Health insurance in Spain

Medical care is expensive and not all the services are included in the public healthcare system’s portfolio of services. Therefore, many users decide to take out a health insurance policy that gives them access to a broader cover, with the possibility of being looked after in private healthcare centres.

This allows them to make the most of the main advantages of the private system, such as fuller cover, more comfortable facilities, more flexible service, availability in wider time bands, highly qualified professionals, cutting-edge healthcare technology… and to save themselves from the common inconveniences of public healthcare, such as overcrowding, delays, waiting lists, restricted time bands and longer and more complicated procedures derived from excessive bureaucratisation of the system which, for example, does not allow patients to visit specialist doctors directly, rather they have to be referred by a general practitioner, which slows the care, diagnosis and treatment down considerably.

Generally, the operation of a medical insurance policy is based on the payment of a monthly or annual premium in exchange for which healthcare services are received. The care may be received through a medical team made up by the insurance company or the user can choose the doctor, pay for these services and the insurance company subsequently pays the expenses that have been justified by the patient. These refund policies are less common in our country, but they are becoming more popular, due to the freedom of choice that the insured party has.

The amount of the premium varies in terms of three basic factors:

• Age and clinical condition of the insured party. People are more prone to becoming ill as they get older; therefore, they must pay higher premiums than younger users. A clinical history on which a chronic ailment or a serious health disorder appears also increases the premium.
• Cover. The larger the portfolio of services covered by the policy, the more expensive the premium that must be paid.
• Copayment. This modality is particularly indicated for users who, foreseeably, are not going to make use of private health services frequently. In these cases, the insured party pays a small part of the services every time they access them. In exchange for this, the amount that must be paid monthly or yearly is less.