In the Spanish healthcare system you can choose between Spanish state hospitals and private hospitals. There is a big difference between these two and it is very important to choose your healthcare insurance carefully. To ensure that you choose the most suitable insurance policy, it is important to consider several points. For example, not only your choice of hospital or where to have a second opinion, but also medication costs and alternative healthcare. Below we outline the differences between the types of healthcare insurance.
Types of private healthcare insurance policies
Most people who live in Spain are entitled to Seguridad Social (state healthcare), which does not offer any options to see other doctors or to go to other hospitals. If you want to have a choice, you will need to take out extra private insurance. A Spanish private healthcare insurance policy offers options for your own wishes, just as you were used to in your own country. A private healthcare policy has many advantages:
- Shorter or sometimes no waiting lists for appointments
- Shorter or sometimes no waiting lists for operations
- In many cases you will not need a referral from your general practitioner (GP), so you can make an appointment directly with the hospital or specialist
- Own choice of a large number of doctors/specialists
- A private room if you are admitted to hospital and the possibility of having an extra bed in it for your partner
With private healthcare insurance you can attend different hospitals and/or doctors per specialism. And, if you are not satisfied, you can change your doctor. You can choose between a healthcare policy for a fixed medical network (a so-called medical healthcare insurance network) or a policy which allows you to go to other doctors and/or hospitals either in Spain or abroad (a so-called free choice insurance policy). And if you are seriously ill, most private healthcare policies offer a second opinion.
Medical healthcare insurance network
A medical healthcare insurance network states which doctors and/or hospitals you may attend, i.e. they are fixed. These are often several doctors and/or hospitals in your direct area. Depending on where you live, it is also possible that the network will offer a doctor who speaks your own language. Since the choice of doctors and hospitals is fixed beforehand, the premiums for this type of healthcare insurance are lower than those for a free choice insurance policy. In addition, the costs you incur in a fixed network will be paid directly by the insurance company. You do not need to pay the bill first and then make a claim.
Free choice healthcare insurance
With free choice healthcare insurance, you can make your own choice of which doctor and/or hospital you want to go to. Often the policy will also cover your costs if you go abroad. In short: this type of insurance policy offers you complete freedom in your choice of doctor and hospital. This type of policy also works with a fixed network. If you use the fixed medical network, the costs incurred will be paid directly by the insurance company. If you choose to visit a different doctor and/or hospital, the insurance cover is based on reimbursement. This means that you must first pay the bill and then reclaim the amount from the insurance company. You claim will be reimbursed in part or in full, depending on the healthcare insurance cover you have taken out.
What costs are not reimbursed?
Private healthcare insurers offer a broad range of cover, although there are certain medical services that are not always reimbursed. In general, medications (except those prescribed during a hospital stay), kidney dialysis for chronically ill patients, and organ transplantations are not reimbursed by private healthcare insurance. However, these costs are covered by the Seguridad Social. Alternative care is not covered by the Seguridad Social and is also often not covered by private insurance, although there are a number of policies that offer a broader range of cover that includes acupuncture, homeopathy and chiropractors.
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Seguridad Social is a sort of basic healthcare insurance in Spain. In general, all people who work in Spain, either as employees, employers or entrepreneurs/freelancers, are entitled to Seguridad Social. Those with a pension or benefit who pay a premium in the Netherlands for healthcare insurance are also entitled to Seguridad Social in Spain. Under Seguridad Social you can make use of certain designated GPs and state hospitals (often working only in Spanish). You have no options to choose other doctors or hospitals. Although Seguridad Social offers good quality care, in some parts of Spain the system does not have enough capacity, which causes long waiting times, and offers less luxurious facilities. If you would like the option of going to another doctor or hospital, or you would like to see a doctor who speaks your own language, we advise you to take out private healthcare insurance.
Seguridad Social versus private healthcare insurance
In Spain being insured for healthcare via the Seguridad Social provides a good basic cover, however, private healthcare insurance or a policy offering expansion on the basic state cover, has many advantages:
- Shorter waiting times for non-life threatening disorders, tests and operations
- Free choice of GP, specialist and hospital
- Private or other hospitals that offer a higher level of service (own room, etc.)
- Second opinion
In addition, it is also important to note that Seguridad Social has different services in each village or town. Some areas offer many more services or facilities than others. You can certainly use Seguridad Social and a private healthcare insurance together. For example, for common or less important disorders you can go to your local healthcare centre (Centro de Salud) run by Seguridad Social, and for specialist care you can go directly to a hospital of your choice via your private healthcare insurance.