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
- Specialist medical 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.
- Ultrasound, allergy tests.
- Functional tests.
- Cobalt therapy, chemotherapy, rehabilitation.
- 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
This covers outpatient surgical interventions.
Should you require inpatient surgery, the insured covers part of the costs and Sanitas assumes the rest.
The share of the cost of services by the insured is divided into three levels, depending on the complexity of the intervention and cost associated:
- LEVEL 1 €1000 Hospitalisation without surgical intervention.
- LEVEL 2 €2000 Surgical operation e.g. caesarean birth.
- LEVEL 3 €3000 Major surgical operations e.g. open-heart operations.
You will need to contact us to organise the authorization of the service that you require before arranging your admission to hospital so you know the level of what we cover and the services that you need to pay for.
4. WAITING PERIODS *
- Vital Emergencies: IMMEDIATE (possible death within 24h).
- Outpatient surgery: 3 months.
- High technology diagnostic tests: 6 months (ex MRI, PET).
- Psychology: 6 months.
- Childbirth: 8 months. (This applies even if you proceed from another company).
- 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.
- Vasectomy: 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 all waiting periods.
5. WORLDWIDE EMERGENCY HEALTHCARE.
- Emergency overseas travel assistance: In collaboration Olympus, up to a maximum of €12,000 per year.
- 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.
- 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.
6. MEDICAL ASSOCIATES
Medical network can be found by downloading the Sanitas App or in sanitas.es.
7. CO PAYMENTS (EXCESS)
The coparticipation in the cost of services or copayment is a measure established by the majority of the Health insurance companies with the purpose of making their insured aware of the responsible use of the medical services.
In the other hand, with the copayment generic increases of Premium to all the portfolio of customers are avoided due to the distribution of such cost according to the use of the medical services performed by each client.
Below detail of the copayment that you will have to pay for each use of the services, this is charged monthly together with the premium.
SANITAS DENTAL 21
3,00 euros per service that is already included in the policy, the services with deductibles have no excess attached to them.
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.
8. 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. Maximum contractual age 75 year, once contracted there is no upper age limit to remain insured.