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HEALTH PLAN BENALMADENA GENERAL
Introduction:
HEALTH PLAN BENALMADENA is an insurance for everbody with a postal address and a Spanish bank account in Spain. With your personalised swipe card you have direct access to the network services of Sanitas. There is no limit per insured as long as the medical network of Sanitas is being used. For approval for an operation or special examinations, you should telephone 902 10 24 00. This is after the doctor or specialist of the medical network of Sanitas has given you a voucher.
The cover of HEALTH PLAN BENALMADENA (see also under HEALTH PLAN GENERAL CONDITIONS):
In general the following services are included:
- General medicine and specialities (consultations);
- X-rays and diagnostic tests;
- Anatomic pathology;
- Psychiatry (consultations);
- Ophtalmology (consultations);
- Outpatient surgery;
- CAT scans and nuclear magnetic resonance (NMR);
- Oncology (consultations, test and medication);
- Preventive dentistry (consultations, dental cleaning, extractions and cures);
- Logophoniatrics;
- Hospital Care;
- Ambulance transport;
- Second medical opinion: if you fall seriously ill, you are entitled to a second opinion from a specialist of international reputation.
- Preventive medicine programmes;
- Childbirth preparation programmes;
- Children's health programme;
- 24-hour telephone helpline.
For dental treatment, you can take out the dental supplement named SANITAS DENTAL. With this discount product basic treatments (consultations, dental cleaning and extractions) are free and other treatments have a discount of up to 50%. There is no waiting period.
The covered areas of SANITAS HEALTH PLAN BENALMADENA
- The cover is national. So you can live anywhere in Spain. However, most of the insured live in Benalmádena, hence its name.
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- Since 2008 you can also use the medical network of Sanitas in the United States. Hospitalization is than covered up to ? 24.000 with a sublimit of ? 1.500 for the delivery. Outpatient treatment is covered up to ? 6.000. You need to call Sanitas for this on number 902 408 409.
Please note that travel and lodging costs are not covered.
- HEALTH PLAN includes a travel insurance covering your healthcare needs when abroad. This service is offered in collaboration with Europ Assistance. The number you should dial is +34 91 345 65 84 (also on the back of your insurance card). If necessary you can make a collect call.
The cover is worldwide and is valid for trips shorter than 90 days. Medical expenses are covered up to a maximum of 10,000 euros per person per claim. If necessary the insured will be brought back to Spain. The costs hereof are unlimited. Furthermore, if you are entitled to the Spanish Social Security, I strongly advise you to ask them for a free blue card (Tarjeta Sanitaria Europea) for medical assistance in most European countries. This card is known in those countries and avoids you to pay for medical travel costs in advance.
If requested I can help you with a single travel insurance or an annual travel insurance (annual premium from 105,24 euros), covering medical expenses without a limit.
The most important exclusions of SANITAS HEALTH PLAN BENALMADENA (see also under HEALTH PLAN GENERAL CONDITIONS)
- There is no cover for all types of pre-existing and/or congenital diseases, defects or deformations, as a result of accidents or diseases that occured prior to the date of each Insured's inclusion in the policy; as well as those that may stem from the former. Therefore it is important to declare all health problems in order to know if Sanitas wants to exclude something. For problems related to the exclusion, you can use the services of the Spanish Social Security (if you are entitled to them).
If you have a pre-existing disease or defect and you don't want exclusions in your policy, I might be able to help you with a medical assistance cover without personal exclusions from another insurance company. Please ask me for more information.
oseEd - There is cover for domestic and sport accidents, but in principle not for work and traffic accidents. Work accidents should be covered by the employer and traffic accidents by the Spanish car insurance.
However through a separate accident insurance with an annual premium from 45,36 euros, I can help you with medical assistance cover in case of any accident in principle. It is important to show the policy or know the policy number when medical assistance is requiered. Connected clinics are among others Cl?a Santa Elena, Hospital Xanit and USP Hospital de Marbella.
- There is no cover for medicines related to out-patient treatment. So if the doctor or specialist of the Sanitas network prescribes a medicine, you have to pay the medicine at the pharmacy yourself.
- Furthermore there is no cover for:
* organ transplants (except autologous transplant of bone marrow peripheral blood parent cells due to tumours of a haematological strain, and cornea transplant);
* chronic dialysis;
* rehabilitation after a neurological problem (e.g. a cerebral hemorrhage) or because of the Crohn's disease.
If entitled to, you should use the Spanish Social Security for this or take out a medical assistance cover from another insurance company. Please ask me for more information.
Above shows that HEALTH PLAN should be seen as a supplement on the Social Security. But the cover of CLASSIC is so good that in practice you never use the services of the Social Security.
The waiting periods after starting SANITAS HEALTH PLAN
HEALTH PLAN has generally only waiting periods for hospitalization (8 months) and for sterilization (180 days). Please note that the first insurance year any request for physiotherapy, tests, etc. will be checked in order to see if the cause was prior to the effective date of the insurance. If so, the request might be refused.
Entrance age and medical history:
The maximum entrance age is normally 69 years. And the medical history will always be taken into account.
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