There are many reasons for contracting Private Medical Insurance, but usually the most common reasons can be summarized as follows:

• Resident or Applying for Residency or Visa in Spain. As you will be aware, a requirement for the Residencia Application will be a Private Medical Insurance without any Co-payment, if you are not eligible for National Health Service here in Spain.
• Avoid Waiting Lists. Spanish National Health Service is, without doubt, one of the best in the world, but it has long waiting lists, longer than you would hope to wait for diagnostic tests, consultations with specialists such as traumatologists, endocrinos etc. and even for surgery.
• Being able to choose your Doctor. Very often, we may want a doctor that was recommended to you, or that we know is the best in their field. Medical Insurance is able to give you access to those professionals, either because they are within the Insurer’s Medical Network or because you have chosen to have Reimbursement Cover.
• Prestigious Clinics and Treatments. Many of the most prestigious doctors and with the most years of experience work within the Private Medical Sector. A way of getting access to them is via a Private Medical Insurance that works with those doctors and medical centres.

The Waiting Period is a period of time that you have to wait from the effective date of the Policy until you can start to use some of the medical services. The Waiting Period can vary depending on the type of insurance that you have contracted. Some examples of medical services that have Waiting Periods are: hospital care, childbirth and surgical operations. Our Medical Insurance has some of the shortest waiting periods on the market at 6 months, 8 months and 6 months respectively.

Once you have consulted with a specialist, it is possible that the Doctor will want to carry out a diagnostic test (x-rays, MRI Scans, blood tests etc.) and it may be that some of those tests will require previous authorisation by the Insurance Company. The Insurer has a dedicated multi-lingual telephone line from which you can request authorisation from the Insurer. In most cases, authorisation can be immediate, however, on some occasions, it might be necessary to send additional documentation, such as a Medical Report, to the Insurer in order to be obtain the authorisation. This would normally be the case for surgical operations.

We provide you with a couple of options if you have to request a Medical Authorisation:

• Call the Telephone Number 976 506 000.
  
• E-mail: autorizaciones@segurosdkv.es

Via your Customer Area, in English, you will have access to the Medical Network Guide from which you can select the doctor with whom you want to consult. You are not limited to just that doctor, if you wish to consult with another you are free to choose another from within the Network.

It is normal for a Medical Insurance Policy to have a Clause regarding pre-existing conditions. This Clause establishes that you must declare to the Insurance Company all illnesses diagnosed prior to taking out Medical Insurance. This is to ensure that Insured Persons do not act in bad faith, taking out a Medical Insurance, not as a prevention measure or for the purposes of general health care, but specifically so that the Insurance Company will cover the costs of an illness or condition that was previously diagnosed.

Not informing an Insurance Company of illnesses or conditions diagnosed before entering into contract, would be considered fraud by the Insurance Company.

The purpose of the Medical Card is to identify yourself at the Medical Network Clinics or Specialists as a customer with our Medical Insurance coverage. Thanks to this Medical Card, you will have access to visits with the best specialists, diagnostic tests, and emergency services without having to make physical payment for these services as the Medical Network Clinic or Specialist will invoice directly to the Insurance Company.

The Medical Card will also include important telephone numbers that you might need including Customer Services; 24 Hour Assistance and even the Worldwide Travel Assistance Service.

Do not worry, we are here to assist you and find a solution. If you have lost your Medical Card, it has been stolen or even damaged; you just need to let us know and we will arrange for the Insurance Company to issue another Medical Card to you. If you already have appointments and need a Medical Card to identify yourself to a Medical Network Clinic or Specialist, again, do not worry, we will request a Temporary Card until your new one arrives.

With the Medical Network Insurance, you might choose a level of cover that has Co-payment charges for the use of the Medical Services. The Co-payment, like an Excess, is your contribution to the Medical Costs, usually a fixed amount depending on which service is used. Just like an Excess, the Co-payment is a means of keeping the Insurance Premium lower by selecting Medical Network coverage with Co-payments. If you need Medical Insurance for your Residencia you will need coverage without a Co-payment (sin Copagos), otherwise you are free to choose the level of coverage that best suits you financially.

The Co-payments will vary depending on the service that you are using, and depending on the level of Co-payment that you have selected when you contracted your Medical Insurance.