximum of attendant is allowed.
10,000 USD The allowable transportation
costs are reimbursable up to a
maximum of 10,000 USD
Medical transport (no See ambulance See ambulance
ambulance) by
professional services
Helicopter ambulance See ambulance See ambulance
Search & rescue (e.g. in Not covered Not covered
case of ski-accident)
Repatriation patient to See ambulance See ambulance
his/her home country
Medical evacuation of See ambulance See ambulance
patient to 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*
Vaccination Not covered Not covered
Routine physical exam Not covered Not covered
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: Not covered Not covered

psychologist
Immunotherapy Not covered Not covered
IUD (intrauterine device) Not covered Not covered
Check-ups (mammography, Not covered Not covered

PAP smear test, PSA-test,
urological examinations)
Hearing test Not covered Not covered
Eye test to determine the Not covered Not covered

dioptre by an ophthalmologist,
optometrist or optician
Eye examination due to a Covered* Covered*

medical condition (i.e. not
routine or to determine the
dioptre)
2.5. At the licensed qualified health care provider’s (other than doctor)
GENERAL RULE
All treatments and medicines must be prescribed by a qualified and registered medical
doctor.
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 of 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)
Dietician, nutritional counselling Not covered Not covered
Physiotherapy Covered* Covered*
Pre- and postnatal exercises Not covered Not covered
Other treatments not provided by Covered* Prior Approval Covered* Prior Approval needed
a doctor (and no physiotherapy) needed Ayurveda not covered
Ayurveda not covered
Acupuncture Covered* Covered*
Chiropractic treatment Covered* Covered*
Psychological treatment given by: Not covered Not covered
• a licensed psychologist;
• a licensed psychoanalyst;
• a licensed psychiatric social
worker.
Custodial care Not covered Not covered
Hospice care for the terminally ill Not covered Not covered
Relationship therapy Not covered Not covered
Outpatient treatment for alcohol Not covered Not covered

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.
Eye test to determine the dioptre Not covered Not covered

by an ophthalmologist, optometrist
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 Covered* if related to an accident^ Not covered

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

hospital for which a hospital
theatre is required The doctor’s fees and the cost of
(e.g. surgical tooth extraction) the dental items are included in 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
^Definition of accident: Impairment of physical integrity through the sudden action of an internal force
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
• generally medically Claim form: Claim form:
recognised and fully
approved by the relevant • doctor’s prescription stating: • doctor’s prescription stating:
legislation in force; • the name of the patient; • the name of the patient;
• required as a result of • the diagnosis; • the diagnosis;
illness, accident or • the name of the medication; • the name of the medication;
maternity. • the dosage; • the dosage;
• the official original invoice • the official original invoice
clearly mentioning: clearly 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 Vitamins that are taken for
preventive reasons are not
covered.
Only covered in case of treatment
for a vitamin deficiency.
Multivitamins Not covered Not covered
Homeopathy Covered* Covered*
Phytotherapy, herbal products Not covered Not covered
Chinese medication Not covered Not covered
Appetite inhibitors aimed at Not covered Not covered

weight loss / dietary products
Drugs for obesity Not covered Not covered

management (Xenical, Meridia
and Reductil)
Products aimed at quitting Not covered Not covered

smoking
Bifosfonates/Medication to Not covered Covered* if certain conditions are

treat osteoporosis (Fosamax, fulfilled.
Evista etc.) Prior Approval 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 Not covered Not covered

sulfate
Hair and nail growth Not covered Not covered

stimulating products
Medication to (temporarily) Not covered Not covered

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

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

stimulate 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*

Repair of orthopaedic devices Covered* Covered*

Orthopaedic shoes Not covered Covered*

Inlay soles
Hearing aids Not covered Not covered
Rental of an aerosol/nebulizer Not covered Covered*

Rental of a CPAP appliance Not covered Covered*

Rental of sphygmomanometer Not covered Not covered

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

Crutches Covered* Covered*

Rollator
Standing frame
Support stockings for varicose Covered* Covered*

veins Prior Approval needed Prior Approval 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*
Home trainer Not covered Not covered
Infrared lamp Not covered Not covered
Incontinence material Covered* Covered*

Wig Not covered Covered*
Special bathing suit after breast Not covered Not covered
amputation
Special bra after breast Not covered Covered*
amputation Prior Approval 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)
2.10. In the laboratory/medical imaging facility
GENERAL RULE
Diagnostic Laboratory/Medical Imaging coverage is 100% unless stipulated differently below.
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

DETAILED COVERAGE DESCRIPTION

Your coverage .................................................................................................................4

2. Summary of benefits .....................................................................................................6

2.1. In the hospital.................................................................................................6

2.2. Ambulance and transportation expenses ...........................................................9

2.3. At the General Practitioner’s ........................................................................... 10

2.4. At the specialist’s .......................................................................................... 11

2.6. At the optician’s ........................................................................................... 13

2.7. At the dentist’s................................................................................................ 14

2.8. At the pharmacist’s ........................................................................................ 15

2.9. At the specialised supplier’s office .................................................................... 17

2.10. In the laboratory/medical imaging facility ........................................................... 19

All amounts are expressed in USD.

Submission of invoices 1 year after date of service for medical expenses

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 Complementary coverage

Fees surgeon and/or costs Covered* Covered*

Other hospital expenses Covered* Covered*

Accompanying person Not covered Not covered

Private nurse during Not covered Not covered

Transplantation: Covered* Covered*

Transplantation: expenses Not covered Not covered

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

Minor surgery in doctor’s Covered* Covered*

Specific Compulsory coverage Complementary coverage

Outpatient chemotherapy Not covered 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*

Infertility treatment Not covered Not covered

Pregnancy and childbirth Not covered Not covered

Item Compulsory coverage Complementary coverage

Ambulance Covered* Covered*

Item Compulsory coverage Complementary coverage

Consultation Covered* Covered*

Annual subscription fees Not covered Not covered

Minor surgical intervention Covered* Covered*

Vaccination Not covered Not covered

Routine physical exam Not covered Not covered

Item Compulsory coverage Complementary coverage

Consultation Covered* Covered*

Treatment Covered* Covered*

Second surgical opinion Covered* Covered*

Outpatient mental health care: Covered* Covered*

Outpatient mental health care: Not covered Not covered

Immunotherapy Not covered Not covered

IUD (intrauterine device) Not covered Not covered

Check-ups (mammography, Not covered Not covered