Thursday, 20 November, 2014
Private Health Insurance in Spain

The recent turmoil in the worlds economy has served to highlight that the welfare state in Europe as we know it, is no longer sustainable. One of the consequences will be that the way in which Governments provide healthcare will experience a major upheaval, with more onus being placed on individuals to bear a larger share of the cost. This in turn will lead to an increased demand for private health insurance, and the insurance industry will most likely respond with a wider variety of products and services to plug the gaps left by the State.

"The Welfare state in Europe is no longer sustainable."

Insurance is at the best of times fraught with potential problems, pitfalls, exclusions as well as of course relief and satisfaction when the Insurance policy does what it is supposed to do - pay out in the event of a loss. This is particularly true of the health insurance market, where we have the added complication that we are dealing with an incredibly emotive and sensitive area such as someones personal health and wellbeing.

"Certain diagnositic procedures and treatments may require prior authorization by the insurer."

Currently health insurance products in Spain fall into two main categories, and premium rates tend to be very competitive, although by the same token the limits and sublimits contained within the policies tend to be lower than in the UK. The first category is where in exchange for a premium an Insurer will provide an extensive network of doctors, specialists, medical centres and hospitals throughout Spain, and all the client need to do is visit one of these approved centres and upon presentation of their membership card the centre will invoice the Insurer directly without the client having to part with any money. Certain diagnostic procedures and treatments may require prior authorisation by the Insurer so it's best to check with your Broker first or indeed the helpline provided by the Insurer.

The second category is where in addition to providing the network of specialists, the Insurer also offers the possibility for the client to go to any healthcare specialist or centre not on the approved panel, and to then present the Insurer with the corresponding invoice and they will reimburse up to 90% of the invoice. This free choice extends to medical professionals and centres both inside and outside of Spain, but again, it's always best to keep your health insurer informed of any treatment you require as often they will need to approve certain treatments.

"Golden rules when buying your Private Health Insurance"

For anyone seeking to buy private health Insurance, or indeed for those who already have it, but who want to avoid any nasty surprises in the event of a claim, I would highlight the following "golden rules";

1. Ensure that you disclose any pre-existing medical conditions when completing the application for health insurance. The advice here, is if in doubt declare it, and do not give Insurers an excuse to contest your claim.

2. If you have private health insurance, and have an existing medical condition, be aware of being tempted away by cheaper alternatives, as you may find that the new Insurer will exclude any future treatment of existing conditions or anything related to them.

3. Make sure you fully understand how your health insurance policy functions, and in which circumstances you must seek approval from your Insurer before receiving treatment.

4. Before buying your health insurance, make sure that you fully read the policy wording, so as you are completely aware of any limits, sub-limits and above all exclusions which are applicable to your contract. Most Insurers in Spain now have policy wordings in different languages, so this should not be a problem. If you are unsure, or the policy does not fully meet your requirements, flag your concerns to your broker and they should be able to recommend suitable alternatives.

5. Ensure that the policy you choose suits your lifestyle, and if you travel extensively and require overseas cover, then make sure that this option is included.

Private Health Insurance plays a very important role in modern society, and many people experience first hand the enormous benefit of having this type of insurance. However, it is also only fair to say that Health Insurance is a minefield of options, limits, exclusions etc., and if you are considering buying private health cover the best advice is to arrange a meeting with a specialist independent and regulated Insurance Broker who having listened to your requirements should be able to recommend a suitable policy.

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