How Treatment Is Arranged With Sanitas Residents Visado
Some care you can walk into. Some needs a written prescription from a doctor in the network first. Some needs Sanitas to authorise it before it happens — and for a small number of major operations, Sanitas appoints the hospital and the surgeon itself. Below is what the General Conditions say about how each route works — the conditions for Sanitas Residents Visado, which that page links for download in full.
Nine routes, and which one applies to you
The conditions do not provide every kind of care the same way. Some care you walk into. Some needs a prescription from a network doctor first. Some needs Sanitas to authorise it, and a few procedures are arranged by Sanitas from end to end. Knowing which applies is the difference between turning up and being turned away.
- Walk in. You may attend freely, in Spain, the consulting rooms of consultants, general physicians and paediatrics, and the emergency centres in the Sanitas contracted network for this product. The clause adds a check worth making: your User Guide to Doctors and Services names the consultants for which a prescription or authorisation is needed first, so free access is the general rule rather than a guarantee for every name on the list.
- A network doctor writes a prescription. Diagnosis tests, therapeutic methods and certain care services need a written prescription from a physician in the Sanitas network before they can be performed. Psychology consultations specifically must be prescribed by a psychiatrist, general practitioner, oncologist or paediatrician.
- Prescription, then Sanitas authorises it. As a general rule, surgical operations and inpatient treatment need express prior authorisation from Sanitas following a written prescription from a network professional. Certain therapeutic methods, diagnosis tests and other care services need the same.
- Certain techniques need an accredited professional. Laparoscopic and arthroscopic procedures, and those using radiofrequency or laser techniques, must be carried out by professionals specifically arranged and accredited by Sanitas for that technique.
- For complex surgery, Sanitas appoints the team. For neurosurgery, heart surgery and backbone surgery covered by the policy, Sanitas appoints the healthcare centre and the professionals for each individual case, before the procedure.
- Care at your home. Sanitas provides home services in localities where it has an arrangement for them, covering family medicine, paediatric medicine, emergency care and nursing. Any change of home address must be notified reliably, with at least eight days' notice, before requesting a service. The same eight-day duty carries on through each renewal.
- Temporarily in Cantabria or Navarra. Care there is provided through the networks of entities Sanitas has contracted for those regions. Present your Sanitas card at their offices and follow their administrative steps. This is about using a policy you already hold: it does not mean that a new policy can be arranged for someone whose insured address will be in either region.
- Emergencies. Emergency care is provided through the resources Sanitas designates, as set out in the User Guide. In a life-threatening emergency where you need to be admitted, Sanitas must be informed reliably so that it can transfer you to a partner centre once your condition allows.
- Providers outside the network. Outside the life-threatening emergency route above, Sanitas does not pay the fees of professionals outside its medical network, or the cost of admission or services those professionals order. Treatment you arrange yourself outside the network is not covered, whoever recommended it.
This page describes Residents Visado. Residents Platinum Visado works differently in places, and we have not set its arrangements out here. Routes one to five are about permission — what has to happen before a service goes ahead. Six and seven are about place. Eight and nine are what happens when something is urgent, or when you step outside the network. If you are unsure which applies to a treatment you are planning, ask us before it is arranged rather than afterwards.
Three obligations that sit on the insured.
Show the card, and identification if asked. When you receive covered services you present your Sanitas card, and your national identity document if it is asked for.
Supply reports and estimates when asked. Where Sanitas asks for them, you provide medical reports or a provider’s cost estimate so it can decide whether the care requested is covered. Until those arrive Sanitas is not obliged to cover the request, so paperwork that sits waiting holds up the decision.
Understand who is responsible for the medicine.The same line is drawn twice over. Sanitas provides cover under the terms of the policy and is not bound by the decisions that professionals may make, whether or not they belong to its network. Put more fully: as the insurer, Sanitas covers the financial cost of the medical services required under the policy, but does not intervene in or supervise the medical acts performed by the healthcare professionals who treat the insured.
Ask us about a specific procedure
If you want to know which of these routes a particular treatment falls under, ask — we will go through what the conditions say, before you commit rather than after. No obligation.
Prefer to talk it through first? Phone an adviser, or request a callback.