since 2/2000
Commercial Premises insurance - Spain
Community Insurance 'Comunidad' - Spain
Company Platinum - health plan for employees in Latin America and the Caribbean
España - seguros médicos - pero ¿cuál?
Patrocinadores - América Latina y el Caribe
'Residencia' (medical insurance)
Retirement? How about retiring to Spain?
Sanitas Accesible Down Syndrome
Sanitas Accesible Síndrome de Down
Sanitas Health Plan Classic or Sanitas Multi?
Sanitas Oro Reembolso / Reimbursement
Sanitas Residencial - residences in Spain, for the elderly
Complementarios de Salud (Diversificación)
'Student Visas' (medical insurance)
Studying outside Spain for at least 6 months?
www.e-agentelocaldeseguros.com
Sanitas Oro Reembolso (Reimbursement policy) - general information
Information about the product ( Contact me / ¿Cómo ponerse en contacto conmigo? saniprof@mail.ddnet.es )
This product has been created for non-Spanish residents in Spain, over 60, who spend at least 6 months a year in Spain. There are 2 versions of this product. The other one is described below (see table)
Details:
The policyholder will be covered 100% of the cost using the Sanitas network and will receive a refund of 70% of the cost of non-Sanitas providers in Spain and other countries.
Cost (Spain - except other regions - 'Oro Reembolso'): ( Rest of Spain - plus taxes)
(Discount of 4% for annual payment and 2% for 6 monthly payment)
S- Reimbursement without franchise
- Limits (2005)
REIMBURSEMENT
PERCENTAGE OF MEDICAL EXPENSES WITH SANITAS ORO REEMBOLSO
(Non-franchise
modality)
Recommended
services in
Services
in
CONTRACTED
GUARANTEES
INSURED CAPITAL
(per year and person insured)
|
|
TOTAL |
OVERSEAS |
||
|
|
Pesetas |
Euros |
Pesetas |
Euros |
|
OVERALL
LIMIT |
15,000,000 |
90,151.82 |
5,000,000 |
30,050.61 |
A. Hospital Treatment |
12,000,000 |
72,121.45 |
4,000,000 |
24,040.48 |
B. Non-Hospital Treatment |
3,000,000 |
18,030.36 |
1,000,000 |
6,010.12 |
CONTRACTED GUARANTEES – PARTIAL LIMITS
|
|
AMOUNT
INSURED |
|
|
|
PESETAS |
EUROS |
A.
HOSPITAL TREATMENT
|
|
|
A.1. In-patient (total per day) |
32,000 |
192.32 |
A.2.
UVI/ICU (per
day)
|
53,000 |
318.54 |
A.3.
Medical fees per procedure (including
surgeon, assistant and anesthetist fees)
|
e |
e |
|
- Minor and outpatient surgery (Group 0, OMC classification) (total per operation) |
50,000 |
300.51 |
|
- Minor and outpatient surgery (Group 1, OMC classification) (total per operation) |
60,000 |
360.61 |
|
- Minor and outpatient surgery (Group 2, OMC classification) (total per operation) |
75,000 |
450,76 |
|
- media surgery (Group 3, OMC classification) (total per operation) |
250,000 |
1,502,53 |
|
-
media surgery (Group 4, OMC
classification) (total per operation) |
350,000 |
2,103.54 |
|
- Major surgery (Group 5, OMC classification) (total per operation) |
450,000 |
2,704.55 |
|
- Major surgery (Group 6, OMC classification) (total per operation) |
550,000 |
3,305.57 |
|
- Major surgery (Group 7, OMC classification) (total per operation) |
650,000 |
3,906,58 |
|
- Grand surgery (Group 5, OMC classification) (total per operation) |
900,000 |
5,409,11 |
A.4.
Brain sterotaxic surgery
(all costs included) (total per year and policyholder)
|
1,000,000 |
6,010.12 |
A.5.
Medical fees for consultation (total
per day)
|
15,000 |
90.15 |
B.
NON HOSPITAL
TREATMENT
|
PESETAS |
EUROS |
B.1.
Medical consultation:
|
|
|
|
Primary
healthcare (total per consultation) |
7,000 |
42.07 |
|
Specialised healthcare (total per consultation) |
15,000 |
90.15 |
B.2.
Ambulance
(total per policyholder and year)
|
100,000
|
601,01
|
B.3.
Dentistry (only
extractions, cures and dental cleaning) (total per policyholder and year)
|
40,000
|
240.40
|
B.4.
Special domiciliary care and domiciliary
services
|
150,000
|
901.52
|
B.5.
Chiropody (unlimited)
|
|
|
B.6.
Diagnostic tests (total
per policyholder and year)
|
150,000
|
901.52
|
|
Clinical analysis (total per procedure) |
10,000 |
60.10 |
|
Clinical analysis (total per policyholder and year) |
25,000 |
150.25 |
|
Conventional radiology (total per procedure) |
10,000 |
60.10 |
|
Conventional radiology (total per policyholder and year) |
25,000 |
150.25 |
|
Ecography (total per procedure) |
8,000 |
48.08 |
|
Ecography (total per policyholder and year) |
20,000 |
120.20 |
|
Bilateral Mammography (total per procedure) |
10,000 |
60.10 |
|
Bilateral Mammography (total per policyholder and year) |
10,000 |
60.10 |
Bilateral CAT scan (total per procedure)
|
16,000 |
96.16 |
Bilateral CAT scan (total per policyholder and year)
|
32,000
|
192.32 |
Bilateral NMR (total per procedure)
|
30,000
|
180.30 |
Bilateral NMR (total per policyholder and year)
|
60,000
|
360.61 |
|
Densitometry (total per procedure) |
12,000
|
72.12 |
|
Densitometry (total per policyholder and year) |
12,000
|
72.12 |
|
Holter (total per procedure) |
15,000
|
90.15 |
|
Holter (total per policyholder and year) |
30,000
|
180.30 |
|
Ergometry (total per procedure) |
10,000 |
60.10 |
|
Ergometry (total per policyholder and year) |
20,000 |
120.20 |
|
Echocardiogram (total per procedure) |
10,000 |
60.10 |
|
Echocardiogram (total per policyholder and year) |
20,000 |
120.20 |
B.7.
Special treatments
|
|
|
|
Linear accelerator (total per policyholder and year) |
300,000 |
1,803.04 |
|
Cobalt bomb (total per policyholder and year) |
200,000 |
1,202.02 |
|
Chemotherapy (total per policyholder and year) |
300,000 |
1,803.04 |
|
Renal Lithotripsy (total per policyholder and year) |
160,000 |
961.62 |
|
Dialysis (all included) (total per procedure) |
16,000 |
96.16 |
C.
REHABILITATION
(total per policyholder and year)
|
100,000 |
601.01 |
|
§
For psychiatry, “A” and “B”
guarantees will have a global maximum limit of Ptas 150,000 / € 901.52
per year and policyholder and the maximum period for psychiatric hospitali
|
||
General rules (Sanitas Oro Reembolso)
For more information please contact David Harris
saniprof@mail.ddnet.es or saniprof@wanadoo.es Fax: (+34) 91 803 2484
Telephone: (+34) 91 8043802
Sanitas updates - actualizaciones referentes a su seguro médico...
General rules (Sanitas Oro Reembolso)
General Rules of Use (Sanitas Oro Reembolso)
Special rules (Sanitas Oro Reembolso)
Services recommended by Sanitas in Spain (Sanitas Oro Reembolso)
Claims procedure (Sanitas Oro Reembolso)
Primary care and specialist consultations (Sanitas Oro Reembolso)
Home visits by primary care physicians (Sanitas Oro Reembolso)
Prescriptions (this doesn't refer to medicines) (Sanitas Oro Reembolso)
Exempt services (No prior authorisation needed) (Sanitas Oro Reembolso)
Non-exempt services (requiring Sanitas authorisation) (Sanitas Oro Reembolso)
Special services (Sanitas Oro Reembolso)
Hospitalisation (Sanitas Oro Reembolso)
Home emergencies (Sanitas Oro Reembolso)
Preventive medicine programmes (Sanitas Oro Reembolso)
Supplementary care for travel abroad (Sanitas Oro Reembolso)