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FAQs about our private health insurance in Spain


What are the medical insurance requirements in order to take out medical insurance?

If you wish to take out your health insurance with us, all you have to do is prove that you are normally resident in Spain and that you are of legal age. In the latter case, if your intention is for the insured person to be a minor, their father, mother or legal guardian must be the policyholder.


How long does health insurance last?

Private health insurance is an annual policy which renews automatically. If you do not wish to renew your policy, you need to advise us by providing one month’s notice ahead of its expiry date.


Does Caser Health Insurance cover COVID-19 detection tests?

At Caser, we have joined the fight against the coronavirus pandemic, working with the health authorities to prevent and stop the spread of COVID-19. If you are part of Caser Salud you can purchase your tests, either PCR Test or Serological Test at a special price via Caser Más Beneficios.


Are children automatically covered in my health insurance policy, and can I include more people?

Of course you can, the more the better. You can save up to 35% discount on some of our products if you take out a family policy.

In the case of a new-born baby, if you have held a policy with us for longer than 8 months, don’t forget that you have 15 days to include him/her without any gaps in coverage or pre-existing conditions and without completing a health questionnaire.


What is patient health questionnaire?

This consists of a health declaration signed by each one of the insured persons who will be included in the policy prior to it being formalised. It includes relevant questions regarding the state of health of each person to be insured.

In the event of falsehood, inaccuracy or intentional omission of information in any of the declarations made in the questionnaire, the Company may cancel the insurance policy.


Is it possible that they may decline to medically insure me on the basis of my questionnaire or medical history?

Yes, it is possible. Our intention is to always be able to offer you a quality medical insurance policy that is tailored to your needs.

However, there are some illnesses that we cannot insure given that the monthly premium would be excessively high, as well as the payment for use of the services.


What is the health insurance age limit when taking out a policy?

Our health insurance age limit is currently 69 years old for all of the health insurance products.


Does age have a bearing on the cost of medical insurance?

Yes. Age is one of the main factors for calculating the premium, as old age increases the risk of illness.


What is the maximum term limit?

Caser Salud does not have a maximum term limit. If you are happy with us, we will be delighted to renew your policy on an annual basis.


Can you object to the extension of your health insurance policy renewal?

The insurance is contracted for the period envisaged in the Particular Conditions. On its expiry, it shall be tacitly renewed annually. However, any of the parties may object to the renewal via written notification to the other party, when carried out in advance no less than one month prior to the conclusion of the current insurance period if the policyholder, and two months if it is the insurer.


How can I make my medical insurance payment?

For medical healthcare insurance, and not dental healthcare, the premium can be paid monthly, quarterly or annually without any charge. This is paid via a current account direct debit, in the name of the policyholder, which is expressly indicated in the insurance application.


Can I take out health insurance while pregnant?

Yes. However, you must remember that there are qualifying periods required for certain benefits, diagnostic tests, procedures, hospitalisation, etc., in this process. You should consult the contract terms and conditions.


How do I prove I am insured by Caser? Will I have a health insurance card?

Via a personally issued, non-transferable card from Caser. This will show your insurance number, personal details, and the type of insurance that you hold. When you visit a Health Centre, you just need to present the card.

In certain cases, due to safety reasons, you may be asked for another type of identification instead of your card.


How does medical insurance work? Do I have to pay for services?

In our range of products, there are insurance policies that require co-payment and those without co-payment, to allow the price to be tailored better depending on each person’s use.

The products that offer co-payment involve your co-participation for the use of a service. For the products without co-payment, you only pay the cost of the premium.


What is the insurance qualifying period?

The qualifying periods make reference to the minimum period of time that you have to fulfil following registration as an insured person in the policy, in order to be able to make a claim and use certain services. For example, for procedures, use of high tech diagnostic centres, prosthesis, etc.


What is a health insurance co-payment?

Health insurance co-payment means that insured persons participate in the cost of the services that are included in the majority of medical insurance policies on the market.

This involves a payment of a small amount by the insured person to make use of certain services, and that way, avoiding an increase in the generic cost of the premium for all customers who hold the same insurance, by assigning these amounts according to the individual use of each person.


What is a health insurance reimbursement?

Reimbursement is a type of insurance where you decide at any time which doctor you want to consult, who you want to operate on you and which centre you want to be admitted to. If they are not in Caser’s medical directory, you will pay the costs and then we will subsequently reimburse you with a proportion of the charges, between 80 and 90% depending on the service, up to a limit of €210,000 per insured person, per year.


How do I request a reimbursement?

Once you have the invoice, you should complete the form and attach a copy of the invoice when you submit the form. Within 10 working days, we will reimburse you for the corresponding amount in accordance with the established reimbursement conditions in the policy. It’s very simple.


Where can I check the medical directory?

On our Medical Directory page, you can always check the up-to-date list of professionals who are at your disposal.


Can you choose your own doctor on health insurance?

Yes, as long as they are in our extensive directory of renowned medical professionals.
In the event that you wish to visit a doctor who cannot be found in our approved medical directory, we recommend “Caser Salud Prestigio”, given that it offers the reimbursement payment method and you have complete freedom to choose a doctor.


When can you start using your medical insurance?

You can start using it from the first date that appears on your contract. When you are taking out a policy online, we will ask you from which date you would like the policy to take effect.
You have to bear in mind that in order for us to register a policy, this needs to have been paid beforehand to cover the first month as a minimum. Remember that there are qualifying periods for certain services.


How to check health insurance policy? Where can I check what is included?

You can check in the General Conditions of your contract or in the conditions or good practice guide that can be found on our product pages online.

We would always recommend that you read the General and Individual [those that apply in your particular case] Terms and Conditions to be sure, and if you have any questions, get in touch with us so that we can answer them.

  • Via email on our form.

  • Call us on +34 910 551 655


Which services do I have to receive authorisation to use? And how do I request authorisation?

As a general rule, you need to request authorisation for hospitalisation, high-tech diagnostic tests, special treatments and prostheses. However, we will tell you about the tests that specifically require authorisation.

And with it request it:

  • By calling us on +34 910551655

  • By contacting us through your Customer Area, as long as you are the policyholder of the Medical Insurance policy.

Once requested, we will get in touch with you via text or via a phone call.


How do you pay me back any Pharmacy Costs?

It’s simple. You can do it online through our Customer Area by clicking on the “reembolsos” option or by postal mail:

Print out the Pharmacy Costs request form, and attach the original invoices and the medical receipt that your doctor has given you. *The receiving patient’s full name must appear on them.

  • Send it to us at Caser, Avenida de Burgos, nº 109, 28050, Madrid

  • After 15 working days, we will reimburse you with a payment into the same account that you use to pay your insurance direct debits.

And that’s it..


How do I get my eyeglasses reimbursement?

It’s easy. You can complete the process online via our Customer Area by clicking on the “reembolsos” option or through traditional mail:

Download the Pharmacy Costs request form, and include the original invoices and the medical receipt provided by your doctor. *Ensure that the full name of the receiving patient is clearly stated on these documents.

  • Mail the form and attachments to us at Caser, Avenida de Burgos, nº 109, 28050, Madrid.

  • Within 15 business days, we will initiate a reimbursement to the same account used for your insurance direct debits.

And that is all.


What is a Second Medical Opinion?

With Caser Salud, we guarantee that you can have a second medical opinion, meaning complementary information and a medical opinion from an expert doctor about a serious illness, such as Oncological diseases, Cardiovascular diseases, Neurological and neurosurgical diseases (including cerebrovascular accidents, spinal cord injuries, degenerative and demyelising diseases of the nervous system), Acquired Immune Deficiency Syndrome (AIDS), etc. without it costing you anything extra.


What should I do if my insurance card lost?

If you lose your Caser card, don’t worry. You can request a new one in two ways.

  • Customer Area. Access your customer area to request it.

  • Call us on +34 910 551 655.


Where and how to file a claim?

Caser offers the “Servicio de Defensa al Asegurado” [Insured Defence Service] (Complaints and Claims) for all their customers at Avenida de Burgos, no 109, 28050 Madrid, and at the email address defensa-asegurado@caser.es

If your claim is dismissed or more than two months have passed without you having received a response, you can also start an administrative claim process brought before the “Servicio de Reclamaciones de la Dirección General de Seguros y Fondos de Pensiones” [the General Insurance and Pension Funds Directorate Claims Service], Paseo de la Castellana, 44, 28046 Madrid. Likewise, you can go to the appropriate Courts and Tribunals service.


Am I entitled to any tax benefit with health insurance?

In general, with Insurance for Individuals, the premiums paid for the current insurance do not confer any rights to any tax benefits. They are not deductible from Personal Income Tax (IRPF in Spanish) and do not confer any rights to deductions or allowances. However, there may be certain special cases in some Autonomous communities.

In the event that the policyholder is a business owner or a professional who is subject to IRPF under the Direct Estimate Tax Regime, there is a maximum limit for deductions per person and calendar year.


What does hospitalization mean?

An insurance policy with hospitalization cover is a health product that guarantees hospital care, offering the insured party a wide range of useful cover.


How to calculate your health insurance premium?

Although our goal is to know that, you are always satisfied, we are aware that there are areas in which we can still improve. For this reason, our Policyholder Advocacy Service is at your disposal


Does health insurance cover hospital stays?

When selecting the health insurance that best suits your protection needs, you will have the possibility of choosing between those modalities that include hospitalization coverage in your health insurance or those that, on the contrary, do not include this possibility. 


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