Financial indentification (form)
en
fr
Legal entity (form)
en
fr
CIGNA / Statement of accident
This is the form to declare an accident in relation to AIACE's Accident Insurance
en
fr
For a quick reimbursement of your glasses
This document explains how to proceed in order to get a quick reimbursement of your glasses
en
fr
de
Declaration of complementary financial assistance (in relation to a request for prior authorisation)
This is the form to declare complementary financial assistance from other sources in relation to a request for prior authorisation
en
fr
de
it
da
nl
fi
el
pt-pt
es
sv
Request for priority treatment of reimbursement of medical expenses
This is the form to request a priority treatment of a claim for reimbursement of medical expenses (in 11 languages). May apply for priority treatment members covered primarily by the JSIS who incur medical expenses in excess of 600 € over the 15-day period preceding the claim for reimbursement and wish to request accelerated treatment of the claim.
en
fr
de
it
da
nl
fi
el
pt-pt
es
sv
Evaluation of the degree of independence
The reimbursement of services associated with dependence (stays in an institution and the costs of carers) excluding residential drug rehabilitation, depends on the degree of dependence.–– This is determined by the patient’s doctor on the basis of two questionnaires. Here is the one about the degree of independence.
en
fr
de
it
da
nl
fi
el
pt-pt
es
sv
Serious illness (application form)
This is the form to apply for recognition or extension of recognition of a serious illness with summary of the rules
en
fr
de
it
da
nl
fi
el
pt-pt
es
sv
Direct Billing (prise en charge) of costs of care in a convalescent or nursing home or equivalent establishment
This is the form to request direct billing for costs of care in a convalescent or nursing home or equivalent establishment
en
fr
de
it
da
nl
fi
el
pt-pt
es
sv
Health screening (claim for reimbursement)
Claim for reimbursement form for expenses linked to the health screening
en
fr
Request for prior authorisation
Here is the form to request a prior authorisation. Some treatments require a prior authorization (list appended to the form).
en
fr
de
it
da
nl
fi
el
pt-pt
es
sv
Claim for reimbursement
Claim for reimbursement of medical expenses
en
fr
de
Direct billing (prise en charge) for high medical costs / hospital stay
Form to request direct billing of high medical costs or hospital stay. For beneficiaries of primary cover under the JSIS. Also with a reminder of the applicable rules.
en
fr
de
it
da
nl
fi
el
pt-pt
es
sv
Dentistry / Form
Dentistry single form for estimates and bills
en
fr
de
it
da
nl
fi
el
pt-pt
es
sv
Special reimbursement Art. 72(3) / Form
This is the form to apply for a special reimbursement according to Art. 72(3) as well as a reminder of the applicable rules.
en
fr
de
it
da
nl
fi
el
pt-pt
es
sv
Request of an advance payment of major medical expenses
Application form for advance payment of major medical expenses for beneficiaries of primary cover under the JSIS, with the conditions to benefit from it (in 11 languages).
en
fr
de
it
da
nl
fi
el
pt-pt
es
sv
Membership application form
In 2020, AIACE has more than 13,000 members. The more numerous we are, the more representative we will be: join us and become a member.
en
fr