Private Health Insurance
Everything about a private health insurance in Spain
In Spain, the health insurance policy through the government (Seguridad Social) is completely separate from the private insurers. Take out a Private Health Insurance if you want to be sure you are properly insured regarding medical costs in Spain.
Is Spain most people are therefore insured through the government and have separate private health insurance. Luckily, premiums for private health insurance are usually a lot cheaper compared to other countries.
Benefits of a private health insurance compared to the coverage of the Spanish government through the Seguridad Social:
- Private room and bathroom for hospitals admissions + bed for partner to spend the night
- No or short waiting times to go to a specialist of to have surgery / treatment
- Direct access to specialists; you do not need to be referred by a doctor, but you can make an appointment directly (with exception of the physiotherapist)
- You do not have to be an official resident of Spain or working in Spain, as long as you are there most of the time.
- Free choice of doctors, specialists and hospitals within the Cuadro Médico, which is a very complete and comprehensive list.
- The right for a ¨second opinion¨in the event of life-threatening illnesses
How to choose the right insurance package
Once you have decided to take out a private health insurance, it appears to you that the range of insurance policies are extremely large and the premiums vary enormously. What are the premium differences? What is really important when choosing health insurance?
- You must have a clear understanding of the main reason for contracting this insurance. Private health insurance is often a requirement for becoming a tax resident in Spain nowadays. In this case you must take out a health insurance that has NO copayments. Otherwise you will not meet the requirements. In Spanish they call this ¨sin copago¨
- If you don’t need the policy for your residency application, you are able to select the lowest premium, which is usually for the packages with a copayment or you can choose to pay a little more and have no copayments.
- In addition to medical care, do you also want coverage for the dentist or is this not necessary? Keep in mind that dental coverage is never for free, with the exception of a number of basic coverages which are for free. You pay a reduced rate for necessary treatments or procedures at the dentist. For children there is usually an interesting discount for the placement of brackets and the maintenance.
- Note policies that are too cheap, this could mean that certain coverages are excluded. Always check very carefully what is excluded.
- Can the insurer unilaterally cancel the policy if the customer becomes seriously ill and therefore has high costs for the insurer? Unfortunately, there are insurance companies in Spain that actually do this. The customer pays a yearly premium, while he or she practically does not use the policy, but when the customer suddenly needs to use the policy a lot, and costs rise, the insurer unilaterally cancels the policy. Note that our insurer is not allowed and cannot do this. The only reason for unilateral cancellation is when the customer doesn’t pay his premiums.
- There are policies which allow a complete free choice of doctors, specialists or hospitals. The premiums of these types of policies are considerably higher and usually this is not necessary because you already have a wide selection of the best specialists through the insurer´s medical guide.
- Would you like to go to a doctor outside Spain? Because for example, you travel a lot? There are policies that offer the option of visiting a doctor also when it doesn’t concern emergency visits.
What to keep in mind in any case
- Most private insurers only accept new customers up to the age of 67. After that, it is difficult or impossible to take out private insurance, so make sure to be on time!
- Private insurers may discriminate based on age or medical history. They only accept very healthy people and completely exclude all existing medical complaints from coverage. Such as High blood pressure, cholesterol and diabetes are the likely reasons not to be accepted for this insurance.
- If you have medical history, it is advisable to ask your doctor for a medical report in English, with stamp and signature.
- All private insurers have a waiting period (¨carencia¨). This is a period in which you are NOT yet entitled for full coverage. This period differs per insurer between 10 and 12 months and usually excluded the following coverage in this period: operations, hospitalization, childbirth, expensive examinations (cat scan, etc.). Only when you come from another Spanish private insurer (recently) these waiting times will be waived, except for child birth.
After reading this you will undoubtedly have many questions. We are here for you, to guide you and to help you make the right choice for you and your family.