Sanitas Avanza Cover

 

1. HEALTHCARE BENEFITS

  • Unlimited Consultations: Enjoy unlimited consultations in primary care and across all specialties. Our team of more than 3,600 doctors, including specialists in general practice, is ready to provide you with expert medical advice.
  • Simple Diagnostic Tests: As part of our comprehensive coverage, we offer a wide range of simple diagnostic tests, including blood and urine tests, and simple radiology procedures. These tests help us assess your overall health and detect any potential concerns.
  • High-tech Diagnostic Tests: Our healthcare plan includes access to high-tech diagnostic tests, such as CT scans, MRIs, and ultrasound scans. These advanced imaging techniques allow for more detailed and accurate diagnoses, ensuring effective treatment plans.
  • Simple Therapeutic Methods: We understand the importance of providing holistic care. Our healthcare plan covers various simple therapeutic methods, including physiotherapy, aerosol therapy, wound treatment, and more. These methods are designed to promote your well-being and aid in your recovery.
  • More than 400 Surgical Procedures: Our comprehensive coverage extends to over 400 surgical procedures, including tooth extraction, abscess treatment, vasectomy, and tonsil removal. These procedures are performed by skilled medical professionals to ensure the highest level of care, only outpatient.
  • Basic Dental Cover: Maintain optimal oral health with our basic dental cover, which includes consultations, scale and polish procedures, wound treatment, and extractions. We prioritize your dental well-being as an essential part of your overall health.

2. SANITAS DIGITAL BENEFITS

Video Consultation with All Specialties: Connect with our extensive network of doctors, covering more than 3,600 specialists from various fields, including general practice, through video consultations. This convenient feature allows you to receive medical advice and guidance without the need for in-person visit With unlimited consultations
  • 24-Hour Emergency Support: Experience peace of mind with our 24-hour emergency video consultation services. Whether you require immediate medical assistance for general or pediatric emergencies, our dedicated team is available to provide prompt and expert care, without the need for appointments.
  • Personalized Digital Health Plans: Take advantage of our personalized digital health plans, which cover a range of specialized areas such as Personal Trainer, Nutrition, Child Health, Pregnancy, and more. These plans are designed to cater to your specific needs, providing tailored guidance and support.
Online Procedures via Mi Sanitas App
  • Simplify your healthcare experience with our user-friendly Mi Sanitas app. From making appointments to accessing test results, managing prescriptions, and obtaining medical authorizations, the app streamlines your interactions with our healthcare system, ensuring efficiency and convenience. wherever it is most convenient for you.

3. WAITING PERIODS & RESTRICTIONS

  • Psychology: Maximum of 4 consultations per month and a limit of 15 sessions per Insured per year.
  • Podiatry: Maximum of 12 sessions per Insured per year.
  • Interventions: Covered only for difficulty groups 0, 1, and 2 according to the classification of the Organización Médica Colegial (Medical College Organization).
  • Newborn healthcare coverage is provided only if the newborn is registered as an Insured with Sanitas.
  • This product has waiting periods: the time that must pass between enrollment in the health insurance and the possibility to request the use of certain services:
    • 3 months: Surgical interventions for Groups 0 to II according to the classification of the Organización Médica Colegial.
    • 6 months: Complex diagnostic tests.

4. CO-PAYMENT- EXCESS

  • For the first 6 medical acts: No co-payment fee (0€).
  • For services 7 to 15: A co-payment fee of 5€ per medical act/ service.
  • For services from the 16th and beyond: A co-payment fee of 10€ per medical act.
Additionally, for complex diagnostic tests, therapeutic methods, and surgical procedures, there is a co-payment fee of 12€. In case of emergencies, the co-payment fee is 8€, and for high frequency services, there is a co-payment fee of 20€. Please note that there is a limit of €350 per insured per year for these high frequency services. This co-payment structure allows you to share the cost of healthcare while ensuring access to a wide range of services and treatments. e.g. if you use the policy 8 times (consultations) the excess would be 6 x 0€ (0€) + 2 x 5€ (8€) a total of 8€ (applies per person per year).

5. WHAT IS NOT COVERED:

  • Traffic accidents.
  • Occupational accidents.
  • Practice of high-risk sports.
  • Healthcare provided by Social Security centers.
  • Preventive medical check-ups.
  • Any pre-existing health condition known to the Insured prior to the contract and deemed not covered according to the Company’s technical criteria.
  • Voluntary termination of pregnancy.
  • Healthcare derived from chronic alcoholism, drug addiction, intoxication due to alcohol, psychotropic drugs, narcotics, or hallucinogens abuse, suicide attempts and self-harm, diseases or accidents caused by serious negligence or fault of the Insured.
  • Any aesthetic or cosmetic treatment or intervention.
  • Medications not marketed in Spain.
  • Any type of healthcare provided in a hospitalization setting, as well as any surgical intervention not corresponding to those included and detailed in the general conditions of the product.
Maximum contractual age: You may contract up to age 60. There is no upper age limit to remain insured.

6. CANCELLATION POLICY

Contracts are 12 months and notice to be given 1 month prior to renewal.
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