GROUP HEALTH INSURANCE
Two policies to choose from. Double the benefit received.
Health insurance allows your company to offer the social benefit most valued by employees: healthcare. Because when you improve the relationship with your employees, your company also benefits.
- Available with a minimum of three insured persons.
- Three payment formats: policyholder, insured or mixed.
Two health insurance policies with the prestige and solvency of Mapfre Spain:
Healthcare insurance
Content Healthcare insuranceComprehensive coverage through Mapfre Spain's dedicated medical insurance pool that includes: medical, surgical and hospital interventions, to which other additional health-related benefits are added.
- 33,000 healthcare professionals.
- 450 health centres.
Reimbursement insurance
Content Reimbursement insuranceInsurance that lets you choose services and professionals from the Mapfre Spain approved medical list, or alternatively the medical centre or hospital you prefer, paying the expenses yourself and then being reimbursed for a high percentage of them.
- Reimbursement of 80% of outpatient expenses.
- Reimbursement of 90% of hospital expenses.
With benefits for your company
Improves the working relationship with employees
Content Improves the working relationship with employeesReduce absenteeism
Content Reduce absenteeismIt is a tax deductible item
Content It is a tax deductible itemAnd, of course, with benefits for your employees.
Access to top-quality healthcare
Content Access to top-quality healthcareFor him or her, but also for your family
Content For him or her, but also for your familyBetter work-life balance
Content Better work-life balanceWe're here to help you,
Insurance experts line: 91 807 09 84
Content Insurance experts line: 91 807 09 84Insurance mailbox
Content Insurance mailbox
It might be called insurance, but it surely means peace of mind.
For your business, your employees, your operations, your fleets ...
For your business, your employees, your operations, your fleets ...
Interest hedge
Healthcare insurance
Healthcare insurance is an insurance policy from Mapfre Spain which offers comprehensive coverage, through Mapfre Spain's dedicated medical insurance pool, made up of more than 33,000 healthcare professionals and 450 health centres, with medical, surgical and hospital interventions, to which other additional health-related benefits are added.
Summary of cover
- Primary care.
- Hospitalisation.
- Second diagnosis and access to the hospital network in the US. UU.
- Diagnosis of infertility and assisted reproduction (48 months grace period).
- Domestic and international adoption.
- Emergency medical care abroad.
- Specialist care.
- Organ transplants.
- Prostheses and implants.
- Psychotherapy.
- Osteopathy.
- Pedicure.
- Biomechanical study of walking.
- Cryopreservation of umbilical cord stem cells.
- Dental guarantee.
- Over-the-phone medical guidance.
- Psychological counselling.
- Paediatric counselling.
- Preventive and rehabilitation medicine, such as family planning, childbirth preparation, healthy child programmes, early diagnosis of diabetes and breast, gynaecological, coronary and prostate diseases, etc.
- Health channel.
Additional cover that can be arranged:
- Complementary medicine: acupuncture, homeopathy and natural medicine.
- Refractive surgery for myopia, astigmatism and hyperopia.
- Genetic obesity profile.
- Gastric balloon.
- Personalised home-help services.
- Access to the University Clinic of Navarra.
- Blood screening test for colon cancer.
- Enhanced neonatal screening.
- Discounts at aesthetic medicine and beauty treatment centres.
- Special prices in spas and thermal treatments.
- Special terms and conditions in day centres, residences and other services for senior citizens Mapfre Spain.
Reimbursement insurance
How benefits can be received
Benefits can be obtained in two ways from medical expense reimbursement insurance:
- Through a dedicated medical insurance pool
As with the Healthcare insurance policy, choosing from the services of over 33,000 healthcare professionals and 450 health centres included in the healthcare guide (Guía Médica Asistencial). - Through the reimbursement of expenses
Reimbursement insurance makes it possible to use not only the services provided through the medical pool, but also to freely choose services offered outside the medical guide, pay for them and be reimbursed later for a high proportion of the payment made.
Reimbursement limits
The maximum reimbursement amounts established for each type of cover are indicated in the policy itself and are reviewed each year based on the CPI. They also vary depending on whether the medical intervention is on an inpatient or outpatient basis:
- Outpatient: 80%
- Inpatient: 90%
Group health insurance terms and conditions
Policyholder
Group health insurance is only available to Bankinter customers that are companies or self-employed workers who are responsible for employees. It is not a necessary condition that the group of insured persons be Bankinter customers.
Insurable group
The insurable group may or may not be 100% of the company's employees.
The beneficiaries must have the status of groups, understanding a group to be those collectives that meet the following premises:
- An initial minimum of three insured persons.
- The insurable group must have a common relationship with the policyholder that is recognised by law. In general, it will always be the insured party (employee, associate, etc.) and their spouse and dependent children. Barring certain exceptions, other relationships are not authorised.
It will not be considered as a group and, therefore, should be treated as individual insurance:
- The company's customers.
- Subscribers.
- Industrial estates.
- Business confederations.
- Business associations.
- Merchants Associations.
- Shopping centres.
- Groups.
- Associations or groups of students or alumni.
- Subcontracted companies, suppliers or collaborators.
- Volunteers.
- Any grouping similar to those mentioned.
Types of groups
Depending on its composition, the group will be considered as either open or closed, in accordance with the following:
- Closed group
One in which, from the initial effective date, 100% of the insurable group is incorporated, but always with a minimum of five insured persons. - Open group
In this case, not all of the insurable group is included as membership is normally voluntary (minimum of 10 insured persons). It is equivalent to special terms and conditions for groups and candidates with a common bond, with proof of belonging to the insurable group being essential, in accordance with the insurance company's underwriting rules. - SMEs and self-employed
Where 100% of the insurable group is incorporated from the initial effective date (minimum three insured for self-employed and minimum five insured for SMEs).
Payment methods
Health insurance policies offer three payment formats:
- Policyholder payment.
- Insured party payment.
- Mixed payment: one part is paid by the policyholder and the other by the insured party.
Grace periods
Depending on the size of the insured group (number of insured persons) the grace periods may be reduced. The periods indicated below are those established, as standard, in the general terms and conditions of the policy.
- Six months
Surgery on an outpatient or inpatient basis, hospitalisations of any kind except for extreme or vital emergencies, magnetic resonance imaging, PET, gamma camera, coronary CT, vascular and interventional radiology, polysomnography, dialysis, urological extracorporeal lithotripsy, medical or radiotherapy oncology, second diagnosis, access to the US hospital network rehabilitation, treatments and special services. In the latter case, there is no grace period for the “Healthy child” programme. - Eight months
Cover for pregnancy, childbirth or caesarean section and cryopreservation of umbilical cord stem cells. - SMEs and self-employed
One in which, from the initial effective date, all of the insurable group is included (minimum three insured persons). - Eight months
Cover for pregnancy, childbirth or caesarean section and cryopreservation of umbilical cord stem cells. - Twenty four months
National and international adoption. - Forty eight months
Study of sterility and treatment through assisted reproductive techniques for both members of the couple.
FAQs
How does healthcare insurance differ from reimbursement insurance?
The differences are remarkable. In our case, the Healthcare insurance, the insured can choose professionals of all specialties and medical centres from a medical guide without having to make any payments, except for any services that have an excess.
In addition, reimbursement insurance gives the insured party a free choice of professionals or health centres; paying for the care they receive first and requesting reimbursement afterwards.
Can I split the payment of my premium?
Yes, in both insurances it is possible to make the payment on an annual, semi-annual, quarterly, bimonthly or monthly basis.
What is understood to be a group?
A collective of insured persons that meets these conditions is considered to be a group:
- An initial minimum of three insured persons.
- Policyholder: legal entity with a CIF Tax ID Number, (a NIF Tax ID Number is only authorised for self-employed business owners who are responsible for employees and have policyholder payment). The policyholder's signature is mandatory in the insurance application.
- The insurable group must have a common relationship with the policyholder that is recognised by law. In general, it will always be the insured party (employee, associate, etc.) and their spouse and dependent children. Barring certain exceptions, other relationships are not authorised.
What is not considered a group?
Here are a few examples that will help to make it simpler to understand:
- Customers.
- Subscribers.
- Industrial estates.
- Business confederations.
- Business associations.
- Merchants Associations.
- Shopping centres.
- Groups.
- Associations and groups of students and alumni.
- Subcontracted companies, suppliers or collaborators.
These, and any other grouping similar to those referred to, should be treated as individual policies.
Who pays the premium in a group insurance policy?
There are three formats:
- Policyholder payment: The entire amount of the insurance is assumed by the company.
- Insured party payment: payment of the policy is the responsibility of the insured party.
- Mixed payment: the cost of the insurance is shared between the company and the insured parties.
These, and any other grouping similar to those referred to, should be treated as individual policies.
What does Healthcare insurance cover?
The policy has various areas of cover that can be extended. These are as follows:
Basic guarantees
- Outpatient care.
- Primary care.
- Specialist care.
- Hospital care.
Additional guarantees
- Accidental death.
- Emergency medical care abroad.
- Domestic or international adoption.
- 24-hour medical guidance.
- Cryopreservation of blood and umbilical cord tissue.
Optional guarantee
- Dental guarantee.
Various value-added services are also included:
- Complementary medicine: acupuncture, homeopathy and natural medicine.
- Refractive surgery for myopia, astigmatism and hyperopia.
- Genetic obesity profile.
- Gastric balloon.
- Personalised home-help services.
- Access to the University Clinic of Navarra.
- Blood screening test for colon cancer.
- Enhanced neonatal screening.
- Discounts at aesthetic medicine and beauty treatment centres.
- Special prices in spas and thermal treatments.
- Benefits in day centres, residences and other services for Mapfre senior citizens.
What does Medical expense reimbursement insurance cover?
The policy has various areas of cover that can be extended. These are as follows:
Basic guarantees
- Primary care.
- Specialist care.
- Hospital care.
- Special treatments and services.
Additional guarantees
- Emergency medical care abroad.
- Domestic or international adoption.
- 24-hour medical guidance.
- Cryopreservation of blood and umbilical cord tissue.
Optional guarantees
- Dental guarantee.
- Great Cover
Various value-added services are also included:
- Complementary medicine: acupuncture, homeopathy and natural medicine.
- Refractive surgery for myopia, astigmatism and hyperopia.
- Genetic obesity profile.
- Gastric balloon.
- Personalised home-help services.
- Access to the University Clinic of Navarra.
- Blood screening test for colon cancer.
- Enhanced neonatal screening.
- Discounts at aesthetic medicine and beauty treatment centres.
- Special prices in spas and thermal treatments.
- Benefits in day centres, residences and other services for Mapfre España senior citizens.
USEFUL INFORMATION
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Health insurance offered by Mapfre España Compañía de Seguros y Reaseguros, S.A. and sold through Bankinter, S.A., as a BANCASSURANCE OPERATOR with registered office at 29 Paseo de la Castellana (28046 Madrid), recorded in Volume 1857, Folio 220, Page 9643 of the Madrid Companies Register, holder of Tax ID Number A-28157360 and registered with the special administrative registry of the General Directorate of Insurance and Pension Funds at the Ministry of the Economy and Finance (44 Paseo de la Castellana, 28046 Madrid), http://www.dgsfp.mineco.es, under the bancassurance operator code OV0028, has taken out the civil liability insurance required under Article 152 of Royal Decree-Law 3/2020 of 4 February on urgent measures, which incorporates into Spanish law various directives of the European Union concerning public procurement in certain sectors: private insurance, pension plans and funds, taxation and tax litigation.
The bancassurance operator has entered into insurance agency agreement with the entities listed here.