PHILIPSBURG--Although she has lost her toe, Helena Richardson now at least has her SZV card.
The Daily Herald approached social and health insurance provider SZV recently in light of the disquieting story of the diabetic who went without proper medical treatment for a worsening foot wound and ultimately saw one toe amputated, to enquire about emergency healthcare for the uninsured.
The situation of 61-year-old Richardson is a special case. She previously explained to this newspaper that she was not covered for medical treatment because she did not have a 60+ card from SZV, she did not have the card because she was not yet on pension, and she had been late to apply for pension because she had been struggling with a painful wound on her other leg that required multiple surgeries when her regular medical insurance expired.
A blister that worsened into the wound that led to the amputation started in the same month that she applied for the pension, she said.
It should be noted that SZV sped up the process for her to receive her pension, calling an emergency meeting after she showed the newer wound to SZV officials, and that her tax papers still were required for the 60+ card application.
The card eventually was picked up by Richardson's son on her behalf, the day after the amputation, which was one week and two days after the emergency meeting. While expenses are covered from then on, it is unclear whether the surgery was covered and needs to be discussed between the two parties.
While SZV does not disclose information on specific cases, some information was provided that also would be applicable to other cases.
"When someone reaches the age of 60, they are no longer insured under the ZV law (health insurance). They become eligible for AOV/pension, a 60+ insurance or FZOG (for retired civil servants), all of which require an application process," read a company statement based on invited comments concerning the application process.
"The senior can apply for pension up to 6 months before reaching the pensionable age. To receive a 60+ insurance, one must submit all the required documentation [an attachment was provided with a list of required documents – Ed.] and then a calculation is made, based on their income.
"The premium is calculated over their actual income. So if one receives 'other' income next to their AOV/pension it will also be included in the calculation. Once all the documentation has been submitted and the calculation has been made, the senior will receive an appointment.
"This appointment is made upon availability and can take up to 2 weeks. During this appointment, the senior will receive their insurance card.
"It is every individual's responsibility to file their income taxes each and every year.
"It is the responsibility of every person approaching the pensionable age of 60 to enquire about the procedures involved in receiving pension, what documents need to be submitted and what their rights and obligations are. They have to submit an application for pension up to 6 months to ensure that all relevant information is received and the process can proceed smoothly."
Concerning coverage for the uninsured, SZV first pointed out that, in general, everyone has the responsibility to be insured for "the various aspects of their life such as medical care, driving a car, having their home protected against theft, hurricane damage ...."
SZV further stated, "It all depends on the reasons why a person does not have insurance. If a person does not have an insurance card for medical care or his/her insurance card has expired, they can always pay for their medical treatment and be reimbursed afterwards for this treatment. However, it is important to establish if this person was entitled to have a medical insurance card at the time of their medical treatment.
"If yes, they can submit an application for reimbursement of the paid medical treatment, a guarantee letter can be issued if it pertains an emergency medical treatment or a temporary insurance card. If not, they will not receive any reimbursement."
