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
- More than 40 services included in your policy: consultations, cleaning, diagnostic tests, fluoridation etc.
- Discounts of up to 30% and 40%: Dental pricing is set within the Sanitas network, so that you know the fees you are paying in advance.
- Access to the exclusive Millennium 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.
- Reimbursement up to €200 euros for the treatments you need only in directory.
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 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 waiting periods, the only one remaining would be birth 8 months.
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. COVER IN THE USA
- This added benefit gives you access to private centres in the USA to one of the most prestigious clinics and hospitals, such services to be accessed, needs to be previously authorised by Sanitas. Basically, for a second medical opinion with leading professionals and US hospitals or treatment with advanced methods diagnostic and therapeutic.
- Limits: US coverage reaches 100% of medical expenses per year with capital insured and listed below:
- Total limit in the United States: 30,000 €
- Hospital care to 24,000 € with delivery to sub-limit of € 1,500.
- Outpatient assistance up to 6,000 €
8. MEDICAL ASSOCIATES
Available online in sanitas.es and also in the Sanitas APP.
9. PREMIUMS DISCOUNTS
- Discounts for number of insured in the policy:
10% if there are 3 or 4 insured
15% if more than 4 insured/policy
- Discounts per premium payment
2% for six monthly payments
4% for yearly payment
10. OTHER BENEFITS.
- Second medical opinion specialists worldwide reference in the case of diseases severe chronic.
- Coverage: in case of death of the policyholder of the Sanitas policy takes over the payments of the premium for 12 months.
- Hospitalization allowance: compensation of 69 € for each day of hospitalization, up to a 90 days as a result of illness or accident if hospital expenses are not run by Sanitas.
- New Services advantages: discounts on services such as laser eye surgery, assisted reproduction, surgery and aesthetic medicine, hair solutions … With this product, the insured already has included:
- Maintenance fees free for 20 years with the contracting of Sanitas Umbilical Cord (valued at € 1,520 approx.).
- Eco 4D free, by contracting Sanitas Umbilical Cord Treatments, Assisted Reproduction (IVF).
- € 100 in the following services: Complete checkups; Aesthetic surgery (bilateral breast reduction/augmentation, liposuction valued on more than 1,500 €);
- Laser Eye Surgery (myopia, hipermetría, astigmatism), € 50 per operated eye.
11. CANCELLATION POLICY
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.
12. LIMITS ON REIMBURSEMENT COVER
- For services utilised outside medical directory in Spain and worldwide 70%
- Contracted guarantees: Insured capital
- Total capital: 90.000€
- Hospital assistance 70.000€
- Room hospitalization per day 183.00€
- Hospitalization UCI per day 295.00€
- Normal birth 1.900, 00€
- C- section 2.000, 00€
- Medical fees, consultations on an inpatient basis ( per session, query a day) 55.00€
- Medical fees per intervention (including fees for surgeon, helper or anaesthetist)
- Outpatient surgery and minor (Group 0 classified) / per intervention 415.00€
- Outpatient surgery and minor (Group 1 classified) / per intervention 490.00€
- Outpatient surgery and minor (Group 2 classified) / per intervention 565.00€
- Medium surgery (Group 3 classification) / per intervention 1.200,00€
- Medium surgery (Group 4 classification) / per intervention 1.600,00€
- Major surgery (Group 5 classification) / per intervention 2.000,00€
- Major surgery (Group 6 classification) / per intervention 2.800,00€
- Major surgery (Group 7 classification) / per intervention 3.200,00€
- Great surgery (Group 8 classification) / per intervention 4.800,00€
- OUTPATIENT ASSISTANCE LIMITS 18.000,00€
- Primary assistance/ per consultation 45,00€
- Specialist consultation/ per consultation 95,00€
- Terrestrial ambulance 455,00€
- Odontology ( extractions, cures and cleaning) 258,00€
- Prosthesis 2.000,00€
- psychiatry 905,00€