Taking out a health policy involves knowing a lot of technical and medical terms, and we do not always know all of them, despite being important. Here you will find a glossary that we hope will resolve some of your doubts.
At Insurance Expat Spain, we specialize in online contracting of Sanitas health insurance policies, with expatriates in Spain being our main customer profile.
We will be delighted to advise you on choosing the policy that best suits your case, whether you are a student, a self-employed worker, a business owner, or a member of a large family.
10 Insurance Terms
Policy
Written document that contains the Terms and Conditions governing the insurance and the rights and duties of the parties and that is used as proof of existence thereof.
The policy comprises: the insurance application, health questionnaire, General, Particular and Special Terms and Conditions, and the supplements or addenda that are added to it either to complete or amend it.
Full Coverage
These are policies that cover a wide range of medical services and are required by the Government of Spain for expatriates who wish to obtain a visa.
Sanitas offers several policies with full coverage, such as Sanitas Mas Salud, Mas Salud Familias, International Students, and Sanitas Professionals.
These policies include Primary care, Medical specialties, Video consultations with specialists, Simple and complex diagnostic tests, Simple and complex therapeutic methods, Surgical interventions, Hospitalization, Advice program, Measurement of vital constants by facial imaging, Dental coverage, and Urgencies in trips abroad.
Policyholder
The physical person or body corporate that, together with Sanitas, signs this contract and who may be the same as or different from the Insured and to whom the obligations arising therefrom correspond, particularly the payment of the premium, except for those that, due to their nature, are the obligation of the Insured.
Insured
Each person included in the policy and specified in the Particular Terms and Conditions, entitled to receive insurance benefits and who may or may not be the same as the Policyholder.
If you are coming to Spain with your family, you will find our Sanitas Mas Familia policy, perfect for all insured members, including your little children.
Beneficiary
Person to whom the insurance Policyholder acknowledges the right to receive the compensation or benefit arising from this contract, to the corresponding sum.
Co-Payments
Co-payments are a common feature in health insurance policies where the insured pays a fixed amount for a specific medical service.
Co-payments are designed to share the costs of medical care between the insurer and the insured.
At Sanitas, you can choose whether you want your policy without any co-payment, or with a low or medium co-payment. Remember that you must choose a policy without co-payment if you need to obtain a visa for Spain.
Reimbursement
In a reimbursement model, the insured initially pays for medical services and then requests a reimbursement from their insurance company.
At Sanitas, we offer you complete freedom to visit the specialist you prefer, even if they are not in our medical directory. You can access any professional, medical center or hospital, even outside Spain, and Sanitas will reimburse a percentage of your bill expenses.
We provide you with a wide range of add-ons to choose from, adapting to your needs, with maximum amounts ranging from €50,000 to €300,000, and reimbursement percentages of services of 80%.
Health Questionnaire
Declaration that must be truthfully and fully completed and signed by the Policyholder or Insured before formalization of the policy and used by Sanitas to assess the risk subject to insurance.
Waiting Periods
Waiting periods are the time that must pass from contracting the insurance until you can use certain services, which are usually complex diagnostics or treatments.
For medical visits and simple diagnostic tests like blood and urine analysis, ultrasounds, x-rays, etc., there are no waiting periods and you can use them from the first day.
If you already have other health insurance and come to Sanitas, these periods may be eliminated. Indicate this at the time of registration.
Repatriation
In the realm of health insurance, repatriation refers to the process of transferring an ill or injured insured back to their home country for medical treatment or after their death.
The Government of Spain requires as a condition for expatriates contracting an insurance policy that includes repatriation in case of death.
At Sanitas, we offer a small add-on that will meet this requirement if your policy did not already include it.
10 Health Terms
Social Care
Medical admission becomes social admission when a patient with functional deterioration or affected by age-related chronic processes and/or disorders has surpassed the acute phase of the disease and requires healthcare but not under admission to hospital.
Cytostatic Medicines
Cytotoxic medicine, which is used in oncological chemotherapy and can stop the proliferation of cancer by acting directly on the integrity of deoxyribonucleic acid chains (DNA) and cell division, inhibiting normal cell multiplication, of both healthy and cancer cells.
They are a mixture of heterogeneous substances used in antineoplastic treatment.
Procedure
The action of subjecting a person with a disease to the necessary control or examination, carrying out the corresponding tests, for either diagnostic or therapeutic purposes, for the symptoms or alterations reported during the consultation with the healthcare professional.
There are different types of procedures: surgical, therapeutic and diagnostic. In all cases, there’s need for a competent specialist doctor in an authorized center (hospital or outpatient center) that usually requires a specific room with the necessary equipment.
Osteosynthesis Material
Pieces or elements of metal or of any other kind used for joining the ends of a fractured bone or for welding joint ends.
Orthopaedic Material
External anatomical parts of any kind used to prevent or correct body deformities such as, for example, a back brace, harness, or crutches.
Radiopharmaceuticals
These are medicines that contain a small amount of active substance, known as a tracer, which is tagged with a radionuclide, causing them to emit a dose of radiation and which is used for both diagnostic and therapeutic purposes.
Simple Therapeutic Procedure
A simple therapeutic procedure is defined as a therapeutic procedure prescribed by a doctor on the medical chart during the consultation for which highly complex equipment and medical staff are not required, as it is carried out by non-medical healthcare staff.
This header also includes wound treatment, injectable drugs, some types of physiotherapy, etc.
Complex Therapeutic Procedure
Any method requiring a healthcare or hospital setting with technical equipment, a room and/or specialized health professionals.
For invasive procedures, the healthcare facility where it is performed must also have adequate personnel and resources to deal with any complications that the patient might experience as a direct or indirect consequence of the method.
Complex Diagnosis Test
Any test that requires a healthcare facility or hospital with technical equipment and specialized health professionals in order to perform it and/or to interpret the results due to their complexity.
Similarly, the healthcare facility where it is performed must have appropriate staff and resources to address any complications that the patient might experience as a direct or indirect consequence of the test.
For example, this includes all tests: CAT scan, MRI, neurophysiology, nuclear medicine, genetic, molecular biology, endoscopy, hemodynamics, interventional radiology, etc.
Prosthesis
Any element of any kind that temporarily or permanently replaces the absence of an organ, tissue, organic fluid, member or part of any of these.
By way of example, this definition encompasses mechanical (joint substitutes) or biological elements (heart valve replacement, ligaments), intraocular lenses, medication reservoirs, etc.
Contact us and let us help you taking out a health policy with Sanitas
