Types of policies
There are three choices on types of policy:
- NATIONAL COVER WITH NO CO-PAYMENT
- NATIONAL COVER CO-PAYMENT
These vary in price and understanding your needs will direct you to the right option.
As Brokers, we can advise you on the best option and which insurance provider will best suit your needs. Policies can be complex and therefore it is recommended that you use an expert in this field when choosing a policy as there is fine print in each contract that needs to be explained.
National Coverage covers you in Spain with no payment towards consultations or operations. There is also a standard cover abroad for emergencies. This is usually 12000 euros of cover internationally. We always advise clients to take out travel insurance to supplement the national cover, meaning you are 100% covered in Spain and 100% covered abroad.
National Coverage with Co-Payment covers you in Spain, where the insured person pays towards the consultation or medical operation. This cover includes emergencies abroad.
International coverage is the 3rd option and covers 100% of medical costs in Spain and up to 90 % of costs incurred abroad. There are a few options for international cover with 100%, where there is no excess. Having no excess, however, really increases the cost and we only recommend this in a few cases.
Important points when choosing a Health insurance policy in Spain
Co-payment policies: These have variable Excess/Deductible within the policy and the reason for opting for this type of policy is purely price. If you are rarely sick it does make sense to have a policy with an excess/deductible. However, if you are for example over 50, there is an increased likelihood of illness and therefore a policy with no excess would be a more prudent option.
Where you are based: If you are based in Spain full-time, a national policy will be the sensible option. A travel policy can always supplement your national policy. If you spend six months in Spain and six months in your home country or traveling, it is advisable to have an international policy if possible.
Pregnancy and Childbirth: If you are pregnant and have no policy in place there are a few options to cover the pre-birth and delivery but the cost will be more than joining a policy not being pregnant.
Pre-existing conditions: If the insurer decides a health issue that comes up during the application process is a pre-existing condition, they may exclude the condition. For this reason, it is important to outline your medical history when filling out the health insurance application. As if the pre-condition is found out at a later date when the policy is active there is a possibility the insurer will void the policy.
In some cases, especially with chronic or terminal illnesses, medical insurers will reject your application. However, in most cases, they will accept you on the policy with the condition excluded from cover. Therefore you will not have cover for that illness, however, for any other condition or emergency, you will have full coverage.
It is rare that health insurers accept any pre-existing condition with an increased premium for the health policy. Unlike in the case of travel insurance, where this is very common.
Mild conditions are likely to be accepted with no exclusions. For example, a skin problem usually does not mean you will have cover excluded for that issue.
Ideally, you will have no pre-existing conditions and in this case, you will be accepted with no exclusions or conditions.
If you have a serious or terminal illness, we can source a company that will accept this, however certain conditions will be applied
Emergency help: All policies come with 24 hr worldwide emergency cover in relation to medical emergencies, ambulances, and home visits by doctors. Even co-payment and national coverage offer this when abroad, up to a monetary limit, and providing you are not out of Spain for a limited time, which is usually just over two months.
Repatriation to Spain: If you have a major illness while abroad having private health cover will cover you to be flown or transported by land back to Spain in case of a medical emergency. If you have an international policy you will be covered 90% abroad and have the option of being repatriated back to Spain to receive 100% coverage.
Premiums and Payment options: Prices vary depending on the cover you have purchased. Discounts are given if premiums are paid upfront. However, most people tend to purchase policies on a monthly basis with annually renewable contracts.
How to choose a private medical policy in Spain:
Which insurer and what cover you choose depends on many aspects and it is imperative you speak with an expert to run through all your options to avoid the pitfalls.