Health Insurance and Reimbursements
We are a private practice — and we take care of the paperwork for your reimbursement
At Clínica Myalgia we do not have direct-billing agreements with health insurers. We work as a private practice, which lets us give each person the time and personalisation that define our method.
The good news: most health insurance policies with reimbursement cover let you recover part of the cost of consultations, treatments and procedures carried out outside their network. And we issue all the documentation needed to keep the process simple.
How it works, in 3 steps
You pay for the consultation or treatment in full at the time, as with any private provider.
We give you a detailed invoice-receipt, with your tax number (NIF), a description of each service (consultation, test, treatment), the date and the amount. When your insurer requires it, we also provide the medical prescription/report and, for physiotherapy, a copy of the physiotherapist's professional licence.
You submit the reimbursement claim to your insurer (usually via their app or online portal) and receive the refund by bank transfer, in line with your policy.
Out-of-network reimbursement is typically between 30% and 50%, with per-service and annual limits set out in your contract. Always check the terms of your policy before going ahead.
What you need to keep
Detailed invoice-receipt (with tax number, description of services, date and amount) — issued by us.
Proof of payment.
Medical prescription, where applicable (required, for example, for physiotherapy/physical and rehabilitation medicine).
Clinical report, if the insurer asks for one.
How to claim with the main insurers
Rules and percentages vary by plan and may be updated by insurers. The figures given are a guide only — always check your policy or with your insurer.
Médis
Claim through the Médis website or app, under Despesas → Nova Despesa, attaching the documents (up to 10). On options 1, 2 and 3, out-of-network reimbursement is usually 35%. Claims are typically processed within a few days. Watch the deadline: on the Classic Plan it is often 30 days from the date of the receipt; on corporate policies, up to 120 days.
Multicare (Fidelidade)
Claim on MyFidelidade (computer or app), using the "Pedir Reembolso" option: enter the policy and insured person, choose the type of expense and attach the invoice/receipt. You can track the status in real time. Usual deadline: up to 120 days after the expense (unless your Particular Conditions say otherwise).
Allianz
Claim via the myAllianz app or the eCliente area, with no need to send paper originals. Alternatively, email Allianz's health reimbursement service, quoting your tax number and policy number. Reimbursement can be processed in about 24 hours.
Generali / Tranquilidade
Reimbursement by uploading the receipt in the customer area. Some plans combine co-payment and reimbursement — on higher tiers, out-of-network consultations can be reimbursed at high percentages. Check your option.
ADSE (Regime Livre)
For ADSE beneficiaries who choose providers outside the network: pay in full and submit the claim on the ADSE Direta portal (or by post). For physiotherapy/physical and rehabilitation medicine you need a medical prescription stating the number and type of treatments, an itemised invoice-receipt and a copy of the physiotherapist's professional licence; the services prescribed and those carried out must match. The amount follows ADSE's Regime Livre table — you can estimate your refund with the simulator on the ADSE website.
Other insurers (AdvanceCare, AXA, Future Healthcare, SAMS, etc.)
The principle is the same: pay, get the detailed invoice-receipt and submit it via the insurer's app, portal or email, within the deadline. Our administrative team will help you gather everything you need.
Our team is here to help
If you're unsure which documents to ask for or how to submit them, our administrative team is happy to guide you. Our aim is to make access to the best care straightforward.
This information is general guidance only and does not replace the terms of your policy or contacting your insurer. Reimbursement rules, deadlines and percentages are set by each insurer and may change.