If you are planning on getting private health insurance in Spain, you must understand the policy terms in order to avoid unpleasant surprises and make sure you have the right medical coverage before arriving in the country.
One of the main aspects to notice in a health insurance policy are the waiting periods, which may affect both your health coverage and your insurance benefits after purchasing your policy.
What is a Waiting Period in Health Insurance?
Waiting period is a fixed period of time after the policy is issued during which the insurance does not cover the cost of a particular medical service. Waiting periods are commonly included in health insurance policy terms, designed to protect insurance companies from misuse.
The list and the duration of these periods, included to avoid policyholders who purchase a health insurance policy when they already require immediate assistance, varies depending on the type of health condition or treatments, insurance company and coverage.
Understanding waiting periods is key to choosing the best private health insurance, as well as to avoid unexpected claim denials.
While some waiting periods are quite short, others may extend for several years, so it is essential for the insured party to carefully go through the policy terms before making a decision.
Types of Waiting Periods
There are different types of waiting periods related to health conditions or treatments, that usually include an initial waiting period, and others related to pre-existing conditions, specific diseases and maternity.
Initial Waiting Period
The initial waiting periods usually apply to hospitalisation, surgery, complex diagnostics tests. They vary depending on the health insurance company, but it often ranges from 6 to 8 months after purchasing the policy.
This means the company will not accept any claims which require the indicated type of assistance during this period, except for life threatening conditions.
The purpose of this initial waiting period is to prevent individuals from purchasing a health insurance policy only when they already face medical expenses.
Pre-existing Condition Waiting Period
In some exceptional cases insurance companies may accept some pre-existing conditions applying waiting periods, which means the policy will not cover expenses related to these conditions for some time, ranging from 1 to 4 years, usually.
These previous conditions usually include some injuries or minor surgeries (like recently operated appendicitis). The duration of these waiting periods varies depending on the insurer and the specific health condition.
Choosing the best health insurance plan in Spain when having this type of condition can be a challenge and requires a deep knowledge of the market and its insurance companies. Studying different options, such as portability, might be of interest to avoid coverage gaps.
It is advisable to understand the different options in health insurance plans, including the differences between comprehensive insurance and outpatient insurance, and checking the policy terms and its list of diseases covered and waiting periods.
Maternity Waiting Period
Health insurance benefits related to maternity often come with waiting periods of 8 or 10 months.
This is particularly relevant for couples planning to start a family, so it is advisable to check the waiting periods related to these medical costs. In most cases the insurance company will not cover pregnancy check-ups and childbirth if the insured is already pregnant when the policy is taken out.
Why Do Waiting Periods Exist?
Waiting periods are designed to prevent individuals from abusing the system, and guarantee it is sustainable.
Health insurance services and premium pricing rely on the evaluation of risks, so it is necessary to avoid high medical costs from new policyholders for it to function properly and maintain stability.
With these waiting periods, insurance companies make sure purchasing a health insurance policy only when anticipating high medical costs is not an option.
How to Manage Waiting Periods Effectively
Although all these insurance exclusions might seem hard to understand, managing waiting periods effectively just requires some planning.
- Make sure you consider your healthcare needs in advance.
- Compare policies, insurance companies and waiting times.
- Avoid gaps in your insurance coverage.
- When switching insurers, study your portability options to carry forward waiting period credits.
All this can be way easier if you find a reliable insurance broker that helps you find the best private health insurance providers and plans according to your specific situation.
Can Waiting Periods Be Reduced or Waived?
Waiting periods vary, so you will have to compare the options available depending on your specific needs.
For example, portability can be ideal for your case, especially if you are switching companies without a coverage gap, and will minimize and cancel most of the waiting periods.
Nevertheless, comparing the different options in the market and their waiting times based on your personal health status is always a must if you want to get the right health coverage.
If you have any doubts and consider getting professional assistance to make an informed decision, contact us at Just Insurance. We have extensive knowledge of the market and specialize in health insurance for expats in Spain, so we will be happy to help you find the right private health insurance plan in Spain.
