1. How does a health insurance work?
There are two main types of health insurances. Our main products are insurances that rely on a medical network (Cuadro Médico) of doctors, clinics and hospitals, from which the insured can freely choose the professional they wish to see. The customer registers the visits to doctors and centres with the personal insurance card, after which the invoices are sent directly to the insurance company. Therefore the customer does not need to pay the invoices nor ask them to be refunded.
The other main type is the reimbursement insurance. With this type of insurance the insured can also use other healthcare providers outside the medical network. In that case the company reimburses a certain percentage of the cost, for example 70-90%.
2. What is a copayment?
In some policies the customer is charged a copayment for each medical consultation. The amount varies according to the service and the insurance.
3. Are there waiting periods?
However, generally there are qualifying periods for the following services:
- Surgical interventions or hospitalisation for medical or surgical treatment, except in cases of vital emergency.
Oncological and cardiovascular treatments and dialysis.
Birth assistance. The waiting period does not apply in case of premature or dystocic deliveries.
If you currently have a health insurance and want to switch the company, it is usually possible to eliminate the qualifying periods indicated in its general conditions.
4. What is excluded from the coverage?
Pharmaceuticals and medicine of any class, except for the medication given during a hospitalisation, and except for chemotherapy.
Healthcare for all kinds of pre-existing diseases, injuries, defects or congenital deformities that the insured has at the moment the contract takes effect.
Diagnostics, treatments, and surgical operations carried out for strictly aesthetic or cosmetic reasons.
Travel and/or transport costs.
Transportation to/from the healthcare provider is not covered by the policy, except for ambulance transportation.
Surgical techniques employing laser, except for cataract operations and skeletal muscular rehabilitation.
Voluntary interruption of pregnancy.
5. How to contract the policy?
- The policyholder must be over 18 years old.
- All the persons applying for the insurance must fill out a health questionnaire.
- The Insurer has the right to ask the applicant for any information that they consider necessary for contracting the insurance.
In order to contract the insurance you need to complete the application and the health questionnaire. We kindly ask you to fill out the questionnaire completely and with as detailed information as possible. In case of declaring a pathology in the questionnaire and if you have a corresponding medical report, you can send it to us together with the questionnaire.