Students Health Insurance Basic

We will contact you as soon as your application has been reviewed!

Personal Information
FeelsLikeHome Membership
Health Questions
Payment Details
Summary

Order Number

Personal Information

1) Insurance Holder (parent or legal guardian)

Gender *

Male Female

First Name: *

Last Name: *

Street *

House Number *

Door Number *

Postal Code *

City *

Citizenship *

Date of birth: *

E-Mail Address *

Phone number (in case of emergency)

2) Insured Person (student)

Gender *

Male Female

First Name: *

Last Name: *

Street (Adress in Austria) *

House Number *

Door Number *

Postal Code *

City *

Citizenship *

Date of birth: *

E-Mail Address *

Phone number (in case of emergency)

Which educational institution do you attend? (please specify) *

How did you hear about us? *

If other, please specify

In order to buy this insurance at our discounted group price, you need to be a part of the FeelsLikeHome.at community.
FeelsLikeHome.at is a platform for expats and international students that provides all necessary information. There is no membership fee or anything like that. It is a free community from internationals - for internationals.

Password: (8 characters minimum)

Repeat Password:

The Passwords you entered did not match

Your Password must be at least 8 characters long

Student confirmation: *

I hereby confirm that my child/guarded child is currently a student of an educational institution (accepted)

Health-related questions

Please answer the health questions for the insured person

Height (in cm) *

Weight (in kg) *

Are you currently or have you been treated for one of the following health impairments?*

diabetes
HIV-positive results
excessive overweight (body Mass Index over 38)
chronic liver disease
chronic inflammable bowel disease
chronic kidney disease
chronic lung disease
Hepatitis B
Hepatitis C

Are you currently or have you been treated for one of the following health impairments? (1)

Yes No

If Yes, please give details

Have you ever had benign or malignant tumours such as leukaemia, breast cancer, melanoma, brain tumour, adenoma etc. Have you ever had chemotherapy or radiotherapy? *

Yes No

If Yes, please give details

Are you currently or have you been treated for one of the following health impairments?*

Heart attack
chronic heart disease
vascular disease (e.g.PAOD/peripheral arterial occlusive disease, aneurysm..)
blood -clotting disorder (also caused by medication)
blood diseases (e.g. haemolyitic anaemia such as sickle cell anaemia)
congenital anomalies (e.g.meabolic diseases, hormone disorders, cleft lip/palate)

Are you currently or have you been treated for one of the following health impairments? (2)

Yes No

If Yes, please give details

Are you currently or have you been treated because of psychological illness over the last 3 years? *

Yes No

If Yes, please give details

Have you had any medical required treatments (inc. drug therapy) or contact to a medical specialist within the last 3 years? *

Yes No

If Yes, please give details

Are you currently or have you been treated because of complaints of the musculoskeletal system over the last 3 years? *

Yes No

If Yes, please give details

Did you have a coronavirus infection in the last 3 months? *

Yes No

Did you have a coronavirus infection with longer lasting (more than 4 weeks) symptoms/ consequences or hospitalization in the last 12 months? *

Yes No

If Yes, please give details

Have you planned any out-patient treatment, medical examination, in-patient hospital stay or a stay at a health resort or rehabilitation center, or has such been advised by a doctor? *

Yes No

If Yes, please give details

Are you doing sports professionally? (If sport is your main source of income) *

Yes No

If Yes, please give details

Are you currently pregnant? (If male, please click No) *

Yes No

Start Date of Insurance Period:

You can choose the start date of your insurance (always the 1st of the month).

If you want to be insured immediately, please chose the current month*.

*If this date is in the past the insurance period will start with this date and you have to pay premium for the whole period. Insurance cover (payment for expenses for medical treatment) will not start before we have accepted your application for insurance.

You will be insured instantly after receiving a positive answer that you have been accepted (confirmation e-mail).

Choose start date of insurance: *

Bank Details:

Please enter your Austrian or other European Bank Account.

The payment will be withdrawn from your account automatically.

Bank Name *

IBAN Code (20 digits) *

Payment method – Direct Debit

SEPA-Direct Debit Mandate (Authorization to collect the receivables via SEPA Direct Debit)

I/We allow the named recipient of payments to withdraw payments from my/our bank account via SEPA-Direct Debit.

In addition, I/we authorize my/our credit institution to transfer the claims made by the named recipient of payments from my bank account via SEPA-Direct Debit.

I/We can request within eight weeks from the debit date a refund of the charged amount. The agreed upon with my/our credit institution conditions are valid in this case.

IBAN
Payment recipient:

UNIQA Österreich Versicherungen AG
Creditor-ID: AT10AT00000001017
A-1029 Wien, Untere Donaustraße 21

Payment method confirmation *

I hereby confirm the payment method

2. Your Product:

Student Health Insurance BASIC
Price: EUR 64.07 / month
Insurance provided by: UNIQA Insurance AG

The legally binding language version of all documents and information is German. Documents and information given in English shall be only of an informative nature!

General Terms and Conditions of Insurance*
Terms and Conditions of Student-Plus- Insurance(German & English)*
Distribution & Withdrawal Information*
Factsheet (German)*
Data Protection Policy*

confirm_avb

➢ I hereby confirm that I have downloaded and accepted all terms of insurance

confirm_avb

I hereby confirm that I have downloaded and accepted the terms for processing my health data

Privacy Statement*

privacy_policy

I hereby confirm that I have downloaded and read the privacy policy

Sorry!

You have answered one or more of the health questions with "YES".
Therefore you cannot take out the insurance online.

But don't worry - we will find a solution for you.
We have received your contact information and will shortly get in touch with you for an individual quote.