Health insurance over 65 : How does it work?Yohan Leuthold
Health insurance over 65: How does it work?
In Spain, most insurance companies set a subscription age limit of 65. However, the insurance policies taken out have no specific age limit and are maintained throughout the life of the insured.
There are still several possible alternatives to take out an insurance after the age of 65:
1. DKV and SANITAS companies provide insurance up to the age of 75.
DKV Seguros, has been operating in Spain for more than twenty years as a branch of ERGO, one of the largest insurance groups in Germany and Europe. The company has 30,000 health professionals and 1,000 medical centers.
SANITAS was founded in 1954 and is part of the multinational group BUPA. The company has more than 45,000 healthcare professionals.
The companies have several options:
- Company network “cuadro medico”: The client will have to choose from a list of health professionals affiliated to DKV or Sanitas companies. With the company's card, the insured will not have to pay anything and the coverage will be automatic.
- Company network with copayment/deducible “cuadro medico con copagos": This formula also works with a network of healthcare professionals affiliated to the companies. The insured will get a private health card and automatic coverage. The monthly premium will be lower than the first formula because of the copayment/ deductible. The deductibles will be debited the following month with the health insurance Premium.
- Company' network and free choice of doctors : The insured will have the choice of choosing the health professional within the company's network and also outside the network, both in Spain and abroad. In this case, the client will get a refund of 80% of the bill if they consult outside the company's network.
There are also options to reduce your health insurance premium according to your needs. It is possible to take out an insurance policy that covers only hospitalization or only specialists. DKV offers DKV MODULAR insurance.
2. Take out insurance after the age of 75 with ADESLAS.
The company Adeslas has more than 40,000 specialists affiliated to the company and more than 1,500 medical centers. It is one of the most represented insurance companies in Spain and has recently started insuring senior citizens.
Until now, if you did not have a health insurance before you turned 75, the insurance companies would refuse you because you were over the age limit. The company Adeslas launched a few months ago the Seniors product that can match with your needs. The subscription age limit is 84 years old.
The insurance premium varies between 60 euros/month and 120 euros/month:
- 55- 59 years old: 60 €/month
- 60-64 years old : 70 €/month
- 69 years old : 80 €/month
- 70-74 years old : 100 €/month
- 75-84 years old : 120 €/month
The insurance company has a specific medical questionnaire with somes diseases accepted:
- diabetes type 1
- Chronic obstructive pulmonary disease
- Class one and two obesity
The insured will have a personal health advisor at the time of subscription and make a personalized plan and support for a client who requires special attention. A doctor will be assigned a dual function: assistance and support in the management of health needs.
The advisor will be responsible for monitoring you and referring you to other specialists. In addition, he will provide to the client with the most efficient and economical way to access to health care. The client will be able to have the main medical specialities without any copayment, or with a copayment for the rest of the medical assistance.
Co-payments also have maximum limits, so that the insured will always know how much he has to pay. These limits are 250 euros per year for outpatient treatment and 700 euros per year for inpatient treatment.
The insurance covers emergencies, specialists and general practitioners, tests, protheses and surgeries.
If you don’t have health insurance yet, don’t hesitate to ask us for a comparison of the best health insurance here.
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