Navigating Health Insurance Abroad for Your Child

My mother-in-law says she has an intuition that never fails her, especially when it comes to her grandchildren. She texted me one afternoon, shortly after I’d had my second child, asking if they were all right. Less than an hour later, I responded by asking if she could meet me in the emergency room. My elder child had fallen at daycare as he ran after a ball, and his teacher predicted he’d need a few stitches.

Having sound health insurance abroad for my children was never a question. I take out short-term policies when I travel back home to the United States and have an accident-prone and clumsy toddler, so their safety and well-being was discussed before we even brought them into the world.

Whereas healthcare in the United States is a myriad of acronyms and an accident can merit dizzying bills, Spain’s system is more straightforward. The care provided in Spain is top-notch and for a fraction of the Price – even if you are taking out private insurance. Navigating health insurance abroad may be different than in your country, so it’s important to add this task to your list prior to moving.

Private and Public Health Care in Spain

Spain’s public social security system is considered one of the best in the world and funded through social security payments from both employees and employers. This means that there is universal coverage for all residents and that, if a parent is working, all family members are eligible for coverage.  You can also be eligible as a pensioner, a pregnant woman, a student or as part of a special agreement, depending on where you live and your country or origin.

If you do not qualify, you can either pay out of pocket or look into private providers, which provide more a là carte options and different pricing structures.

The advantage to private healthcare in Spain is that wait times for appointments and specialists are often far shorter, and you can choose your own doctor. When it comes a child’s health insurance abroad, this can sometimes be a more comfortable option. If language is a factor for you, insuring yourself privately will allow you to find a GP or specialist that speaks your native tongue.

When living in Andalucía, I always used the public system; when I was pregnant with my first child and moved to Madrid, however, I used my private coverage more often because of the wait times over the summer. I was, truthfully, dissatisfied with the unavailability of appointments during my important second semester screenings. I ended up going public for shots and vaccines, prenatal classes and the genetic screening; everything else – including both births – were done through my private insurer because it gave me more freedom of choice.

Health insurance abroad for expats

If you’re an expat or looking to move to Spain, taking out a state-approved healthcare plan is imperative for your visa application. The Ministry of Foreign Affairs requires all non-Schengen parties wishing to reside in Spain for any period 90 days or more to provide proof of health insurance that includes repatriation services and no co-pays.

So, navigating health insurance abroad becomes a necessity rather than an afterthought.

Caser’s insurance for expats will do more than cover you for your visa: your customizable plan can include hospitalizations, routine check-ups or specialists your child may need, including dental. Check out your options by using Caser’s online calculator.

Co-pays versus universal coverage

I have had Caser’s Activa plan since 2013, opting for copays for the few visits I make to hospitals and specialists each year – in fact, the doctor visits and blood tests I needed for my pregnancies cost less each month than my prenatal pills!

Running the numbers for newborns who would need monthly visits for the first year plus trips to the ER for each touch of a fever, we opted for full coverage for our children with a private insurer. This meant a longer hike to a clinic because there were not as many healthcare providers in our neighborhood, but we found a pediatrician who is kind, patient with my incessant questions and extremely professional. What’s more, everything is covered, so I can plan accordingly each month and not worry about surprise bills.

If you already have private insurance, you can oftentimes get a discount on multiple plans for family members. It’s important to work with an agent you trust and to read the fine print, as well as consider the factors listed below.

Availability of Coverage and Doctors

As previously mentioned, Spain’s public health system employs highly qualified professionals in its public hospitals and clinics. While nearly anyone residing in Spain may have access, recent polls reveal that about 20% of residents take out private insurance – many, no doubt, like myself have both schemes and thus wider access to professionals.

Additionally, budget cuts and the fallout from the COVID-19 pandemic have affected the healthcare structure, which has had negative effects on wait times, availability and services.

While wait times may be shorter with private insurance, you will likely find limited professionals or clinics that take your insurance. For us, language was not a factor though we wanted to find a good pediatrician in our neighborhood. We have a private hospital less than five minutes from our home that makes lunchtime visits or emergencies easy to handle, and the hospital includes many specialities that we need as our children grow, like a speech pathologist.

Pre-existing conditions and other health factors

The public healthcare system will insure anyone, regardless of their medical history; like in other developed nations, your levels of coverage and cost may depend on any pre-existing conditions as well as your age. Your agent can help you find a plan that works best for your family and any health concerns you may have for your children, such as allergies or pediatric dental care.

Another recent addition to many plans is virtual visits and telehealth consultations in which you can speak to a professional via video chat, thus saving on waiting at the clinic or having to get out of bed when you just feel lousy. For parents, this can provide peace of mind and ultimately be less of a hassle if your little ones are too sick to wait in the ER or you’re away from home.

Something important to note is that prescription medicine is not covered by insurance in most cases. Subsidies slash the prices by 40-70% but do plan to spend on everything for your children from vaccines not covered nationally as well as extensive dental work.

The Takeaway on Health Insurance Abroad

In the end, Enrique’s condition was nothing more than a butterfly bandage and a lollipop couldn’t fix. In the week following his first set of stitches, we’d have another close call plus a second visit to the ER, but I simply had to hand over Enrique’s insurance card and wait to be treated. For us, having private insurance provided the most flexibility and access to the doctors and clinics we wanted, and having full coverage means that we don’t have any surprises with medical bills.

Health insurance abroad for your family is an extremely personal decision, but equipped with the correct information it can make a world of difference when a flu or broken bones strikes.