In our research we were surprised to find that several
countries around the world ranked higher than the US in quality of health
care. In most cases, the cost of health
care in these countries is significantly less than in the US. We have purchased our insurance in Spain through
Sanitas, which is the largest insurance network in the country. At the time Spain ranked 8th in
quality of care and the US ranked 24th in one of many reports that we read.
Our plan looks like a regular US PPO plan that includes doctor
visits, lab work, hospitalization and up to 60 days and 20,000 euros per person
in travel insurance coverage including travel within the US. We were able to purchase it by working with an English speaking agent completely by email(see complete info below). We filled out the required two forms she needed, scanned and sent them back and had coverage start the day we arrived in Spain.
How has it worked out?
Well, for starters, we had some trouble obtaining our insurance cards
because Sanitas had an incorrect address for us. This took two months to iron out but in the
meantime we had a toll free number for the providers to call if we required
health care and an email which included our policy numbers and anything else
that we would need to verify that we did have coverage.
Sanitas has a web site where we could look up the doctors
that were in our city and participated in the private insurance plan. We could sort them by location and by the
ability to speak English. Since we had
almost no Spanish at all when we arrived in Spain this was an important factor
for us. The web site is in Spanish but
the auto-translate in Google Chrome worked just fine for figuring it out.
Marilyn had a nasty cold or flu bug when we first arrived in
Spain (caught it in the Canaries) and we walked into a pharmacy. Farmacias are wonderful things in Spain. Pharmacists are all doctors, they are diagnosticians and can prescribe most non-narcotic,
non-chemotherapy drugs including antibiotics. The pharmacist gave her a decongestant and cough syrup and told her the
problems would be gone in three days. It
was. How convenient! Total cost 9 euros.
10 days later Mike was having a problem. He started to experience severe stomach pain
and cramping and did not get out of bed for most of one rainy day in
Marbella. Marilyn decided something
needed to be done and walked down to the nearest Farmacia. After describing the symptoms to the pharmacist,
it was determined that he was suffering from stomach spasms and an
anti-spasmodic was handed to Marilyn.
She was told this should eliminate the problem in 1 or 2 days. It did.
Total cost 5 euros.
So now we had been indoctrinated into the first level of
health care intervention in Spain, the Farmacia. Inexpensive, convenient, and it worked. No appointments, no prescriptions, and if the
pharmacist thinks you need a doctor they will send you to one. In Spain, at least one farmacia must be open
24 hours every day in a specific area and the location of the nearest farmacia,
that will be open after hours for each day of the week are posted on the door
of every farmacia.
After we were settled in Granada, Mike noticed a mole that seemed
to be growing and become worried about it.
We made an appointment, with an English speaking dermatologist, in
Granada from the health plan network on the Sanitas website. It took us a couple of weeks to contact the
office because it was August and the office was closed for vacation. When we made the appointment it was on a
Friday at 6:30 p.m.
When we asked our friends about the odd time they told us it
was because we were “private” patients.
Turns out that the doctors usually work in the clinics in the mornings
until 2pm, then take the usual Spanish long lunch break along with the rest of
the population from 2-5pm and then see their private patients in their offices
from 5-8 in the evenings.
Arriving at the doctor’s office, we were buzzed into the
building and again, buzzed into the office.
There was very little traffic in this office building and the only
person in the waiting room was the medical assistant. We were shown to a waiting room that would
rival the lobby of many prestigious law firms and we gave the medical assistant
our health insurance card.
The card was returned and we were shown into the doctor’s
consultation room, where the doctor himself took a medical history quickly and
efficiently. The physician spoke with us
about the problem and took Mike into his examination room which was attached to
his office. After determining that the
mole wasn’t dangerous we asked him if he would remove it anyway. He agreed but explained that we would have to
get an authorization from the insurance company for them to cover the 80 to 90
euro procedure. We scheduled an
appointment for two weeks hence and left with the information needed to obtain
the necessary authorization.
Obtaining the authorization was relatively easy, done on the
Sanitas website (we really needed our Spanish for this) and the mole was
removed. The doctor gave us the removed
mole in a bottle of liquid with the name of a pathologist and an authorization
note and told us that if we wished, we could have the pathologist evaluate the
tissue…just to be sure. He was positive
that the tissue was not problematic but wanted me to have the choice. I chose not to. Total cost 12 euros, each visit – the copay
for the office visit.
There is a limitation of coverage in the public health
service, for example, one of our friends, a Spanish citizen, needed to have
oral surgery to remove a small benign tumor.
This surgery included the removal one of his upper teeth. He was scheduled for surgery about three
months after the problem was diagnosed.
The surgery is covered in full but a bridge or implant after the surgery
is not. He will be out of pocket about 600
euros to fix his teeth. This is still
cheaper than in the US, but a lot of money here in Spain. He has contacted the University to find out
if he would be eligible to have the dental students do the reconstruction work,
if so, it will cost about half the normal fees.
Under a private insurance plan the dental work after the
procedure would be covered at 50%.
Interesting.
Jumping ahead six months; after we got our final invitation
to serve in the Peace Corps it included the need for an updated medical
check-up. Since our insurance coverage
was in Spain, with the approval of the Peace Corps we went to the web site, for
an English speaking family practitioner and scheduled an appointment for what
we in America would call an annual checkup.
Our Spanish was much better but for medical situations we were still
more comfortable in English.
The appointment was scheduled for two days out, we went
together. The doctor was great. Once she understood what we needed (apparently
annual exams are not normal in Spain) she examined us both and wrote out the
orders for a complete blood work up.
Then she told us where to go to get the document that is the Spanish
equivalent of a “Certificate of Good Health” for her report needed by the Peace
Corps (in Spain you must purchase all the forms that are required by the
government). These particular forms cost
3 euros each and the doctor shared a laugh with us when she told us that, believe
it or not, you buy them at the estanco (tobacco shop). Irony at its finest.
We found a lab in the insurance network and were told to
come anytime between 8:30am and 1pm on a weekday – no appointment
necessary. We went on a Thursday morning
and, after hilariously learning a new Spanish word “orina” (urine – funny,
never needed that word before this) we were in and out in less than 30 minutes,
with the results to be picked up on Monday.
No cost, it was included in our insurance. Back to the doctor with our reports in hand, in and out with our certificates signed and a hand written translation done and signed by the doctor in no time at all.
So far, we have to say that our experience with the Spanish
health care system has been absolutely fabulous and worth the total monthly
cost of about $190 in premium plus co-pays for both of us together.
Our Insurance agent info:
Our Insurance agent info:
Susan Warner
and new email info@healthinsurance-spain.com
Sanitas Agent 17517
telephone: 951 272 124
Mobile: 615655348
Fax:951239211
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