Getting sick is probably one of the biggest worries when you’ve just moved to Spain. I recently had to go to the emergency room at a private hospital for acute gastroenteritis. It was an emergency, so I didn’t think much and just paid with my card. It was only afterwards that I started to figure out how to get reimbursed for the cost. After some research, I successfully got my money back, so today I’m sharing my personal experience to help anyone who might need it.
First, let’s be clear: this reimbursement process is mainly for those with private health insurance. If you use your public health card within the public system, most services are free, except for a portion of prescription costs when [buying medicine in Spain], so you generally don’t have to pay large sums upfront and then claim them back. However, for international students or working professionals with private insurance, claiming reimbursement after a doctor’s visit is quite common. This is especially true if you visit a hospital outside your insurance network or undergo urgent treatment that required pre-authorization but there was no time to get it.
Breaking Down the Reimbursement Process
The specific process may vary slightly between insurance companies, but the general steps are similar. I have Adeslas, and their process was quite straightforward.
Step 1: Prepare Your Documents
This is the most crucial step. If your documents are incomplete, your claim will likely be rejected. Be sure to keep all your paperwork!
| Required Document | Description |
|---|
| Reimbursement Form | Usually downloadable from the insurance company’s website. Fill in your personal details and information about the medical visit. |
| Medical Report | Issued by the doctor, stating the diagnosis and treatment plan. |
| Official Invoice (Factura) | The most important document |
![/i] It must be an official invoice (Factura)
, not a simple receipt. The invoice must include your full name, NIE number, the hospital’s details, a breakdown of costs, and proof of payment. |
| Prescription | If medication was prescribed as part of your [medical reimbursement], you need to include the prescription slip. |
| Proof of Payment | The card transaction slip or a bank transfer record to prove you have paid the bill. |
Step 2: Submit Your Claim
Most insurance companies now support online submissions, which is very convenient. Just log in to your insurance company’s app or online portal, find the “Reembolsos” (Reimbursements) section or similar, and follow the instructions to upload photos or scans of all your documents. Of course, if you prefer the traditional method, you can also submit paper copies at one of the insurance company’s physical offices. After submission, you will receive a case number to track the progress of your claim.
Step 3: Wait for Approval and Payment
After submitting, all you can do is wait. The insurance company will review your documents to ensure they are complete and that the treatment is covered by your policy. In my experience, if all the paperwork is in order, you should receive a decision within 15 to 30 business days. Once approved, the reimbursed amount will be deposited directly into your registered bank account. It’s important to note that you might not get a 100% reimbursement; the exact percentage depends on your insurance policy terms, with 80%-90% being common. So don’t expect to get the full amount back—it’s not like the public system where you use a [Spanish medical card]. All in all, as long as you prepare the documents correctly, the process is quite smooth. I hope you never have to use your insurance, but if you do, I hope this guide helps!
