RESIDENCY / VISA COMPATIBLE PLANS
WITH REIMBURSEMENTS
In network and to your choice: these policies apart from being able to utilise the clinics associated you can also use the clinics to your choice, outside network in Spain and worldwide, you usually have to pay for the medical bill upfront and the invoice to our claims department for the reimbursement, they usually take around 10 days for the funds to get back to your account. These are very comprehensive plans that include:
PRIMARY CARE
1. General Medicine: this includes medical care in a healthcare centre, indication and prescription of basic diagnosis tests and procedures (analysis and general radiology).
It includes also home services when, for reasons attributable only to the insurer’s illness, it is not possible to attend a consulting room. In emergencies the insured shall go to the permanent emergency services or else contact emergency customer service using the information provided on the back of your medical cards.
2. Pediatrics and Childcare: This includes the care of children up to 15 years old in consulting room and at home, the indication and prescription of tests and basic diagnosis procedures (analysis and general radiology)
3. Nursing service includes medical care at the healthcare centre and at home.
EMERGENCIES
The policy includes healthcare in the event of emergency. It will be provided in the permanent emergency centres agreed with the insurer and listed in the User Guide to Doctors and Services corresponding to this expat health cover policy.
SPECIALIST CARE
This policy includes all specialist care ( allergology, traumatology, gynaecology, dermatology, etc) and there is no need to go to a General medicine doctor prior if you know what type of specialist to attend, diagnostic tests, including simple (ultrasound scans, blood tests, etc.) and high-tech tests (CT scans, MRIs, etc.).
• Therapeutic methods, including simple (rehabilitation, aerosol therapy, etc.) and high tech methods (lithotripsy, radiotherapy, chemotherapy, etc.).
• Hospitalisation and surgery.
Hospitalisation in a clinic or hospital assigned to your insurance. In case of admission, the patient shall occupy a conventional, individual room with a bed for relatives, except in psychiatric hospitalisation, in ICU and in incubator and the insurer will cover the expenses arising from performing diagnostic and therapeutic methods, surgical treatments (including operating theatre and medicine expenses, provided that they are used in accordance with the indications set out on the product datasheet, except medicine that is not authorised for sale in Spain) and bed and board of the patient.
Usually, preventative care is not covered in Spanish policies, most insurers have covered the following:
• Preventive medicine includes programmes applied to healthy populations covering different activities such as medical consultations, physical exams and basic diagnostic tests prescribed by the specialist concerned for early disease diagnosis:
Pediatrics: Provides for consultation with a specialist, new born health checks (including metabolic screening and early hearing impairment detection via OAEs or AEPs where necessary) and regular health checks to monitor child development (from birth to 11 years of age).
Gastrointestinal Tract: Includes consultation with a specialist and a physical examination as well as basic diagnostic tests.
Cardiology: Includes consultation with a specialist and a physical examination as well as basic diagnostic tests (e.g., ECG, basic blood and urine tests) and a stress test to establish coronary risk.
Pneumology: Includes consultation with a specialist and a physical examination as well as basic diagnostic tests (e.g., chest x-ray).
Gynecology: Provides for an annual gynaecological check for cervical, endometrial and breast cancer prevention. Includes consultation with a specialist and a physical examination as well as basic diagnostic tests (e.g., ultrasound scan, mammogram, pap smear test or gynaecological ultrasound scan).
Urology: Provides for a medical consultation with a specialist and basic blood tests (including PSA determination) and urine tests, along with other basic diagnostic tests (e.g., ultrasound scan and/or prostate biopsy). The recommended frequency for these exams varies in line with the characteristics of each case, which is why it is up to the specialist to establish recommendations in accordance with the expat health cover policy.
EMERGENCIES ABROAD FOR STAYS OF UP TO 90 DAYS
Limits: Usually there are limits per person per year, always check your policy documents to see these limits. And they cover the below:
- Medical expenses (doctors, surgeons and hospitals/clinics) medicine prescribed by a doctor, emergency dentist expenses up to a limit per Insured, excluding expenses related to endodontic treatments, cosmetic reconstructions of previous treatments, teeth cleaning, caps, and implants.
- Hospital fees.
- Fees for an ambulance ordered by a doctor for a local journey.
- Dental cover (see dental section in your policy documents).
- International second opinion:
Includes a second opinion on medical diagnosis or treatment in the event of serious chronic diseases requiring scheduled care of which the course may require new diagnostic tests or therapeutic measures and whereof the life prognosis is seriously compromised. This second opinion shall be issued by a medical report by leading specialists, healthcare centres, physicians or academics in any country in the world, designated by the insurer. Contact us to check what documents are needed for this service to be provided.
Reimbursement benefits – we send the plans limits when we send the personalised quotations:
50.000€ with a reimbursement option of 80%
150.000€ with a reimbursement option of 80%
200.000€ with a reimbursement option of 80%
300.000€ with a reimbursement option of 80%
