Skip to Content

Segmentation

At SMA NEUTRA, we are committed to offering hospital insurance that is accessible to everyone, while ensuring coverage tailored to each individual. To achieve this, we apply segmentation techniques during the underwriting process and throughout the life of the contract.

This method allows us to identify the different levels of risk associated with each insured person and to take them into account in:

  • The acceptance policy;
  • The pricing structure;
  • The scope of coverage.

We use clear and transparent criteria to ensure a fair approach for all our members.

This is used at the time of subscription or during the term of the contract to determine the amount of the premium.
​ The premium is higher when the policyholder has dependents.

⚠ This criterion applies only to Neutra Base & Neutra Optimum.

At the time of enrollment :

  • People aged 65 or over benefit from a maximum waiting period of 12 months;
  • Statistical data show that the risk of hospitalization increases with age.

 In the Neutra +,Neutra Confort, Neutra Top and Dentalis plans age also influences the amount of the premium at the time of enrollment and throughout the term of the contract.

When a person is pregnant at the time of enrollment:

  • A 9-month waiting period applies
  • However, partial coverage is granted from the 7th month onwards.

⚠ This criterion applies only to product Dentalis.

If you were affiliated with an equivalent insurance plan at another entity before joining SMA NEUTRA, you may be eligible for a waiver of the waiting period equivalent to the period already covered.

Membership of the product is reserved for members of the following mutual insurance companies:

This condition applies at the time of subscription and throughout the entire insurance period.

Some specific treatments require a longer internship. For procedures such as orthodontics, prosthetics, or dental implants, the internship lasts 12 months.