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HomeHealthWhat does health or medical insurance cover?

What does health or medical insurance cover?

Health insurance: what they cover and how they work

Do you want to know the main factors and situations covered by medical insurance in Spain? More and more people are going to the private sector to take out this type of health policy, and it is because the concern for health has been increasing exponentially in recent years.

At Sanitas Consulting, we have prepared a complete guide with everything you need about what NPI health insurance covers and what its characteristics are, all with the aim of choosing the rate that best suits your needs. Take paper and pencil and write down the essentials!

What is private health insurance, and what does it consist of?

Private health insurance is a contract between the insurer and the insured in order to protect the latter by offering health benefits such as specialized tests, specific treatments, and medications.

Therefore, when it comes to knowing what health insurance covers, you should know that there are common parameters for most policies on the market, with the main difference being in the additional services they offer.

When choosing the best medical insurance for your day-to-day life, it is necessary to take into account that these can vary from very general coverage (focusing on primary care) to more technical and specialized attention to specific problems.

Main aspects covered by health insurance

It’s time to find out what health insurance covers! Next, we will list the most basic services, both general and special, without counting on specific coverage that insurance companies can offer.

You must bear in mind that, despite the wide variety of services that they make available to you, you will only have to hire the one that suits your needs. That is to say; it will be useless to acquire a family policy that covers comprehensive medical insurance if you live alone.

  • Primary care: GP, pediatrics, or nursing
  • Access to medical specialties: Possibility of accessing cardiology, dermatology, traumatology, gynecology, and many more.
  • Performance of diagnostic tests: Any type of clinical analysis, ultrasound, X-rays, MRI, urology, or urinalysis, among others.
  • Therapeutic methods: Muscular, oncological, or respiratory rehabilitation treatments, among them.
  • Surgical interventions (with or without hospital admission)
  • Hospitalization and emergencies
  • Emergency telephone service and medical advice
  • Possibility of online transactions

What health insurance does not cover: exceptions and limits

The factors covered by health insurance during a lifetime are multiple, but there are certain exceptions to the rule. In this sense, the clients of an insurer cannot ignore those situations in which they will not have the protection of private healthcare.

  • Pre-existing illnesses or consequences of previous accidents.
  • Any clinical situation that arises as a result of armed conflicts, terrorist acts, or work accidents.
  • Voluntary termination of pregnancy.
  • Transplants (except bone marrow or cornea)
  • Aesthetic interventions.
  • When the insured commits fraud or gross negligence, the company may terminate the contract by notifying the policyholder.

What is the best health insurance on the market?

Probably, and if you have come this far, one of the questions that are haunting your head beyond what is covered by health insurance is what is the best health insurance to take out in the sector. Who wouldn’t want these answers? Well, we are going to tell you.

At Sanitas Consulting, we position ourselves as one of the best insurers for clients looking for personalized policies since we have a wide range of services adapted to your requirements.

However, when it comes to finding out what is covered by Sanitas insurance, it is important that you know that we differentiate between three main categories: individuals, freelancers, and companies. Do you want to meet them? Go ahead!

private health insurance

It is the most demanded by clients since it covers medical insurance in a personalized way based on the needs, lifestyle, preferences, economic level, family situation, or the age of the user; It may even be accompanied by additional dental insurance service. Within its main benefits, we can find coverage for general medicine, nursing, pediatrics, hospitalization or emergencies without waiting, allowing Sanitas insurance that covers basic needs to be broad and complete.

Among the most prominent in the catalog for individuals, we can find some such Sanitas Primero y Básico, Sanitas Básico Digital, and Sanitas Blue (to adapt what medical insurance covers to the digital sphere), and Más Salud, among others.

Medical insurance for companies

Finally, if you are wondering what is covered by health insurance for companies at Sanitas, we will give you the answer: all the health care that the workers of an SME, medium-sized or large company may need, such as additional coverage or social benefits.

If you already know what the best medical insurance is and what is covered by health insurance in Spain, it is time for you to get yours by contracting the services of Sanitas. You just have to Get in touch with our team of professionals, who will advise you in a personalized way. We are waiting!

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