Setting up and using a new health policy in Spain

Terms used

• Efecto — The efecto is the date your policy starts.
• Carencias — The carencias are waiting periods after your start date when some services are not yet covered.
• DNI — The DNI is the Spanish national identity card.
• NIE — The NIE is the identification number given to foreigners in Spain.
• Área de cliente — The área de cliente is your insurer's online customer account.
• Cuadro médico — The cuadro médico is the insurer's directory of doctors, clinics and hospitals covered by your policy.
• Volante — The volante is the authorisation your insurer issues so a clinic can do a scan, procedure or admission.
• Copago — The copago is a small fee you pay each time you use a service, in exchange for a lower premium.

Key rules

• Waiting periods: Costly services such as surgery and childbirth are not covered from day one, so check your start date and waiting periods first.
• Prior authorisation: Ask your insurer which services need authorisation before you book scans, procedures or a hospital stay.
• Card and ID: Take your insurer card, digital or plastic, and a photo ID to every appointment.
• Emergencies: Emergency care normally has no waiting period, so save the 24-hour number now.

Start with your policy documents

Your cover may not all start on day one. Open the welcome email or letter and find your policy number, your start date (efecto) and your waiting periods (carencias). Keep that message where you can find it fast.

Set up the app and card

1. Download your insurer's app.
2. Register with your policy number or your DNI/NIE, your email and your mobile number. You will get a code by SMS or email to confirm.
3. Open the digital card in the app. You can use it straight away.
4. Watch the post for the plastic card. It usually arrives within one to two weeks, but each insurer sets its own delivery time, so follow your welcome pack.
5. Create your online customer area (área de cliente) login.

Check the basics are right

Look at your personal data, your bank details and any pre-existing conditions you declared. Make sure the first premium was charged. A mistake in the health questionnaire can lead to exclusions later, so fix errors early.

Save the key numbers

Save the insurer's 24-hour emergency and assistance number in your phone. Add the authorisations line too. Then search the medical directory (cuadro médico) for doctors, clinics and hospitals near you. Only the providers in that directory are covered by your policy.

What the app usually does

Features differ by insurer and product. Most apps let you:

• book, change and cancel appointments;
• search doctors and centres by specialty and place;
• request and track prior authorisations;
• hold video or chat consultations, sometimes with a 24-hour doctor;
• see prescriptions, reports and test results;
• send reimbursement requests, and download policy documents and invoices.

Book your first visit

Within the first week, book a non-urgent visit if you want one. It is a good way to learn how booking works. At the same time, ask your insurer which services need prior authorisation. Scans, procedures and hospital admission often do. For those, the clinic usually asks for the authorisation number (volante) and your doctor's medical request.

What you can use and when

Waiting periods differ by insurer and product, so check your general conditions. Typically:

• Emergencies, consultations, general medicine and basic tests have no wait.
• Hospitalisation and surgery wait around 6 months.
• Childbirth waits about 8 to 10 months.
• High-cost tests, advanced treatments, transplants and prostheses often wait 6 to 12 months.

If you are switching from another insurer, send proof of your previous cover. It can reduce or remove waiting periods. Group policies and some promotions can also waive them.

At the clinic

Show your insurer card, digital or plastic, and a photo ID. Some small centres still prefer the plastic card. The timeline, documents list and checklist below cover the details.

Watch for copayments

Some policies charge a small fee each time you use a service, in return for a lower premium. This is called copago. A policy sin copago costs more but has no per-use fee. Fees are typically a few euros per service, and specialist procedures can cost more. You pay at the provider, or the insurer bills you later by direct debit. Check which type you bought.

Timeline and deadlines

• Check your start date and waiting periods in the policy documents: On the day you receive them

• Receive the plastic card by post: Usually within one to two weeks of purchase

• Book a first non-urgent visit and ask which services need prior authorisation: Within the first week

• Emergencies, consultations, general medicine and basic tests are usable: From the start date, with no wait

• Hospitalisation and surgery become available: Usually after around 6 months

• Childbirth cover becomes available: Usually after about 8 to 10 months

• High-cost tests, advanced treatments, transplants and prostheses become available: Often after 6 to 12 months

Documents you need

• Your policy documents: the welcome email or letter with your policy number, start date and waiting periods (carencias).

• Your insurer card, either the digital card in the app or the plastic card that usually arrives by post, to show at every clinic or hospital.

• A photo ID to show with the card: DNI, NIE, residence card or passport.

• For hospital admission, scans or procedures, the authorisation number (volante) and the doctor's medical request.

• Proof of previous cover, if you are switching from another insurer. It can reduce or remove waiting periods.

First-week checklist for a new health policy

• Check the start date of your policy and any waiting periods (carencias) in your policy documents.

• Keep your policy number and the welcome email or letter somewhere easy to find.

• Download your insurer's app and register with your policy number or DNI/NIE, email and mobile phone, then confirm with the code sent by SMS or email.

• Open the digital card in the app, and watch the post for the plastic card, which usually arrives within one to two weeks.

• Search the medical directory (cuadro médico) for doctors, clinics and hospitals near you, and confirm the ones you plan to use are in the network for your exact product.

• Save the insurer's 24-hour emergency and assistance number, the authorisations line, general customer service, the telemedicine line and the claims contact in your phone.

• Check that the first premium was charged and that your personal data, bank details and declared pre-existing conditions are correct.

Quick answers on using your card and app

What do I show at a clinic or hospital?

You show your insurer card, plastic or digital in the app, together with a photo ID such as your DNI, NIE, residence card or passport.

Can I walk in without an appointment?

Yes, you can walk in for urgent care (urgencias) at in-network hospitals and 24-hour centres, showing your card and ID. Regular consultations normally need an appointment. Some centres offer same-day general medicine, paediatrics or basic blood tests and X-rays, so ask the centre first.

Does my policy work in another province of Spain?

Yes, most Spanish private policies cover the whole country through a national network, subject to your policy terms. Some low-cost or regional products cover only certain provinces, and the network can be thin in some places. Emergencies away from home are generally covered.

Is telemedicine included in my policy?

Most major insurers include some telemedicine in standard policies, usually through the app, with video or chat consultations with GPs, paediatricians and some specialists. Some basic or low-cost products offer it only as an add-on or with restrictions.