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Sanitas Health Plan Complete. General Conditions:
A) PROVISION OF SERVICES
A.1 In Spain
A.1.1. Inpatient, Day case and Out patient treatment in the Insurer network.
When Treatment is received within the Insurer Network, medical expenses for Treatment covered under the Policy will be settled by the Insurer directly with the hospitals, doctors, etc. Treatment may be received in all locations in which there are accredited members of the Insurer Network.
Beneficiaries may go directly to their family Doctor or Consultant, who may refer them to another medical provider within the Network for tests, diagnostic procedures etc. A family doctor in the Insurer Network will be assigned to each Insured and, if applicable, a family doctor for children.
When receiving Treatment in the Insurer Network, the Insured must present their Sanitas Health Plan card, together with the receipt for the last subscription payment. The Insured must also present a national ID card, passport or any other official form of identity, if requested.
Pre-authorisation from the Insurer is required for Surgical Operations, In Patient and Day Case Treatment, Consultant or Doctor Treatment, some therapeutic Treatments and diagnostic tests to be undertaken in the Network, with prior referral from an Insurer Network doctor. This authorisation will be provided unless the Treatment required or condition is not covered under the policy. The authorisation guarantees payment by the Insurer.
Pre-authorisation of Treatment is not required in case of an Emergency, and referral from a Doctor in the Network is sufficient. The Insured should notify the Insurer within 72 hours of beginning Treatment. The Insurer will pay for all covered medical expenses in these circumstances, until the Insured is notified otherwise by the Insurer.
Home Care is only covered when received at the home address notified to the Insurer for treatment included in the Policy and when provided by an Insurer Network doctor. If the Insured changes their address, they must notify the Insurer in writing by recorded delivery at least eight days before Treatment is received.
If the Insured is temporarily resident at another address in Spain, which does not have an Insurer office, the Insured must show the Sanitas Health Plan card in order to get the benefits covered by the policy at one of a number of local affiliate offices of Sanitas. Administrative procedures in each of these offices may vary and must be accepted by the Insured. In exceptional circumstances, the Insurer may refer or transfer the Insured to a public Hospital to receive Treatment.
| A.1.2 Inpatient, Day Case and Out Patient treatment in Spain but outside the Insurer network |
A.2. In the second European country of cover
| Fax: | (00 34) 91 8032484 |
| 'phone: | (00 34) 609 522 300 |
| Also more information on.. | www.e-healthinsuranceservices.com |
You can choose the level of cover you need: