Medical directory health insurance

To learn in further detail about the cover and services included in health insurance, it is important to go over the terms and conditions of each product. 

On our website, you have access to detailed information about the cover of each of our health insurance policies.

• DKV Famedic Plus

• DKV Modular

• DKV Profesional

• DKV Integral

• DKV Mundisalud

• DKV Residentes

• DKV Top Health

These insurance policies differ from each other in the cover and services included. We offer you a wide range of options so you can choose the one that best suits your needs: medical directory or mixed reimbursement insurance policies, comprehensive insurance policies or by modules, and so on. 

See all our information and choose the one that suits you best.

The pre-existing conditions that you had in your previous company will remain, but we will eliminate the waiting periods, so all health services will be available from day one.

A customer who takes out a DKV health insurance will permanently benefit from a lower price in one of these cases:

• Discounts according to the payment method: 2.8% (quarterly payment), 4.6% (half-yearly payment) and 7% (yearly payment)

• Discounts according to the number of insured persons: 7% (four insured persons), 12% (more than four insured persons)

• Discounts applicable based on the current promotion. In the case of DKV Integral, insured persons who take out the health insurance before 28 February 2022 will obtain a 36% discount on the rate for 2022, a 30% discount in 2023, a 24% discount in 2024 and a 12% discount in 2025.

These discounts can be accumulated.

We will explain to you how the duration of the health insurance policy works, when it expires and its renewal. Here

Any policyholder who wishes to request the cancellation of the policy must do so in writing at least one month before the policy's maturity.

Health insurance policies expire at the end of the calendar year, i.e. 31 December; other policies expire one year from the date the contract enters into force.

The following must be included in the cancellation request:
• Tax ID (NIF/NIE) of the policyholder (a scan is fine if sending by email).
• Policy or card number.
• Signature of the policyholder.

You may send your application:
• By post or fax to your local branch
• By email at atencion.cliente@dkvseguros.es. In this case, please attach the scanned Tax ID number/ Foreign resident ID and the document signed by the policyholder.

In addition, if you change your mind after having signed a policy, you have the so-called "right of withdrawal". Once you sign a contract, you have fourteen calendar days to cancel it, and you must notify the company in writing or by telephone. In any case, make sure beforehand that the company in question accepts that option.

A health insurance with copayment is a policy in which customers pay a fixed amount for their insurance, either monthly or yearly, as well as a variable amount, which depends on the times that they have used the policy during the month. 

In addition, according to the conditions of the policy, customers will pay the money separately, each time they go to the doctor or the company will include the additional amount in the monthly bill. 

At DKV, the copayment varies according to the insurance modality you choose. For example, in the DKV Integral medical directory insurance you can choose between the following:

• With high copayment: Complet

• With low copayment: Classic

• Without copayment: Élite 

Example of consultation:

General medicine, paediatrics and nursing (€12 with DKV Integral Complet, €1.95 with DKV Integral Classic)

Other specialities (€20 with DKV Integral Complet, €2.95 with DKV Integral Classic)

The copayment modalities we offer allow you to adjust the price of your insurance even more to what you are prepared to pay and to how you believe you will use it, giving you the possibility of choosing between several options.

Very simple: the insurance's annual amount is lower. If you regularly visit the doctor, the final disbursement will be much lower than that of the health insurance without copayments. Although, copayments usually range between 1 and 20 euros. Further information

In this type of health insurance, a fixed amount is paid for using the services included in the policy, without a price increase for each visit you make. 

It is a flat rate with some annual limitations that may be established in the policy and that you should be aware of (the cost of gauze, splints, medicine or ointments may not be included).

As a result, you will not have to pay any additional charge when you use your insurance.

This insurance's services and cover are distributed into three modules, from which you can take out one, two or all three, adjusting them to your needs in different combinations. Further information

The following tests are included DKV Modularin the insurance's module A:

• Basic blood and urine tests (excluding hormone, immune, genetic and molecular biological testing)

• Simple X-rays without contrast

If you are over 70 years old and want to take out health insurance, you must consider the maximum contracting age offered by each company. Some insurers set the maximum age to take out insurance at 65 or 70 years of age.

You will also find policies that do not have a maximum contracting age, so it is important that you study the available options. Also pay attention to the age from which the company may not renew your health insurance. Find out as much as you can before you decide, because there are insurers who commit to not cancelling the contract after a set validity period.

At DKV, we have the highest age for taking out insurance on the market: up to the age of 75, in an individual modality.

Although we also offer health insurance with no maximum age limit, such as DKV Famedic Plus, an economical health insurance with basic cover designed for everyone, without any age restrictions or limits.

Yes, before attending physiotherapy sessions, you will first have to go to a specialist in traumatology, neurology, rheumatology or a rehabilitating doctor, who will prescribe the sessions.

Insurance companies generally set a maximum limit of sessions per insured person per year. At DKV, we have one of the widest contracting age limits on the market. Further information

If the insurance is taken out when pregnant, there is the possibility of obtaining cover for monitoring the pregnancy and childbirth, exclusively through the medical directory, by means of a premium surcharge paid in a lump-sum.
 
The additional premium for pregnancy and childbirth is as follows:
 
- Balearic Islands and Canary Islands €3,500.
- Rest of Spain: €3,000.
 
If you want to pay a premium surcharge only for monitoring pregnancy (childbirth will not be covered, but the prenatal genetic screening test will): €800 (mainland and islands).
 
N.B.: DKV Modular and DKV Profesional requires a comprehensive insurance policy (all three modules), and reimbursement policies only provide cover in the own services modality.

With each insurance contract renewal, at 31 December, the company may modify the annual premium and the costs for medical acts taking as a base the technical actuarial calculations. Further information

With DKV insurance, you can request a home service when, due to the condition of the ill person, going to a consultation or hospital centre is not advisable from a medical point of view. Further information

We understand as a family unit all relatives who live in the same family home and want to be beneficiaries of the insurance.

The price varies according to the modality, age and place of residence. In addition, different prices can be set according to the policy's modality. In the case of DKV Integral:

• Integral Complet: from €22

• Integral Classic: from €43

• Integral Élite: from €48

It is calculated according to the insured person's age. You can calculate the price of your health insurance by using our calculator.

On the date the policy enters into force, which is when the guarantees covered by the policy become effective. It usually coincides with the policy's issue date, but the customer can set a date later than the issue date. 

If you have a policy with another company, you will have to fill out the application and health questionnaire to make the change. As a new insured person from another company, there will be no waiting periods, but no pre-existing conditions will be accepted.

The insurance can be paid monthly, quarterly, half-yearly or annually. You will also benefit from discounts for paying in instalments. The discounts in the individual modality are as follows:

• 2.8% Quarterly

• 4.6% Half-yearly

• 7% Annually

These discounts are for the individual modality.

The healthcare insurance policies DKV Integral, DKV Profesional and DKV Modular, as well as the mixed reimbursement insurance policy DKV Residentes, include worldwide travel assistance, which guarantees medical assistance abroad in the event of an emergency. Further information

With your DKV medical directory insurance, you will enjoy worldwide travel assistance cover, which in the event of an emergency guarantees the provision of medical assistance abroad. Further information

Yes, we cover the cot and/or incubator for the newborn during hospital admission up to a maximum of 28 days.

Your comprehensive health insurance includes the administration of vaccinations included in the compulsory child vaccination programme in Spain, at certified associated vaccination centres, where the medication will be borne by the insured person, except when provided for free by the provincial Public Health authorities or similar body in the autonomous community.

Authorisations for diagnostic tests. You can request them through the following channels:

1. E-mail at autorizaciones@dkvseguros.es

2. WhatsApp

3. areadecliente.dkvseguros.com

4. Telephone 976 506 000

5. At our branches (not sure if we want to include this channel)

Authorisations for hospital admissions. You can only request them through the following channels:

1. E-mail at autorizaciones@dkvseguros.es

2. WhatsApp

3. areadecliente.dkvseguros.com

In addition, you must send the following documentation in order to request an authorisation for hospital admission:

1. Prescription by a physician included in the DKV medical directory

2. Report signed by the physician responsible, detailing the clinic, date and cause for the admission or surgical procedure.

When you take out health insurance, the medical directory is the most valuable benefit: having close the centres you need to visit and being able to go to a medical specialist whenever you need it.

At DKV, we have more than 51,000 affiliated professionals and 1,000 affiliated medical centres available throughout Spain. Avoid waiting lists and lengthy paperwork. We offer the professionalism of the most convenient and fastest healthcare, while you choose whatever you need at any time.

You can see all the doctors and centres included at medicos.dkv.es

When you become insured, you will also be able to do so from the Quiero cuidarme Más app, which in addition to providing you with solutions to take care of your health wherever you are, you will be able to easily access the medical directory.

If you have taken out a medical directory insurance policy, you may only use the extensive DKV medical directory, which includes more than 51,000 health professionals and 1,000 centres.

But if you take out DKV Integral, in the individual modality, you will also enjoy access to reimbursement cover that may be of your interest:
 

• Reimbursement of the medical expenses incurred abroad for serious illnesses.

• Optional module for gynaecology, obstetrics and paediatrics. It allows the insured person to consult a gynaecologist, obstetrician and/or paediatrician anywhere in Spain and the world, provided that they are not included in the DKV Network of Healthcare Services, and reimburses a percentage of the health care costs generated, taking into account the waiting period and the maximum reimbursement partial limits (for therapeutic acts, care for the newborn) and total limits (per insured person and calendar year, or a proportional part) set out in the table of coverage and limits attached to the specific terms and conditions.

Hospital medical assistance or hospitalisation is the care given in a hospital centre with admission during at least 24 hours for the insured person’s medical or surgical treatment.