Pro Pymes Inicia Cover

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

  • Hospitalisation.
  • Surgical intervention.
  • Intensive Care Unit.
  • Childbirth.
  • 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. EXCLUSIVE DIGITAL COVER

Sanitas Pymes Digital, includes exclusive cover and differential services, which make it unique on the market, providing new solutions to your company to help optimise time and resources. With Sanitas Pymes Digital your employees have new and innovative digital cover that brings the doctor to the workplace.

Digital Doctor 24-hour video consultation with a doctor, without an appointment, in case of any emergency or query from the office.

Medical Assessment Programmes Guidance and care from specialised advisors through personalised prevention and healthcare programmes, with unlimited sessions. • Psychologists: stress management, mindfulness, etc. • Nutritionists: eating at work, eating guidelines, etc. • Personal trainers: Better posture, exercise, etc.

Physiotherapy at work or at home Under prescription, a physiotherapist will go to the employee’s company or home.

5. 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% DICOUNTS IN COMPARISON WITH MARKET PRICES.
FINANCE AVAILABLE AT 0% RATES.

 

6. 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.

FOR COMPANIES BETWEEN 20 AND 50 INSURED- NO WAITING PERIODS APPLY ( EXCEPT CHILDBIRTH)
OVER 50 INSURED: NO WAITING PERIODS APPLY.

* 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.

7. 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.

8. 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.

9. EXCLUSIONS

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.

10. 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.

A RANGE OF SUPPLEMENTS ARE AVAILABLE TO ADD TO THIS POLICY – EXPLAINED BELOW.