Medical care in Spain is at a very high level. In particular, there are several leading European clinics on the Costa del Sol, which are recognized by the European community.
Thus, voluntary health insurance for both foreigners living in Spain and for tourists or property owners on the Costa del Sol (in Marbella) is an integral part.
AgrupacioMutua was founded in 1902. It is one of the leaders in the health insurance market. The company's offices are located in all regions of Spain (headquartered in Barcelona), in particular on the Costa del Sol.
Insurance conditions are very flexible. The price of the insurance policy will largely depend on the conditions that you choose.
Below is a detailed description of what Totalmedic includes, what it covers, and the approximate amount of the insurance policy per family (this amount will vary depending on age).
Totalmedic
What's this?
This is a health insurance program that gives you complete freedom to choose a doctor or medical institution around the world - the company will reimburse you for the money spent.
Discounts available for families of 3 or more
How does the program work?
In Spain:
Full coverage in clinics from the list provided by the company - when contacting them, you just need to present your AgrupacioMutua magnetic card, without fees or any formalities.
Payment of monetary compensation in the amount of 90% of the funds spent on services in clinics that are not included in the list provided by the company.
Outside Spain:
Payment of monetary compensation in the amount of 80% of the funds spent on treatment.
Cash compensation limits
Limit of monetary compensation for one insured person: 200,000 Euro per year, of which:
Hospitalization costs 150,000 Euro
Outpatient treatment costs 50,000 Euro
The annual limit per insured person is EUR 200,000, of which EUR 150,000 is the limit for reimbursement of expenses for inpatient treatment and 50,000 is the limit for reimbursement of expenses for outpatient treatment. The company undertakes to pay compensation within 15 days after receiving the invoice and documentation for the medical services received. In cases where the cost of services exceeds 3000 Euros, the insured may request the company to make an advance payment.
Compensation is paid by the company by bank transfer to the account of the insurance policy holder.
The amount of insurance premiums is determined in accordance with the age limits, which leads to a reduction in the insurance premium for family insurance policies.
Payment form
Once a month - 2% discount
Once every 3 months - 3% discount
Once a year - 4% discount
What does the insurance cover?
The insurance policy covers medical services both in inpatient and outpatient settings, as well as in emergency centers, while the compensation limit is 70 Euros for a visit to a general practitioner and pediatrician, 125 Euros for a visit to a narrow specialist.
Diagnostic methods
Analyzes (clinical, biochemical, cytological, etc.), radiography, ecography, Doppler ecography, etc.
6 months after the purchase of the insurance policy: digital arteriography, ergometry, vascular hemodynamics, Holter monitoring, bone densitometry, computed tomography, nuclear medicine, prenatal tests, positron emission tomography (PET). The cost of radiological contrast materials is covered by the insurance company.
Treatment Methods
3 months after the purchase of the insurance policy:
Aerosoltherapy, laser therapy in ophthalmology and otolaryngology surgery, pain treatment
After 6 months after purchasing the insurance policy: lithotripsy, radiotherapy, cobalt therapy and more.
12 months after the purchase of the insurance policy: outpatient chemotherapy in oncology.
Rehabilitation
3 months after the purchase of the insurance policy. Includes electrotherapy and magnetotherapy.
Family planning
After 6 months from the purchase of the insurance policy: female and male surgical sterilization.
Obstetrics, surgeon and midwife, materials, drugs and anesthesia, accommodation in a ward with a bed for an attendant. Coverage after 8 months after the purchase of the insurance policy, except for urgent cases (in cases of premature or complicated birth, services are provided without taking into account the terms of the policy). The limit is 4,000 Euros for a normal birth or a caesarean section.
After 6 months from the purchase of the insurance policy: includes the fees of the surgeon and assistants.
Hospital treatment
Coverage 6 months after the purchase of the insurance policy. Includes costs for material, medicines, anesthesia, operating room, diagnostic methods, meals, accommodation in a ward with a bed for an attendant.
The compensation limit is 300 Euro/day in the hospital and 500 Euro/day in the intensive care unit.
Help for recovery
After undergoing operations, when the patient was in the hospital for more than 7 days, he is provided free of charge:
- 1 month teleassistance
- 10 hours of home assistance services
Prosthetics
Prosthetics (price of prostheses included): heart valves, pacemakers, hip prostheses, vascular bypass, intraocular lens prostheses in cataract surgery, breast prostheses after mastectomy, internal prostheses in traumatology. The coverage takes effect 1 year after the purchase of the insurance policy and has no limits on the cost of prostheses.
Organ transplant
Coverage 12 months after the purchase of the insurance policy and with a limit of 6000 Euros per process.
Emergency ambulance: compensation limit 610 Euro per year
Travel assistance: coverage up to 12,000 Euros
Preventive medical examination once a year: only in medical centers from the list provided by the company
Payment protection
Economic support (payment by the insurance company of insurance premiums for a period of up to 6 months) in case of loss of work by the insurance policy holder or his temporary disability
Stem cells
Cord blood stem cells collection and preservation service for 25 years, for a fee at special rates of the company.
All time limits on insurance coverage are canceled in the event of life-threatening conditions that arose and were diagnosed after the entry into force of the insurance policy, as well as if the insured made a transfer from another insurance company (except for childbirth (8 months) and outpatient chemotherapy (12 months)).
Second medical opinion
Childbirth preparation course
Medical consultations by phone 24 hours a day, 365 days a year
Equal medical coverage for both newborns and adopted children
Otological examination of a newborn to prevent deafness
Additional services
At special prices of the company, you can contact specialists in specialties that are not included in the main list and are additional or alternative:
Psychology1, Dentistry1, Podology1, Refractive Surgery, Plastic Surgery, Acupuncture2, Homeopathy2, Dietetics, Natural Medicine2, Speech Optics, Audiology, Reproductive Medicine, Postpartum Rehabilitation, Preventive Medicine, Sports Medicine. (1- some procedures or manipulations are free of charge according to the 'List of Medical Services'; 2- The first visit is free of charge)
Who can be insured?
Any natural person residing in Spain, aged:
Individual policy: from 0 to 64 years
Family policy:- policy holder: minimum age 18
-Insured from 0 to 70 years
The average age of the insured cannot exceed 64 years
On average, annual health insurance for a family of 4 (2 adults and 2 children under 18) can cost around 3,000 euros.
www.agrupacio.es
