What is a reimbursement policy?

It is insurance where you choose any doctor or clinic — even outside the insurer's network — pay for the visit, and the insurer reimburses the cost up to a limit (for example, up to €100,000 a year, and more in higher tiers).

How does it differ from a cuadro médico policy?

With a network policy you only see doctors from the insurer's list, but usually with no payment on the spot. With reimbursement the choice is wider (including private clinics and other countries), but you pay first and are refunded afterwards.

Does this policy work for a visa?

Often yes, if it offers full cover with no copays, no waiting periods and a certificate for the consulate. But check the residency conditions in advance — not every reimbursement option qualifies for a visa.

Reimbursement Health Insurance in Spain: Rehabilitation and Free Choice of Doctor

Private healthcare in Spain comes in two formats: a “network” policy (cuadro médico), where you see doctors from the insurer’s list, and a “reimbursement” policy (reembolso), where you choose any doctor yourself. The second gives the most freedom. Let us look at how it works.

What a reimbursement policy is

With a reimbursement policy you freely choose any doctor or clinic — not just those in the insurer’s network. You pay for the visit or procedure, and the insurer then reimburses the cost up to a set limit. Limits vary — for example, up to €100,000 a year, and more in higher tiers.

Such a policy usually includes full cover with hospitalisation, and often network access too — meaning it works in a mixed format: go through the network, or to any doctor with reimbursement.

How it differs from a network policy

Network (cuadro médico): only doctors from the list, but the visit is usually with no payment on the spot.
Reimbursement (reembolso): any doctor and clinic, including private and abroad, but you pay first and are refunded afterwards.

Rehabilitation and other special treatments

Reimbursement policies list rehabilitation alongside other special treatments such as dialysis and nuclear medicine. In practice this is what people ask about most after an injury or an operation: you go to the rehabilitation centre you picked yourself, pay for the course, and then claim the cost back.

How much actually comes back is set by two conditions:

A share, not the whole bill. Outside the insurer’s network a reimbursement policy usually refunds around 80% of what you paid — the rest stays with you. Inside the network (cuadro médico) the same treatment normally goes through with no payment on the spot.
The annual ceiling. Everything reimbursed across the year adds up against a single limit, and its size depends on the tier you choose. This is separate from any copay per visit.

Waiting periods (carencia — the stretch after you buy when a service is not live yet) matter here more than anywhere else: some services only open after six to eight months of cover, and hospitalisation after eight. A policy bought the week after an accident will not pay for the rehabilitation that follows it.

Worth asking before you sign: physiotherapy inside a rehabilitation course and standalone physiotherapy sessions are not always the same line in the conditions — sessions can be capped per year or need a doctor’s referral. If physiotherapy is your main reason for buying, ask for that line in writing.

Who it suits

Those who want a specific doctor or clinic not in the network.
Those who value freedom of choice and are fine with the “pay and get refunded” format.
Those who sometimes get treatment in other countries and want flexibility.

What to look at

Reimbursement limit — how much the insurer refunds per year.
Reimbursement percentage — sometimes not 100% but a share is refunded.
Mixed option — whether there is access to both network and reimbursement at once.
Waiting periods — they can apply to complex services.

Tip: reimbursement works well if you already have “your” doctor or want private clinics outside the network. If not paying on the spot matters more, look at the network option.

How much it costs

Reimbursement policies are usually more expensive than network ones, due to the freedom of choice and high limits. The exact price is calculated individually — by age, cover and limit, the same way it works for any health policy in Spain. The estimate is free and commits you to nothing.

Not sure what to choose — a network or a reimbursement policy? Just ask in the chat — we will help you compare the formats for your situation and prepare a free estimate with a manager.