Private Health Insurance Spain

It seems difficult to Set a list of Top Definitions about Private Health Insurance in Spain is difficult if we consider the number of definitions and legal terms.

Because of our experience, please explain to me what a Day Hospital is “……. Copayments…”, “…..Preexisting illness or condition is…” are a big part of most of the FAQs we must clarify to our clients which most of them do exists in other countries but as usual, some context is “lost in translation”.

Certainly, there are many things you need to know about your health insurance for Spanish residency, however, there are top definitions you need to understand when purchasing insurance in Spain.

These definitions are important to understand how does your Private  Health Insurance in Spain works.

Without further ado, let’s get started.

Top Definitions about Private Health Insurance Spain

Specific Terms and Conditions

Document forming part of the Policy in which the characteristics of the risk being insured are specified and individualized.

Health Questionnaire in Private Health Insurance Spain

Declaration made and signed by the Policyholder and/or the Insured before formalizing the Policy and which is used by the Insurer in assessing the risk being insured.

Pre-existing illness

Illness suffered by the insured before the date on which the insured is incorporated into the policy.

Day Hospital

A person registered as a patient at so-called medical, surgical or psychiatric hospital units to receive a specific treatment or as a result of having been under the effect of an anesthetic for a period of fewer than 24 hours.

Claims Waiting Period or Term

Interval of time during which some of the coverage included in the guarantees of this Policy is not in effect. The said period is calculated in terms of months as from the date on which the Policy comes into effect for each one of the Insured included in said Policy.


The document or documents containing the clauses and pacts regulating the Private Health Insurance contract. These General Terms and Conditions, the Specific Terms and Conditions identifying the risk, and any Special Terms and Conditions which may exist, as well as any Appendices containing the modifications, agreed to during the term of the agreement, form an integral and inseparable part of the Policy.


Individual or entity which signs this Agreement together with the Insurer and thereby accepts the obligations stipulated therein, in exchange for the obligations which the Insurer takes upon itself, although certain obligations, owing to nature thereof, must be complied with by the Insured themselves.

Insurance Card

Document owned by the Insurer which is issued and sent to each person insured under the Policy, the use of which is personal and non-transferable, and which is required to receive the services covered by the Private Health Insurance in Spain.


The amount in which the Policyholder is required to pay the Insurer to collaborate in the financial coverage of each health service used by the Insured included under the Policy. Said amount varies in terms of the different types of healthcare services and/or medical specialties, and the amount thereof, which is determined in the Specific Terms and Conditions, may be updated each annual insurance period.


Acronym for Ayudante Tecnico Sanitario / Diplomado Universitario de Enfermería is a professional who is legally capacitated and authorized to practice the activity of nursing.


The individual or individuals on whom the insurance is taken out


The company which takes on the risk agreed to under contract.

Services Catalogue or Participating Providers

Also called Medical Staff or Medical Panel consists of a Published list of healthcare professionals and establishments located in each province and operated directly by the Insurer or through an agreement with the Insurer, containing the corresponding address, telephone number and office hours. 


Is Any alteration in the health of the Insured not owing to an accident, and which is diagnosed by a physician, requires medical care and the initial symptoms of which appear during the term of the policy.

Hence bear in mind that when you’re purchasing your health insurance for Spanish residency it’s an obligation of your insurance manager to email you the Particular Conditions and General terms and conditions of your policy.

Finally, as a SegurCaixa Adeslas Certified Commercial Office focused on Expats, our main goal is to make things easier to our portfolio, this is why we offer a variety of electronic services such as GDPR Compliant on-line Signature, Online Payment, among others, in other words, no call centers in Spanish. Once you purchase your Private Health Insurance Spain with us, you will enjoy our customer care in English, Incidents Management through our office via email or phone call, Authorization, and more.

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