Insurances of health

In order to avoid surprises it is recommended to in detail clarify the conditions of the policy.

Although in Spain we counted on a public system of health that offers sanitary cover to all the citizens and who areconsidered one of the best ones of the world, the deprived insurance of health also is gaining adept in the last years. Thegreater importance than is granted to the well-being at present and to the personal image, together with the lack ofresources of the public health, they explain the height that is having in Spain the private health. Between theiradvantages, the experts mention the rapidity with whom take care of the patients, the minors or, sometimes, nonexistentwaiting lists and the benefit of services of added value, like offering single rooms, quickly sending the tests ofinformation by mail, email or messages to the moving body… However, everything is not virtues in the private health.The insurances habitually present/display one long list of possible restrictions, do not admit any client and, sometimes, itmust spend a certain period of time to be able to begin to enjoy the contracted sanitary services. In order to avoidsurprises, it is recommended to in detail clarify the conditions of the policy.

Diversity of insurances

At present more than nine million Spaniards they have contracted a private insurance of health. To 2005 closing, thevolume of premiums inverted in private insurances reached 4,484 million Euros, a 9.4% more than in 2004, according toprovisional data of ICEA (Cooperative Investigation between Insuring Organizations). At the moment and before thegreat specialization of products, practically any person can have a deprived insurance of health, since their prices are notexcessively high. However, still the profile of client of the health insurance is the one of a person of spending power halfhigh. Josep Santacreu, delegated advisor of Safe DKV, affirms that the profile of the average client usually is the one of aman, an average of age of 51 years and an upper middle socio-economic level.

Of the nine million Spaniards who have a deprived insurance of health, about two million and average they are civilservants of the State. The group of employees public of the State, the civil servants of the judicial branch and the militaryaccede to the health deprived through MUFACE (General Mutual benefit society of Civil Civil servants of the State),ISFAS (Social Institute of the Armed Forces) and MGF (Mutualidad General Judicial). These mutual benefit societieshave signed agreements of collaboration with Adeslas and Asisa for the benefit of sanitary services to this group.

In order to accede to the private health the organizations they offer three types of insurances: those of medicalassistance, reimbursement of expenses and the insurances of subsidies and indemnifications. Their particularitities are thefollowing:

Insurances of medical assistance: The most extended and demanded they are the insurances of medical assistance, thatprovide to the insured medical aid, hospitable and surgical, in case of disease or accident, through a medical staff offacultative and welfare, clinical centers and hospitals, with which the insurer has subscribed a contract of services. Thistype of policies is extended. Sergio Salamanca, of the department of ICEA statistics indicates that “86% of the emittedpolicies of health in the Spanish market are of this type”.

In this modality of insurances the payment is not covered with a benefit in the form of capital when the insured needsmedical services, but the insurer puts at the disposal of its clients a relation of facultative doctors, arranged hospitals andservices that will take care of the needs of the set of people under this cover. “In these pure insurances of medicalassistance the concept of indemnification by the one of benefit of services has been replaced”, comment from Unespa,the employer's association of the insuring sector in Spain. “Only in very concrete cases (special urgencies, treatments,etc.), the insurer can assume the payment of the expenses originated by other people's services”, comment from Unespa.In the 2004 prime annual average of these insurances was placed in 514 Euros. These insurances of medical assistancecan be divided in several modalities, based on the number of insured: Individual insurances, safe relatives and insurancesof group.

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Policies of reimbursement: The private health also offers the denominated policies of reimbursement. These productsallow to choose the doctor who is desired to receive the medical assistance. The client, in a first step, will be theresponsibility of the expenses of the services that have used, Later, the company commits itself to support the cost of themedical attention. Josep Santacreu, delegated advisor of Safe DKV, affirms that generally the insurances ofreimbursement of expenses are conceived for people who wish to freely choose to what medical or sanitary center to goor that covers wish that go beyond the conventional medicine. Generally, the prime averages of the reimbursementinsurances go up to around the 600 annual Euros.

Insurances of subsidies. The last modality of health insurance is the policy of subsidies. This policy does not cover bymeans of the medical assistance, but it grants an economic indemnification to the client. Sergio Salamanca, ICEA,assures that to this they use it product, mainly, the independent ones. This type of insurances usually serves to cover daysof labor loss in these professionals who work independently. Usually they serve to them to cover part with the loss ofincome that can suffer before their labor absences. The prime average of the more basic insurances of subsidy is of 145Euros to the year.

 

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