Actual cover provided?

I have both private health insurance and have cover via the S1 also. My private health cover includes doctor consultations similar to the family doctor in the public health centre. It covers all specialist consultations. I have had two scans recently which were covered without question.  Luckily I haven't had any operations but my policy covers every eventuality and with no co-payments. The private health insurance is handy if you have an emergency and you can't get an appointment in the public health centre immediately, however, you can always use A&E in the public hospitals if the circumstances warrant it. The only reason I keep the private health cover is because I have a couple of chronic illnesses and this provides a safety net and Im lucky to be in a financial position to do so.. I'm sure you will agree the Spanish public health service is excellent. I should also mention if the private institution prescribes medication that needs to be taken on a long term basis the public health doctor will, providing you present all documentation from the private medical practice, add it to your public records and provide prescriptions which lessons the cost.

My private medical covers everything including dentistry and phycology. Best thing I bought because my daughter's really needed it. As long as you declare any or all current medical issues then they should cover most people. 

So if you are healthy and well and have an accident or just with age you need a hip operation then it's all paid for provided you are on the premium rate

Thanks for that Martyn.

So is there different layers of cover? You mentioned "provided you are on the premium rate".

Is there not full cover then on different layers?

The enquiry is for a young woman in her 40's.......

Steve 

Well I'm with DKV and they have I think 4 different types of cover. I'm on the highest level so I never pay monthly or if ever I visit the hospital. But the lowest package was about €10 a month with Copay and with that package you pay for treatment at hospital. If applying for visa the top level of insurance is needed. Its definitely worth it though, I do think the Spanish social system is brilliant but going private is better, hospital treatment is quicker, rooms are more comfortable, the toilets all have seats and are clean. If operation is needed the wait time for an appointment is far quicker

Thanks for the information 👍 

Steve 

Question for Martyn 1986 please. I have been with DKV since 2018 inc of my wife. I pay 204 euros per month for no co payments supposed to be the top of the range in Private Health Cover. My DKV member number is;10146321. Recently my wife went to Murcia to have Dentist work carried out. We were presented with a 1,500 euro bill as DKV said teeth were not included in our policy neither were ones eyes covered. (We have to date not found out what else is not covered in this expensive fully comprehensive health insurance).  I would also like to point out I was taken very ill some 2 years ago around midnight one evening, I was suffocating. My wife rang the 24hr emergency number on the rear of our DKV cards, Telephone; 976991199. No Answer. Our Spanish neighbor's used their  phone and rang the 24hr Emergency DKV number for some 20 mins, so a total between my wife and our friends of nearly an hour. No Answer. In the end my wife rang the Vega Baja, Orihuela. An ambulance collected me, wonderful hospital and committed staff. DKV were presented with the bill which we we asked to submit. DKV then refused stating we had not used one of their designated hospitals. We explained no one answered their 24hr emergency help line number, thus my wife and friends rang the public number. The ambulance cost us just over 800 euros, a 2 day stay just over 3,400 euros. We are now considering opting into the Spanish health System however due to our age that will cost us well over 300 euros per month. Yes we know about the S1. The UK is on its knees. England has enough problems of her own without us putting extra burden in that direction.  If not careful will end up a third world country itself. Our policy is due for renewal  in December.  My Question to Martyn 1986 would he mind explaining what DKV policy he has, the cost of it,  his policy number so that I may ring DKV and ask what the hell is going on with our so called "Full Cover Policy".  I am also on medication which costs me around 170 euros per month. I am not a well person however I keep telling myself no matter how fed up at times I may feel, there is always someone in a worse position than myself. At that moment in Time 2 years ago I was too ill to be bothered to argue with DKV. Time has just passed. I must also say that DKV have honoured any other treatment that I have had over the past 2 years. Thankyou for listening to my little bit of waffle. R.

I can't say for your situation, it sounded horrible. I have an appointment with a dentist provided by them on the 12th. I paid for the year upfront so I can't say for anyone else. How is the Spanish social going to cost you 300 a month? I'm assuming you had past illnesses for it to be 200 a month? It was 200 a month for all four of us if I wanted. If you call up and speak to Josefina, she was very helpful to me and explain she will tell you. Unfortunately private unlike social care has opening times, emergencies are always open and you just go to the hospital. Even if you call 112 the ambulance will take you to the private hospital of your choice, it does say this somewhere on the policy 

The public system paying into is around 60 euros per month per person under 65 however once over a certain age (65) which we are it jumps per person to 157 euros per month. I had no health issues before coming to Spain. We pay 204 euros near as dam for both of us to DKV per month supposed to be for full no co payments health insurance. If you have cover for a family of 4 then the price sounds wonderful. Mind you for 200 odd euros per month maybe that covers 2 to 4 people? Several times we have been told sorry this is not covered and ended up with a bill. 6 months after my wife complained to DKV they changed their policy wording some 2 years ago. You are correct as long as you now tell them which hospital you are off to its normally accepted however in the "old days" this was not accepted by DKV, it had to be a hospital on their list. This is my fault I have never read their policy. I hold my hands up in the air. I paid my money well have for the past several years, thought right no messing around full cover that's it. I was using the tractor in our rear field and within an hour or so could not breath. Long story however I have a lung problem which I did not know but was brought to the doctors attention when I collapsed. Never happened before however a huge "Flare up" regarding advanced COPD. The tubes in my lungs/airways are narrowing. I just thought it was old age, put up with it. The dust created via the tractor use caused a reaction. I have worked hard all my life breathing in all sorts. I have to take Steroids now which are expensive to elasticate the airways to make it easier for me to breath. Also other medication. My wife went to a private dentist via DKV in Murcia that was fine thinking we were covered (Full Policy) however another con, she was offered via DKV a percentage off the bill, the bill was then reduced to 1,500 euros. Teeth are not covered, neither eyes according to DKV. I must to reiterate read my policy. The policy was taken out with DKV then 3 days later my elderly mother sadly passed away followed by Father a month later, soul destroying, I never got round to reading it. Put in a drawer and left. Time just passed, paid each years bill then as I am certainly "not a spring chick myself" found I myself  needed DKV to find "well Sir we are sorry but !!!!!!"  When you were talking to Tebo53  your reply about DKV and the dentist caught my eye. Any Insurance normally has a twist in it. Must be an age thing, I am rambling on again sorry. Thankyou for getting back to me. I will telephone DKV and have a talk to them. Time to decide which route to take regarding future health cover in Spain. I think either way will  be costly. Once again Martyn1986 thankyou for tolerating me. My Sincere Regards. R.

I have DKV premium cover with no co payments. When I need to see a doctor or attend hospital, I simply show my card and, providing they have an agreement with DKV, I am seen and treated without any bill being presented to me. Dentistry is included but it is basic cover and obviously doesn't include major work. The Convenio Especial does not cover dentistry at all. Only children in Spain receive free dental treatment everyone else has to pay. I use a dentist here in Benidorm who charges 30€ for a checkup, scale and polish. I recently had to have a broken tooth repaired and this cost 30€. Try finding a dentist in the UK at these rates.

DKV have offices in many main towns and cities throughout Spain and it may be worthwhile calling in to your nearest office and asking why you are experiencing problems.

I also have state healthcare via the S1 scheme and my partner contributes to the Convenio Especial. We both maintain DKV as I was diagnosed with two chronic illnesses shortly after I arrived here in 2019 and we maintain private healthcare as a safety net. 

Unfortunately the issues you raise here will not be resolved by Forum members and you need to speak directly to DKV to have these resolved.

If you are resident in Spain you cannot use the NHS in the UK, however, you may be entitled to UK state healthcare paid for by the UK if you’re a resident in Spain and receive a UK State Pension or an exportable benefit.

https://www.gov.uk/guidance/healthcare-in-spain-including-the-balearic-and-canary-islands#:~:text=You%20may%20be%20entitled%20to%20state%20healthcare%20paid%20for%20by,for%20more%20information%20about%20eligibility.