How to choose a medical insurance policy: what you need to take into consideration

 

According to data supplied by Unespa - the Spanish association of insurers - 20 years ago, around 6.4 million people in Spain had medical insurance. Today, this figure has doubled and one out of every four people in Spain have health insurance. But, what do you need to take into consideration when taking out medical insurance? Do you know how to choose a medical insurance policy that’s right for you?

If you are unsure, this guide explains how to choose a health insurance policy, from the main factors to take into consideration to the best tips for taking out an insurance policy that best meets the needs of you and your family. And of course, Adeslas private medical insurance can be adapted to every healthcare need. What are you waiting for? Find out more about our policies.

 

Factors to take into consideration when it comes to choosing your medical insurance policy

Not all medical insurance policies are the same. There are a range of health insurance policies ranging from basic to policies with maximum coverage and protection. That’s why it is so important to familiarise yourself with the various features. If you are not too sure, take note and discover how to choose a medical insurance policy that is right for you.

 

Primary healthcare

This specialism consists of healthcare provided by a doctor, paediatrician or nurse. The Adeslas Primary Healthcare cover includes the following features:

  • General medicine. Assistance at a clinic or at home.
  • Paediatrics. Assistance for children under 14 years of age.
  • Nurse’s office. Service at the clinic and also at home if the patient is bed-bound and after authorisation from an Adeslas-approved physician.

 

Medical specialisms

Undoubtedly, one of the main benefits of taking out health insurance is the option to access a medical specialist directly, without needing to have a consultation with a general practitioner to refer you. In this regard, the provision encompasses multiple specialisms ranging from allergology to urology to cardiology, surgery, endocrinology and nutrition, ophthalmology, oncology, traumatology, etc.

If you are not too sure which doctor to choose, it is important to pay close attention to the medical specialisms in each type of policy. The more you have, the better.

 

A&E

If you have ever wondered how to go about selecting a medical insurance policy, it is also essential that your insurance includes healthcare for emergency situations:

  • Firstly, emergency care in permanent A&E centres (24 hours).
  • And secondly, emergency care at home should the patient so require.

 

Hospitalisation

If you are ready to take out health insurance, it is a good idea to select a medical insurance policy with hospitalisation. This refers to the medical care that a patient receives while admitted to a hospital centre, after this has been prescribed by an approved specialist.

Insurance policies cover different kinds of hospitalisation:

  • Obstetric hospitalisation (deliveries).
  • Medical hospitalisation without surgical intervention.
  • Surgical hospitalisation.
  • Paediatric hospitalisation (for children under 14 years of age).
  • Hospitalisation in an Intensive Care Unit (ICU).
  • Psychiatric hospitalisation.
  • Day hospitalisation (for admissions under 24 hours).

 

Dental insurance

One of the most frequently-used medical insurance policies is for dental cover. Dental care is provided in different ways:

  • Through the insurance company’s own clinics
  • Through preferential dental clinics 
  • Other approved dental clinics

With each of these, the insured party will be entitled to a series of free dental services, and will need to pay the cost established for any dental care provided by the professionals.

 

Medical team

In view of the above, another essential factor when it comes to selecting a medical insurance policy, is to have a list of professionals and healthcare centres, either the insurer’s own or those that have been approved by them, which are available to the insured parties.

  • This is what is known as the medical team.
  • The list should state the address, customer service telephone number and opening hours for each professional or healthcare centre.

 

Refunds

Since we already discussed the insurer’s medical team, we should also deal with the option to access whichever professional we choose without them being included on the list of specialists or medical centres linked to the insurance company. Let’s look at what medical insurance with refunds consists of:

  • For some healthcare options, the insurance companies enable the insured parties to be cared for by professionals and medical centres that are not part of their medical team.
  • Once the insured party has paid the bill, they can request a percentage of the money back from the insurer (according to the provisions set out in the policy’s general conditions and up to the maximum limit established).
  • To receive a refund for the expenses, the original invoice will need to be presented on behalf of the insured party, as well as any medical reports and/or prescriptions, within a certain timeframe.

 

Co-payments

Speaking of payments, co-payments involve paying a small amount of money on top of the insurance premium for the use of certain medical services included in the policy.

  • Health insurance with co-payment fees is a common option with insurance companies and it enables holders to balance out the premium.
  • More simply: like coverage, medical insurance policies with co-payment fees are cheaper than medical insurance policies without co-payment fees.

 

Waiting periods

Continuing with factors that you should be aware of when it comes to selecting a medical insurance policy, something that is common with this kind of policy is the establishment of waiting periods. A waiting period is the time that an insured party must wait, once they have taken out their health insurance, before requesting any medical tests or interventions.

 

Exclusions and limitations

Lastly, as with other types of insurance, with every medical insurance policy, there are exclusions and limitations that are worth knowing about.

  • Exclusions. These refer to services, treatments, diagnoses, etc. that the medical insurance does not cover. Exclusions include dealing with pre-existing conditions which have not been declared in the health questionnaire to be filled in before signing the policy, but which the insured party is aware of. It may also be the case that these conditions would be excluded from the cover even if they had been acknowledged in the form.
  • Limitations. Similarly, insurance policies have limits. For example, in regard to the scope of certain provisions or in terms of the refund for medical expenses.

 

Tips for selecting the best medical insurance policy for you and your family

Having reached this far, we trust that you now have a better idea about how to choose a medical insurance policy. Putting the following tips into practice will also help you find the medical policy that best meets your needs.

 

Assess your needs or those of your family

When it comes to assessing which health insurance policy to choose, you will likely need to consider more than just your own needs. If you have a family and you want all the members of your family to be well-protected, this is all the more reason to pay particular attention to the care that they may need.

At Adeslas, we are aware that every insured party has different needs. That’s why we have medical insurance policies that can be adapted to every healthcare need:

With this wide and varied selection, Adeslas makes it easy to take out an insurance policy that is tailor-made to you. Assess your needs or those of your family and choose whichever one best suits the healthcare you are going to need.

 

Assess the budget you have

And as you consider how to choose a medical insurance policy, you should also calculate your budget. The health insurance premium obviously varies depending on different factors: the number of insured parties, the type of cover, the age of the people included in the policy, whether or not it includes co-payment fees, etc.

If you would like to find out how much a health insurance policy would cost at Adeslas, you can find more information at our sales branches or by calling 900 50 50 40.

 

What other benefits should I take into consideration?

Finally, when you are taking out health insurance, it is worth noting if the policy has any added benefits. For example:

  • Online medical care. Remote consultations, video consultations and online medical advice.
  • Online health services. Online authorisations and refunds, digital cards and electronic prescriptions.
  • Customer service. Service channels for insured parties to make any enquiries 24 hours a day.
  • Discounts. Programmes that enable holders to save on health and wellbeing products and services.

With all the above, we hope we have been able to help you discover how to go about choosing a medical insurance policy. Remember: once you know what type of healthcare you are going to need, analyse the different Adeslas medical insurance policies and select whichever one best meets your needs and budget. We take care of looking after you!