How to book a covered treatment or request a reimbursement
Completing health benefit request and reimbursement claim forms
To apply for a direct medical benefit or reimbursement of medical expenses, it is always necessary to complete and sign the appropriate form, downloadable from this page, and submit it to the Cassa Edile/EdilCassa with which the worker is registered.
A member with the status of employee must refer to the Cassa Edile/EdilCassa of the province in which the company in which he is employed is based.
If the application is not duly signed, including the "Privacy Policy " section, it will not be possible to proceed with processing.
Documentation required for the proper processing of claims for health benefits and reimbursement of expenses
The following must be provided with the application form referred to in point 1:
COPIA DELLA PRESCRIZIONE MEDICA/ IMPEGNATIVA
In the case of a request for a benefit under direct agreement:
- COPY OF THE MEDICAL PRESCRIPTION/REFERRAL with an indication of the pathology reported (certain or suspected) and of any diagnostic tests required
- COPY OF STATEMENT OF SERVICE OR COPY OF LAST PAYSLIP*
*It will be up to the employee requesting the payslip to not reveal any sensitive informationincluded in this document.
COPIA DELLA PRESCRIZIONE MEDICA/ IMPEGNATIVA
In the event of a claim for reimbursement of health care costs incurred, including from the SSN (National Health Service):
- COPY OF THE MEDICAL PRESCRIPTION/REFERRAL with an indication of the pathology reported (certain or suspected) and of any diagnostic tests required
- COPIES OF INVOICES/RECEIPTS FOR EXPENDITURE
- COPY OF STATEMENT OF SERVICE OR COPY OF LAST PAYSLIP*
*It will be up to the employee requesting the payslip to not reveal any sensitive informationincluded in this document.
-
COPY OF A DOCUMENT PROVING IDENTITY**
**This is only required in cases where the request is submitted by email.
We recommend that you always keep a copy of the documentation submitted to the Cassa Edile/EdilCassa and the originals of the invoices/receipts.
Please note that failure to comply with any one of the above requirements will not allow the health benefit to be provided or the expenses incurred to be reimbursed.
3
How to submit claims for medical benefits and reimbursement
Claims for medical benefits and reimbursement can be made in the following ways:
Cassa Edile Counter/EdilCassa
Submission at the counter of the Cassa Edile/EdilCassa where the worker is registered or, if he/she is not registered, at the Cassa Edile/EdilCassa local to his/her place of work.
Before going to the counter, it is recommended to fill in the benefit request form (point 1) and bring the documents to be attached (point 2).
Designated representative (facilitator)
The requirements of point A above may be implemented through a facilitator.
Email or registered mail
Forward the documents referred to in points 1 and 2 to the Cassa Edile/EdilCassa with which the worker is registered, by email or by registered mail with return receipt; for the employee, refer to the Cassa Edile/EdilCassa of the province in which the company where he is employed is located.
4
Authorization and full booking process
Authorisation process
Authorisation process
Your Title Goes Here
The member submits the benefit request to the Cassa Edile/EdilCassa (point 3).
Your Title Goes Here
Once the Cassa staff have completed entering the data, the member, if covered, will receive a text message and/or email confirming authorisation, with instructions on how to book the affiliated health facility themselves.
Your Title Goes Here
By clicking on the link in the email and/or text message, the member can access the page for choosing the affiliated healthcare facility. The page offers a list of facilities to choose from.
Your Title Goes Here
By clicking on the chosen facility, the member can view the facility's contact details to make an appointment. He/she must also indicate the doctor who will provide the treatment. When contacting the healthcare facility, the member must remember to inform them that he/she is insured with Fondo Sanedil - UniSalute.
Your Title Goes Here
If the member wishes to choose a facility other than the three automatically proposed by the system, he/she can independently consult the list of affiliated facilities on the Fondo Sanedil website and then click on the appropriate link at the bottom of the page (see example below).
Your Title Goes Here
The member must indicate the date and time of the appointment already agreed with the chosen health facility.
Your Title Goes Here
At this point, the member, having noted the summary of the appointment with the date and time entered, will see all the information relating to the reservation, including any fee payable by him/her. Clicking on "Confirm" will send the information to UniSalute.
Your Title Goes Here
Once the booking procedure has been completed, the member will receive a text message and/or email confirming the appointment.
Please note that after receiving the booking authorisation text message, the member has 15 days to make the booking at the affiliated facility, after which time it will be necessary to contact the Cassa Edile/EdilCassa with a new authorisation request.
The list of affiliated facilities can be found here.
Complete reservation
The process differs depending on whether or not the member has already made an appointment with the affiliated healthcare facility. In both cases, the procedure allows the member, who is not familiar with the application provided for the management of reservations with authorisation, to use the system to make a reservation. Please note that the healthcare facility must always be contacted personally by the insured person to establish the terms of the appointment.
Complete reservation
WITH AN APPOINTMENT
The member submits the benefit request to the Cassa Edile/EdilCassa (point 3).
If the member has already independently made an appointment at an affiliated facility, he/she gives the required documents to the Cassa staff (points 1 and 2A), indicating on the request form the chosen health facility and the date and time of the appointment. For specialist consultations, the member must also indicate the name of the doctor who will provide the care.
Once the booking procedure has been completed by the Cassa staff, the member receives a text message and/or email confirming the appointment.
WITHOUT AN APPOINTMENT
The member submits the benefit claim to the Cassa Edile/EdilCassa (point 3).
As he/she has not yet made the reservation with the affiliated establishment/medical institution, the member hands over the required documentation to the Cassa staff (points 1 and 2A) without any indication of appointment.
The insured person then contacts the affiliated health facility personally, makes the appointment and promptly communicates the details of the appointment (health facility, date and time of appointment, as well as the name of the doctor who will provide the care in the case of specialist visits) directly to the Cassa staff. Failure to inform the Cassa staff of the details of the appointment will result in the booking not being confirmed.
Once the booking procedure has been completed by the Cassa staff, the member receives a text message and/or email confirming the appointment.
Points to note in the health benefits/reimbursement request process
1
Applications may only be made for claims occurring after 1 October 2020, subject to the company's contributions being up to date.
2
The following are entitled to the PLUS Health Plan:
- members in the manual worker category who received the APE (Construction Staff Seniority) benefit by the end of September of the year in which each insurance year (1 October - 30 September) begins;
- members in the office worker category when 24 months of contributions to the Fondo Sanedil can be verified.
3
The following are entitled to the BASIC Health Plan:
- manual and office worker members who have not met the requirements for access to the Plus plan.
4
For dentistry and odontology services attributable only to the DENTAL TREATMENT envisaged by the Health Plans, the insured member must NOT attach the medical documentation, as the dentist will send the medical history form prepared by the Insurance Company. However, it is necessary for the member to expressly indicate this type of request in the space reserved on the form referred to in point 1.
5
In the case only of DENTAL PREVENTIVE cover, the member must indicate "tartar removal" on the form referred to in point 1 in the space reserved for the description of the service requested. ONLY in this case, for the cover to be acknowledged, the member does NOT have to wait for the dental practitioner to send the medical history form to the Insurance Company and may use the service upon receipt of the text message and/or e-mail confirming the appointment.
6
Dental services are only covered on a reimbursement basis if the member uses the National Health Service.
The purchase of lenses, orthopaedic and hearing aids and expenses incurred through the National Health Service are covered exclusively on a reimbursement basis, if provided for in health plans.
For all other covers, reimbursement is only permitted if the member is domiciled/resident in a province with no affiliated healthcare facilities.
7
The member is required to declare on the appropriate form the existence of any other policies covering the same insured risk. If the same risks are covered by two or more insurances, even if they are related to the Fondo Sanedil (UniSalute and UnipolSai), they will be managed, in compliance with the contractual reimbursement limits, by both companies.
An insured worker who has already been reimbursed by another company for the same insured risk shall be paid only the amount remaining for which he/she is responsible, in accordance with the deductibles and maximums and net of the amount already reimbursed, which must be documented and certified.
8
The member is entitled to an additional period of insurance cover following loss of employment, for 60 days in the case of the Basic health plan or 90 days in the case of the Plus health plan. These periods are counted from the termination of employment on a monthly basis and not for individual days.
Download required documents
Find your nearest Cassa Edile/Edilcassa
F.A.L.E.A. – EDILCASSA ARTIGIANA
Address: Via Calamandrei, 129 cap 52100 AREZZO
Tax Code: 80004910511
SCT Code: AR01
Phone number: 0575295836
Email: falea@fondosanedil.it
ENTE PARITETICO EDILE DELLA REGIONE AUTONOMA DELLA VALLE D’AOSTA
Address: Via Chambéry, 36/38, cap 11100, AOSTA
Tax Code: 80005150075
SCT Code: AO00
Phone number: 0165218711
Email: aosta@fondosanedil.it
ENTE CASSA EDILE DELLA PROVINCIA DI MASSA CARRARA
Address: Via A.Pelliccia, 5, cap 54033, MASSA CARRARA
Tax Code: 82000590453
SCT Code: MS00
Phone number: 058571545
Email: massacarrara@fondosanedil.it
Need support?
Contact your local organisation
How to claim for an accident
Reporting and opening an accident claim
The manual or office worker must submit the accident report form to the relevant Cassa Edile/EdilCassa in person or via a facilitator, or by email/registered mail.
Points to note in the reporting process
1
Applications may only be made for claims occurring after 1 October 2020.
2
It is very important that the form is filled in correctly and completely and signed by the applicant.
The following must be attached to the form:
- Available MEDICAL DOCUMENTATION as identified in the Accident Coverage Guide;
3
Claims must be reported within 24 months of their occurrence.
4
The member is obliged to submit any additional documentation on claims that have already been opened to the Cassa Edile/EdilCassa staff.
5
Solely for neuromotor rehabilitation services to be provided in research hospitals, and hospitals of national importance highly specialised in neuromotor rehabilitation, in accordance with Law no. 833/78 Art. 42 and subsequent amendments and additions, the member must apply exclusively to the following facilities.
6
The member is required to declare on the appropriate form the existence of any other policies covering the same insured risk. If the same risks are covered by two or more insurances, even if they are related to the Fondo Sanedil (UniSalute and UnipolSai), they will be managed, in compliance with the contractual reimbursement limits, by both companies.
An insured worker who has already been reimbursed by another company for the same insured risk shall be paid only the amount remaining for which he/she is responsible, in accordance with the deductibles and maximums and net of the amount already reimbursed, which must be documented and certified.
7
The member is entitled to an additional period of insurance cover following loss of employment, for 60 days in the case of the Basic health plan or 90 days in the case of the Plus health plan. These periods are counted from the termination of employment on a monthly basis and not for individual days.
Information and contacts
The member may contact the relevant Cassa Edile/EdilCassa to obtain information on the status of the reported claim. On completion of the investigation, the Company shall pay the amount due directly into the member's current account by bank transfer.
Download required documents
Find your nearest Cassa Edile/Edilcassa
F.A.L.E.A. – EDILCASSA ARTIGIANA
Address: Via Calamandrei, 129 cap 52100 AREZZO
Tax Code: 80004910511
SCT Code: AR01
Phone number: 0575295836
Email: falea@fondosanedil.it
ENTE PARITETICO EDILE DELLA REGIONE AUTONOMA DELLA VALLE D’AOSTA
Address: Via Chambéry, 36/38, cap 11100, AOSTA
Tax Code: 80005150075
SCT Code: AO00
Phone number: 0165218711
Email: aosta@fondosanedil.it
ENTE CASSA EDILE DELLA PROVINCIA DI MASSA CARRARA
Address: Via A.Pelliccia, 5, cap 54033, MASSA CARRARA
Tax Code: 82000590453
SCT Code: MS00
Phone number: 058571545
Email: massacarrara@fondosanedil.it
F.A.L.E.A. – EDILCASSA ARTIGIANA
Address: Via Calamandrei, 129 cap 52100 AREZZO
Tax Code: 80004910511
SCT Code: AR01
Phone number: 0575295836
Email: falea@fondosanedil.it
ENTE PARITETICO EDILE DELLA REGIONE AUTONOMA DELLA VALLE D’AOSTA
Address: Via Chambéry, 36/38, cap 11100, AOSTA
Tax Code: 80005150075
SCT Code: AO00
Phone number: 0165218711
Email: aosta@fondosanedil.it
ENTE CASSA EDILE DELLA PROVINCIA DI MASSA CARRARA
Address: Via A.Pelliccia, 5, cap 54033, MASSA CARRARA
Tax Code: 82000590453
SCT Code: MS00
Phone number: 058571545
Email: massacarrara@fondosanedil.it
Need support?
Contact your local organisation