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What is and isn't covered under my Expat Health insurance policy?

Here we will provide you with a basic and digestible overview of what is covered under the expat health insurance policy.

Written by Isa

Expat health insurance is a common and great option for expats first arriving in Spain and settling in. It is an affordable insurance option with minimal eligibility criteria, meaning it is quick and easy to sign up for and provides you with initial health insurance in Spain.

What’s covered?

Expat insurance will cover you for new medical conditions that commence after your insurance cover starts (and after the waiting period if that applies to you). This includes both outpatient appointments (e.g. an appointment with a General practitioner), or inpatient hospital treatments. This coverage applies specifically to treatment with a registered medical doctor.

Let's break down the coverage in a simplified comparison table so you can have an initial overview.

Coverage

(per insurance year)

Expat Plan

Out-patient medical treatments

100%

Ambulance transport to in-patient treatment

100%

Ambulance transport to out-patient treatment

X

Dental treatment for pain relief and accidents

€500/year

Preventative dental treatment (eg dental cleanings)

X

Medications and surgical dressings

100%

Radiation therapy, light therapy, and other physical treatments

100%

Massages, compresses and inhalations

€300/year

Therapeutic aids prescribed following an accident

€500/year

General medical aids (with prior approval)

X

Repairs for existing medical aids

X

Visual aids

X

Operations

100%

In-patient medical treatment under general care insurance (multiple-bed room without treatment by private doctor)

100%

Screening check-ups for early detection of cancers

X

Skin cancer check-up

X

Dental check-ups

X

Medically necessary pregnancy treatment and treatment for premature birth

100%

Pregnancy examinations per insurance year

(if the pregnancy started when the policy was already active, and after a 6 months waiting period)

€250/year

Childbirth

(if the pregnancy started when the policy was already active, and after a 6 months waiting period)

100%

Ambulance transport to in-patient treatment

100%

Ambulance transport to out-patient treatment

X

Repatriation, if medically necessary

100%

Repatriation of mortal remains to the home country or funeral in Spain

€10,000

Tele-medical consultation

1 free consult (no copay)

Travel vaccinations

X

Covid vaccinations

X

Covid rapid tests

3 (up to 15 euros)

Fitness applications

X

Pre-existing conditions

X

Gynecological preventative care

X

Regular vaccinations

X

Psychotherapy

X

Now, let's provide some further information on the coverage points listed above.

Additional details on coverage on the expat plan

  • Dental treatment:

    • €500 per year for pain-relieving restorative dentistry including simple fillings and repairs of existing dentures as long as this treatment is performed or prescribed by a dentist. Please note that this applies to new dental issues that occur after your insurance begins and not pre-existing issues or routine check ups.

  • Physical therapy:

    • €300 per year is covered for physical therapy as long as it relates to a new medical issue and there is a referral from a doctor for this treatment (which should be included when you submit your claim)

  • Travel health cover:

    • Anywhere within the EU and the Schengen Area, as well as Andorra, Monaco, San Marino, and the Vatican City (for up to 42 days per trip, with no limit to the number of trips)

    • Additionally, after 1 year on the expat plan, you will receive coverage for up to 6 weeks of travel to your home country per year

  • Ambulance transport that leads to an admission and inpatient treatment

  • Pregnancy cover:

    • Medically necessary pregnancy treatment and treatment for premature birth is covered

    • Pregnancy check-ups are covered within a limit of €250/year, as long as the pregnancy started when the policy was already active, and after a 6 month waiting period

    • Childbird is fully covered, as long as the pregnancy started when the policy was already active, and after a 6 month waiting period

  • Radiation therapy and light therapy

  • Repatriation if medically necessary

  • Corona virus and PCR testing:

    • PCR tests are covered if the test was ordered by a doctor (General practitioner)

What’s not covered?

  • Pre-existing conditions: any conditions that are known before expat cover starts are considered pre-existing conditions.

  • Routine check ups: all other routine check ups, and any conditions that might be discovered as a result of a routine check up, are not covered

  • Preventative and prophylactic treatments

  • Psychoanalytical and psychotherapeutic treatment

  • Treatment relating to an addictive disorder

  • Ambulance transport that does not result in an admission/inpatient stay at a hospital

  • Allied health (aside from physiotherapy): eg occupational therapy, podiatry, social work, dietetics

  • Self inflicted injuries

  • Gynecological screenings

  • Fertility or sterility treatments

  • Holistic/alternative therapies

Need more information?

If you have any further questions, feel free to reach out to us on our support page.

If you would like to learn more about expat health insurance or would like to sign up, you can do so here.

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