Nothing is more important than our health and health of our loved ones
Health insurance – your protection from unforeseen expenses related to unexpected illness.
Expert Seguros Company, as representative of Generali Seguros, offers a series of insurance plans for family or individual insurance.
Individual (for 1 person) health insurance plan SALUD OPCION SINGLE offers complete medical service with guarantee of reasonable value for money service.
The most popular insurance plans SALUD TOTAL and SALUD OPCION FAMILIAR are thought for family insurance. The two plans have significant differences:
SALUD TOTAL insurance plan enables the client to choose the medical institution and the specialist throughout the territory of Spain from the list of Recommended Medical Centres - PREMIUM, extended.
In these centres, our clients will be attended without any extra charges.
SALUD OPCION FAMILIAR insurance contract also enables our clients to choose the medical centre and doctor in the territory of Spain, but from the OPTIMO category list i.e. it is limited; moreover, the client will have to make an extra payment for every visit or procedure – the payment may vary from 2€ to 25€ depending on the terms of contract and type of service. At the end of the trimester the client’s account will be debited with all the extra charges.
This insurance plan is more economical and suitable for those who do not plan to visit doctors often.
SALUD TOTAL insurance policy also gives a possibility to choose a doctor freely around the world using the reembolso (refund) option. In this case the insurance company will refund up to 80% of the total value of service (taking into account certain restrictions).
This option is not available under SALUD OPCION FAMILIAR insurance option.
|Cover||SALUD OPCION||SALUD ELECCION||SALUD TOTAL||SALUD SELECCION|
|1. Doctors –specialists||General||General||General||Serious disease|
|2. Out-patient treatments||General||General||General||Non|
|3. Assistance abroad||General||General||General||General|
|4. Emergency aid||Additional||General||General||Non|
|5. Reimbursement of expenses for emergency aid and obstetrics and gynaecology services in Spain||Additional||General||General||Non|
|6. Reimbursement of GP’s services expenses||Non||General||General||Serious disease|
|7. Additional services||Additional||General||Non||Non|
|8. Compensation due to hospitalisation||Additional||Additional||Without policy expenses||Non|
|9. Dental care||Additional||Additional||Additional||Additional|
|10. Freezing and cryopreservation of maternal cells from the umbilical cord||Additional (7)||General||Non||Non|
|11. Infertility treatment||General||General||Non||Non|
|12. Psychologist consultations||General||General||General||Non|
|13. Hospitalisation in psychiatric centre||Non||Non||General||Non|
|14. Pregnancy and childbirth||Only affiliated centres and specialists from the company’s list||Affiliated centres and specialists from the company’s list and free choice of specialist||Affiliated centres and specialists from the company’s list and free choice of specialist||Non|
|15. New-born care||Non||Non||General||Non|
|16. Reimbursement of expenses for diagnostics of serious diseases||No||No||No||Yes (18.031€)|
|17. Second opinion||No||No||General||General|
Legend: General – guarantees provided under basic policy. Additional – additional guarantees apart from the basic policy
|Age||SALUD OPCION+Additional||SALUD ELECCION (150.000)||SALUD TOTAL (250.000)||SALUD SELECCION|
|Men||25||665,80 €||792,75 €||720,07 €||120 €|
|35||803,45 €||957,88 €||869,60 €||161,29 €|
|50||883,5 €||1.089,18 €||967,49 €||433,36 €|
|Women||25||716,97 €||862,76 €||765,17 €||127,28 €|
|35||1.013,81 €||1.244,19 €||1.086,77 €||156.71 €|
|50||1.013,81 €||1.388,83 €||1.190,12 €||423,81 €|
|Maximum age to contract a policy||64||64||64 to 74||60 to 70|
Insurant may be hospitalized only after a certain period after the policy was contracted. These periods depend on types of medical services and go as follows:
-12 months for preventive medicine;
-8 months for all treatments related to pregnancy, childbirth and possible complications, as well as right to “new-born care” guarantees;
-3 months for cases requiring surgery and hospitalisation, excluding those resulting from accidents, provided for in the insurance policy, or urgent medical treatment for new diseases, diagnosed after the policy was contracted;
- 3 months after celebration of insurance contract for the following treatments:
High-tech diagnostic medical tests, such as catheterisation and other internals tests, including arthroscopy, laparoscopy and amniocenthesis and the following procedures: lithotripsy, radiotherapy, telecobalt therapy or deep fry and chemotherapy, some same-day procedures.
However these time restrictions do not apply in emergency cases or if there is risk to life.
|Temporary restrictions to get medical treatments||SALUD OPCION||SALUD ELECCION||SALUD TOTAL||SALUD SELECCION|
|Surgery and hospitalisation||3 months||3 months||3 months||3 months|
|Diagnostics||3 months||3 months||3 months||3 months|
|First aid||3 months||3 months||3 months||3 months|
|Pregnancy and new-born care||8 months||8 months||8 months||8 months|
|Infertility treatment||24 months||24 months||No||No|
For those who transfer their policy from another insurance company the following limits apply:
No insurance is meant to cover expected and planned medical expenses.
Insurance company excludes previously existing diseases and pathologies; concealment of information about existing diseases and pathologies may be viewed as fraud and grounds for early termination of contract.
(Ilf and Petrov)