How to find the best private health insurance in Spain!

Are you thinking about taking out private health insurance in Spain?

There are many private insurance companies in Spain that offer a wide range of products and health insurance plans, from basic to premium or complete cover.

To help you understand what types of private health insurance are available in Spain and what you should consider when choosing a suitable private health insurance policy, I have put together this guide especially for expats and foreigners.

ASSSA Insurance: Your right private health insurance in Spain with personal and professional advice, also in English:

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General information on private health insurance

Anyone staying in Spain who is not covered by state health insurance or the European Health Insurance Card (EHIC) must take out private health insurance (‘seguro médico privado’ or ‘seguro de salud’).

Private health insurance in Spain can be taken out in addition to the statutory compulsory insurance or as a substitute.

It is a full insurance that includes private outpatient, inpatient and other (optional) benefits, depending on the level of cover.

It basically offers more comprehensive healthcare than the public healthcare system, as private health insurance in Spain attempts to close gaps and therefore often covers health benefits that are not or only insufficiently available in the Spanish state social security system.

What are the advantages of private health insurance?

The advantages of private health insurance in Spain over public healthcare are the comprehensive cover, the personalisation of services and the comfort of the facilities.

These include above all:

• Shorter or no waiting lists

• Direct and fast access to a specialist without having to go through a general practitioner (GP) first

• Faster diagnosis as a result

• Greater choice of doctors’ surgeries and hospitals

• Free choice of hospital and treating doctor

• Personalised and professional customer service in your own language.

• Access to alternative treatment methods and new techniques. As a result, the quality of medical services is generally much better

• Flexibility in the choice of appointments and in obtaining a second medical opinion

• Additional benefits, such as reimbursement of costs for ophthalmologists and dentists, pharmacies or cover for accidents at work

• Access to single rooms and higher benefits for accompanying persons in the event of hospitalisation

What do I need to know if I want to take out private health insurance?

Health insurance policies (‘póliza de salud’) consist of a number of features and conditions in addition to the insurance cover.

You should always consider the following criteria when taking out health insurance in Spain:

Cancellation protection

There should be a contractual guarantee that the insurance company cannot cancel the policy due to age, illness or high policy utilisation.

Spanish private insurers can unilaterally cancel the insurance cover without giving reasons. This may mean that you can no longer take out private health insurance because you may be too old or already too ill.

The health questionnaire (‘cuestionario de salud’)

Before taking out a policy, you will be asked to complete a questionnaire.

This is a document in which you must enter all the information about your health so that a risk profile can be determined.

All chronic illnesses or pre-existing medical conditions should be stated.

The medical directory (‘cuadro médico’)

The insurer will provide you with a list of doctors and clinics that have a contract with the insurance company.

You can then use the doctors and clinics in this network with or without co-payment.

Private health insurance companies generally have their own clinics, laboratories and care centres. This means that insured persons no longer have to wait in long queues and receive the results of their analyses or tests much more quickly.

There are major differences in the ‘cuadro médico’ of the various companies. Above all, you should pay attention to the extent to which doctors who speak your language are listed.

The co-payments (‘copagos’)

A co-payment (excess) is a certain amount that you have to pay each time you make use of a private medical service and which is added to the fixed premium of your health insurance.

Depending on the type of co-payment agreed in the contract, the amount will be higher or lower.

There are policies with a fixed annual co-payment limit as well as policies with no co-payment.

The waiting periods (‘carencias’)

The waiting period refers to the time you have to wait from the time you take out health insurance until you start utilising certain benefits.

This means that a certain period of time must elapse from the conclusion of the contract before you can make use of certain specialists or services. Your insurer sets this period in advance. The insured person must pay the costs of the necessary treatments until this period has expired.

If you want cover from the first day you take out the policy, you should choose an insurance company that offers this option.

Pre-existing medical conditions (‘preexistencias’)

The illnesses you have before taking out the policy must be clarified with the insurance company using the health questionnaire.

If you already have diseases, exclusions from insurance cover or additional premiums are usually agreed. Depending on the pre-existing condition, cover may also be refused.

Exclusions and restrictions

Spanish insurers completely exclude various benefits from their catalogue of services or only insure them to a limited extent.

These usually include, for example, any type of pre-existing health condition, medication, remedies and aids, comprehensive preventive care, dental treatment, naturopathy, cost-intensive treatments such as dialysis, HIV and psychotherapy.

In most cases, there is also only minimal cover when travelling abroad.

However, there are also Spanish insurers who do without all these exclusions.

Healthcare abroad

Most private health insurers offer international health insurance cover when travelling abroad. Including repatriation

As a rule, cover is provided for emergencies, but not for planned treatment or operations.

The maximum age for taking out cover

This depends largely on the insurance company with which you wish to take out health insurance.

In general, the age limit is between 64 and 69.

However, there are also policies from insurers that are specifically customised for the over 70s.

What types of private health insurance are there?

There are many types of private health insurance in Spain, depending on the coverage and the way the premium is paid.

In general, they can be categorised as follows:

Medical directory with co-payments (‘cuadro médico con copagos’)

Here, insured persons have the option of visiting the doctors or medical centres listed in the medical register. However, in addition to the insurance premium, you have to pay a fee for each service you use.

The advantage of an insurance with co-payment is that your premium is usually low and the amount you pay for each consultation with the doctor is not the actual price, but only a small part of it.

These policies are ideal for people who do not need to go to the doctor frequently.

Medical directory without co-payments (‘cuadro médico sin copagos’)

These are insurance policies for which you pay a single premium. You can go to the doctor as often as you like without having to make any co-payments per consultation. However, this increases the price of the premium.

You can choose between all medical centres and hospitals that have contracts with the insurance company.

Health insurance with reimbursement (‘seguro médico con reembolso’)

With this type of policy, you have a free choice of private doctors and clinics, regardless of whether they have contracts with a particular insurer or not. This free choice is sometimes even granted worldwide.

The policyholder must pay the costs of the treatment received in advance. The insurer then reimburses a significant percentage of this, usually between 70 % and 90 %. This means that part of the costs must be borne by the policyholder. In some cases, 100% of the costs are also reimbursed.

This type of health insurance has a higher premium than other insurance policies, where you have to be content with the existing list of doctors.

It is an interesting model for those who opt for private health insurance but want to go to doctors who are not on the list of doctors of the company with which they want to take out the policy.

Product without hospitalisation (‘Producto médico sin hospitalización’)

These policies exclude hospitalisation.

Dental insurance

It only covers dental treatment and services that are usually also included in more comprehensive health insurance plans.

For your right medical insurance cover I recommend the private health insurance from ASSSA: especially designed for expats with the best private health services in Spain (expert advice in English)

It is suitable for Visa and Residencia applications.

What does private health insurance cover?

Private health insurance in Spain primarily covers the following benefits:

General medicine (‘medicina general’)

The insured person chooses their general practitioner/family doctor from the company’s list of doctors.

Treatment is generally carried out at the doctor’s surgery. However, in many cases, if circumstances require it, it is also carried out in the patient’s home.

Paediatrics (‘pediatría’)

This is specialised medical care of infants, children and adolescents usually up to 18 years which, like general medicine, is provided in the doctor’s surgery or at home.

Nursing (‘enfermería’)

The nursing service is provided in the doctor’s surgery or sometimes at home, as prescribed by the family doctor.

Hospitalisation (‘hospitalización’)

Guarantees the patient’s free stay in a private hospital for at least 24 hours.

Day hospitaI (‘hospital de día’)

Patients have the option of staying in this type of clinic after a specific treatment or anaesthetic, usually for less than 24 hours.

Emergency service (‘servicio de urgencia’)

The medical register contains telephone numbers and addresses to contact in an emergency.

Special treatments:

Some insurance policies also include services such as

• Oncology with chemotherapy and radiotherapy, rehabilitation and physiotherapy, transplants, pain therapy, etc.

• Preventive medicine (‘medicina preventiva’)
  • Annual check-ups for cardiology, gynaecology, urology, digestive system and children’s health.

• Dental care
  • Services such as diagnosis and prevention, dental cleanings, extractions, fillings, root and gum treatments, dental surgery, implants and orthodontics.

How much is private health insurance in Spain?

The amount of the insurance contributions (or premium) is calculated according to

• age and gender, as well as the
• extent of the desired insurance cover.

Spanish private health insurance is very reasonably priced due to the low fee agreements with private doctors and clinics compared to other European countries and the exclusion of various services.

You can find insurance policies for less than €10 per month. However, the monthly premiums for private health insurance in Spain generally start at around €30 to €50, depending on the type of insurance and level of coverage.

How do I choose the best private health insurance?

There is a large selection of private health insurances in Spain.

In order to make a suitable choice, it is therefore advisable to be well informed or to seek detailed advice.

The cheapest offer is often not the best.

It is therefore very important to compare the offers and health plans of the different insurance companies: the coverage provided, the clinics, laboratories and specialists they work with, the amount of premiums to be paid, special conditions and much more.

However, the fundamental aspect that should be considered before taking out private health insurance in Spain is the

Coverage of your needs

This means choosing the type of insurance that best suits your needs and wishes.

Do you just want basic insurance that covers general services, or do you want more comprehensive insurance that also includes specialised treatments and benefits, such as cover abroad, hospitalisation, dental care, etc.?

Treatment in your own language may also play a part of your decision.

If you need private health insurance to apply for residency in Spain (Visa or the EU registration certificate), you should check whether the health cover is suitable for your residency application.

Do you already have private health insurance in Spain?

Please let me know about your experiences.

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