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Sanitas Health
Plans Classic |
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Sanitas Health Plan Complete |
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Who is the product for? |
Individuals and Companies, business people travelling
frequently to a second European country etc. No maximum age for
continuing with this policy. La edad límite
de contratación son 69 años |
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The policyholder;
* can use his / her Sanitas card to go to the
Sanitas healthcare network in Spain where 100% of the cost of services
is covered (access to GP, specialists, paediatrics, SRN complete medical
cover - hospitalisation, out-patient, emergencies, diagnostic tests and
their therapeutic methods etc). The member does not pay anything up
front.
*
Cover for emergency healthcare treatment abroad - worldwide
*
access to
Preventive medicine programmes... eg breast and cervical cancer,
prevention of coronary risk, colo cancer (also preparation for giving
birth, child health programme etc)
*
If you are
already pregnant you can join the plan for an adjusted surcharge
* Access to bilingual telephonic assistance 24
hours a day: help, advice or anything related to your policy (English/Spanish)
* Documentation in English / Spanish (general and
particular conditions, user guide, etc)
* Special doctors network (indicating the languages
spoken by the doctors in English and Spanish)
*
*
Second
Opinion (serious illnesses)
*
contributes
to the cost of services (Copayment
costs)
*
Dental (Sanitas dental) - optional
* No waiting periods
Sanitas
updates - actualizaciones referentes a su seguro médico...
If you have 'existing conditions' can you be
covered?
No - unless the actuaries / underwriters decide
otherwise.
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What
benefits are included? |
Primarily in and out-patient treatment, primary care |
| Spain - limited emergency cover outside Spain (
Emergency healthcare cover when travelling outside Spain ) |
In
which countries are the benefits included? |
Spain (either through Sanitas' doctors network or
through reimbursement of medical costs) and
in the member's home country in a second European Country. The
member must live at least 3 months a year in Spain) |
| No limits |
What is the Annual Maximum per membership year? |
€ 500,000 |
| No payment - so no reimbursement |
Level of reimbursement: In the Sanitas network... |
100% reimbursement and all benefits included |
| Only emergency cover outside Spain. No payment is
allowed (the emergency service will decide if it is an emergency and if
so, will pay all costs. No reimbursement of the policyholder's costs are
allowed. (
Emergency healthcare cover when travelling outside Spain ) |
Level of reimbursement: Outside the Sanitas network (including second
country cover) |
90% reimbursement (some benefits have limits / some
benefits are not covered) |
| |
Sanitas Health Plan Complete: benefits covered |
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| Advantages of using the Sanitas network in
Spain... |
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| * 100% cover |
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| * Infant health programme |
Only
available in the Sanitas network |
| * Programme for the prevention of colorectal
cancer |
Only
available in the Sanitas network |
| * Programme for the prevention of coronary
disease |
Only
available in the Sanitas network |
| * Family planning, including visit, treatment
and revision of contraceptive methods, implantation of
intrauterine devices (the cost of the device is not included)
and the treatment of possible complications |
Only available in the Sanitas network |
| * Routine dentistry (including extractions and
treatment to cure any resulting infection and hygienist services). |
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| * vasectomy |
Only available in the Sanitas network |
| * Senior Consultants and surgeons |
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| * Speech therapy (6 months per member and year) |
Only available in the Sanitas network |
| * Podology / Podiatry ( 5 sessions per year) |
Only available in the Sanitas network |
| *
Sanitas
24 hours |
Only available in the Sanitas network |
| * Swipe-card technology |
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| * English and Spanish speaking doctors |
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| * 20,000 doctors and 450 hospitals that work
with direct payment from Sanitas |
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Advantages of using the Sanitas network in Spain... |
| Advantages of using the Sanitas network in
Spain... |
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| * 100% cover |
In-patient /
Out-patient /
Other benefits |
| * Infant health programme |
Only
available in the Sanitas network |
| * Programme for the prevention of colorectal
cancer |
Only
available in the Sanitas network |
| * Programme for the prevention of coronary
disease |
Only
available in the Sanitas network |
| * Family planning, including visit, treatment
and revision of contraceptive methods, implantation of
intrauterine devices (the cost of the device is not included)
and the treatment of possible complications |
Only available in the Sanitas network |
| * Routine dentistry (including extractions and
treatment to cure any resulting infection and hygienist services). |
Only dental emergencies are included outside
Sanitas network |
| * vasectomy |
Only available in the Sanitas network |
| * Senior Consultants and surgeons |
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| * Speech therapy (6 months per member and year) |
Only available in the Sanitas network |
| * Podology / Podiatry ( 5 sessions per year) |
Only available in the Sanitas network |
| *
Sanitas
24 hours |
Only available in the Sanitas network |
| * Swipe-card technology |
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| * English and Spanish speaking doctors |
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| * 20,000 doctors and 450 hospitals that work
with direct payment from Sanitas |
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| * Better claims control - |
this means that you are less likely to reach
your limits |
| *
More benefits available |
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Out-patient benefits |
| Out-patient benefits |
In Sanitas network |
Outside Sanitas network |
In second European country |
| Out-patient: 35,000 euros |
|
Annual maximum outside Sanitas
network and in 2nd European country: 500,000 euros |
Annual maximum outside Sanitas
network and in 2nd European country: 500,000 euros |
| Doctor's fees for consultations |
Covered in full |
90% reimbursement |
90% reimbursement |
| Pathology, X-rays and diagnostic tests |
Covered in full |
90% reimbursement |
90% reimbursement |
| Consultants' fees for psychiatric treatment |
Covered in full |
90% reimbursement |
90% reimbursement |
| Consultants' fees for Ophthalmology (including 1
eyesight check-up per year) |
Covered in full |
90% reimbursement |
90% reimbursement |
| Out-patient surgical operations |
Covered in full |
90% reimbursement |
90% reimbursement |
| MRI and CT Scans |
Covered in full |
90% reimbursement |
90% reimbursement |
| Consultants' fees and diagnostic tests for
Oncology |
Covered in full |
90% reimbursement |
90% reimbursement |
| Routine dentistry to include
check-ups, extractions and hygienist services |
Covered in full |
500 euros (only dental emergencies) |
500 euros (only dental emergencies) |
| Speech therapy (limited to 6
months per member and year) |
Covered in full |
Not covered |
Not covered |
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In-patient benefits |
| patient benefits |
In Sanitas network |
Outside Sanitas network |
In second European country |
| In-patient |
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Annual maximum outside Sanitas
network and in 2nd European country: 500,000 euros |
Annual maximum outside Sanitas
network and in 2nd European country: 500,000 euros |
| Hospital accommodation |
Covered in full |
90% reimbursement |
90% reimbursement |
| Nursing care, drugs and dressings |
Covered in full |
90% reimbursement |
90% reimbursement |
| Surgeons', anaesthetists' and physicians' fees |
Covered in full |
90% reimbursement |
90% reimbursement |
| Theatre charges and intensive care |
Covered in full |
90% reimbursement |
90% reimbursement |
| Pathology, X-rays, MRI and CT scans, diagnostic
tests and physiotherapy |
Covered in full |
90% reimbursement |
90% reimbursement |
| Cancer tests, drugs and consultants' fees for
Oncology |
Covered in full |
90% reimbursement |
90% reimbursement |
| Psychiatric hospitalisation (limited to 90 days
throughout membership of the policy)
Waiting period... |
Covered in full |
90% reimbursement |
90% reimbursement |
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Other benefits |
| Other benefits |
Sanitas network |
Outside Sanitas network |
In second European country |
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Annual maximum outside Sanitas
network and in 2nd European country: 500,000 euros |
Annual maximum outside Sanitas
network and in 2nd European country: 500,000 euros |
| Emergency local road ambulance |
Covered in full |
90% reimbursement |
90% reimbursement |
| Maternity cover (including pre and post-natal
checks)
waiting period... |
Covered in full |
5,000 euros |
5,000 euros |
| New born (Cover for congenital conditions during
first 28 days of life as long as included on an existing policy) |
Covered in full |
90% reimbursement |
90% reimbursement |
| Prosthesis (including cardiac valces, aorta,
arteries, pacemaker, cornea, reconstruction breast surgery,
draining of liquid from brain, joint or ligaments and bladder /
sphincter control only) |
Covered in full |
5,000 euros |
5,000 euros |
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Second Medical Opinion |
Covered in full |
Covered in full |
Covered in full |
| Podiatry (limited to 5 sessions per member and
year) |
Covered in full |
Not covered |
Not covered |
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Dental supplement (optional benefit) Only available in
Spanish network |
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Waiting periods?
Birth - 300 days / vasectomy and sterilisation -
180 days
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Waiting periods |
| Waiting periods -
Sanitas network |
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| * 180 days for Vasectomy and
sterilisation |
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| * 300 days for childbirth delivery |
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| Waiting
periods - Outside Sanitas network |
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| * 90 days for |
hospitalisation and surgery (in
Sanitas network and in second European country
there is no waiting period) |
| * 90 days for |
physiotherapy, laser,
rehabilitation, ultrasound, pathology test and
special home care (in Sanitas network and in
second European country there is no waiting
period) |
| * 150 days for |
radiotherapy, chemotherapy,
cobalt therapy, radioactive isotopes, linear
accelerator, CAT scan, MRI scan, nuclear
medicine, bone densitometry, lithotripsy,
digital arteriography, radioneurosurgery and
transurethral hypertermia of the prostate (in
Sanitas network and in second European country
there is no waiting period) |
| * 300 days for |
childbirth delivery |
| * 2 full years for |
in-patient and out-patient
psychiatric treatment (in Sanitas network there
is no waiting period) |
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Emergency healthcare cover when travelling outside Spain |
Emergency care outside Spain |
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