1. PRIMARY CARE
- General Medicine (GP).
This includes medical care in a healthcare centre, indication and prescription of basic diagnosis tests and procedures (analysis and general radiology). It includes also home services when your illness is preventing from attending the consulting room.
- Paediatrics – care of children until the y are 15 after they can use a GP.
- Nurse care service: Includes healthcare at the healthcare centre and at home.
- Emergencies: These include healthcare provided in permanent emergency centres that belong to Sanitas.
- Transfer of sick person by ambulance- performed by land.
- Preventive medical check-ups.
2. MEDICAL CARE PROVIDED BY SPECIALISTS
- Access to specialist care, including outpatient surgery.
- Genetic studies: Comprises only those necessary for diagnosis and/or prescription of treatment of affected and symptomatic patients.
- Additional methods of diagnoses. Radiology, CT scanner, electrocardiogram, etc.
- Ultrasound, allergy tests.
- Functional tests.
- Cobalt therapy, chemotherapy, rehabilitation, radiotherapy, physiotherapy, oncology, etc.
- Obstetric-Gynaecological Nursing (Midwifery)- Care provided by a midwife will be available only for hospital-based child delivery.
- Speech and Language Therapy: It is included only when related with organic processes, to a maximum of 6 months a year per Insured.
- Podiatry (Chiropody exclusively).
3. HOSPITAL CARE
- Surgical intervention.
- Intensive Care Unit.
- Clinical Psychology.
- Single room with bathroom as well as all the expenses arising from hospitalisation.
- Accommodation, meals, medication.
- Bed for companion.For all specialities: medical fees, costs arising from surgery.
4. DENTAL COVER- DENTAL 21
- More than 30 services included in your policy: consultations, cleaning, diagnostic tests, fluoridation etc. rest of the services have a deductible that you will pay at the clinic.
- Discounts of up to 21% Dental pricing is set within the Sanitas network, so that you know the fees you are paying in advance.
- Access to the exclusive Milennium Dental Centres: These centres are equipped with the latest technology and all dental specialties and diagnostic tests are available under one roof.
- Modern treatments using state of the art technology, at your service: All the benefits of a quality dental plan provided by the leading medical insurer in Spain.
DENTAL SUPPLEMENT AVAILABLE: 10, 90€ MONTH PER PERSON PER MONTH – 40-50 SERVICES INCLUDED WITH 40% DISCOUNTS IN COMPARISON WITH MARKET PRICES.
FINANCE AVAILABLE AT 0% RATES.
5. WAITING PERIODS *
This is the period of time (calculated by months elapsed from the effective date of the insurance) during which some of the covers included do not enter into force, these are applied to all new customers that enter the private sector new and standard industry ( applied by all insurers).
- Vital Emergencies: IMMEDIATE ( possible death within 24h report required)
- Outpatient surgery: 3 months
- High technology diagnostic tests: 6 months (ex MRI, PET).
- 20 week scan pregnancy: 6 months
- Endoscopy and colonoscopy : 10 months
- Psychology: 6 months.
- Childbirth and C section: 8 months.
- Hospitalisation, including inpatients, day patients 10 months.
- Radiotherapy, chemotherapy, cobalt therapy, radioactive isotopes, linear accelerator, scanner, magnetic resonance, nuclear medicine, bone densitometry, lithotripsy, digital arteriography, radio-neurosurgery and prostate hyperthermia services: 10 months.
* If transferring from another insurance company in Spain or any of the BUPA GROUP and have been with that insurer for more than a year, by providing a copy of your particular conditions and last receipt of the premium with them, Sanitas will eliminate all waiting periods.
6. WORLDWIDE EMERGENCY HEALTHCARE.
- Emergency overseas travel assistance: up to a maximum of €12,000 per person/year provided that the care required occurs within the 90 consecutive days from the start of the trip.
- Covers expenses from doctors, surgeons, hospitals and/or clinics outside Spain as a result of medical attention received abroad, derived from an illness or accident occurring abroad.
- Doctors’ fees.
- Drugs prescribed by a doctor or surgeon over 3 euros.
- emergency dentistry fees, excluding endodontics, aesthetic reconstructions from earlier treatments, oral cleaning, prosthesis, crowns and implants, these are covered by the previous amount up to a maximum of €241 per insured.
- Hospitalisation costs.
- Costs for ambulance services requested by a doctor for a local journey.
To use this cover while abroad you first need to contact Sanitas Emergency Abroad Numbers from the back of your Sanitas membership cards and they will advise where to go in case of emergency in the area you are at that time. T& C of this cover available below.
7. MEDICAL ASSOCIATES
This plan is to be only used within medical associated clinics and doctors; the list is available online in sanitas.es and also in the Sanitas APP.
The cover excludes, although we know that there remain competitiveness and that remains a complete healthcare product:
- Health care provided at clinics that are not associated.
- Healthcare derived from chronic alcoholism, drug addiction or intoxication due to abuse.
- Water and home birth.
- Voluntary interruption of pregnancy.
- Surgery relating to Parkinson’s, Epilepsy and radiosurgery.
- Vaccines and autovaccinations of all types.
- Alternative medicine.
- Acts of war.
9. CANCELLATION NOTICES
Contracts are annual and if you wish to cancel you will need to send a letter requesting cancellation one month prior to renewal of your policy.
10. CO-PAYMENT CHARGE
These are additional charges applied to Mas Salud Optima and Plus when utilizing the services, these are applied according to the below tables of excess and they are per medical act used ( even if you are going to have one visit to the clinic, within that visit more services can be performed).
Co-payments are charged every month and are based on services/individual tests used. If you don’t use any services you’ll receive no extra charges together with the premium, breakdown of these charges are available either asking us for it or logging into your own sanitas.es private client area.
Mas Salud No Excess – Co-payment charges (N/A)
MAS SALUD PLUS.
SANITAS DENTAL 21
- 3,00 euros per visit
SANITAS MÁS SALUD PLUS
Antenatal classes; Physiotherapy (10 sessions), ventilation therapy (15 sessions), oxygen therapy (30 days for BPAP and CPAP and 15 days for aerosol) : • 12,00 euros
Other services (number of consultations per year):
- From 0 a 6 medical acts within the same within the same year –> 0,00 euros
- From 7 a 10 medical acts within the same within the same year –> 4,00 euros
- From 11 a 15 medical acts within the same within the same year –> 7,00 euros
- From 16 a 999 medical acts within the same within the same year –> 10,00 euros
SANITAS MÁS SALUD OPTIMA
SANITAS DENTAL 21
• 3,00 euros per visit
Antenatal classes; Physiotherapy (10 sessions), ventilation therapy (15 sessions), oxygen therapy (30 days for BPAP and CPAP and 15 days for aerosol) : • 20,00 euros
Diagnosis/therapeutic tests, complex: 12€
Other services (number of consultations per year):
- From 0 a 3 medical acts within the same within the same year –> 4,00 euros
- From 4 a 10 medical acts within the same within the same year –> 7,00 euros
- From 11 a 15 medical acts within the same within the same year –> 10,00 euros
- From 16 a 999 medical acts within the same within the same year –> 15,00 euros
A RANGE OF SUPPLEMENTS ARE AVAILABLE TO ADD TO THIS POLICY – SEE FULL SPECIFICATIONS BELLOW.