Reimbursement of psychologists in Spain

Psychologists in health insurance policies

Today, it's quite possible to find a health insurance policy that includes access to psychology sessions and visits to the psychologist's office as an additional specialty. But conditions can vary greatly from company to company. And in more ways than one. It's not just that they have a "vast medical repertoire" and hundreds of centers. It's the quality of service that's most important. Especially when it comes to limitations.

The most influential difference is the number of annual psychological consultations included in the "special treatment" cover. In the case of Sanitas, which also offers this service in its most basic health insurance, there are fifteen per year. But there are others who offer up to twenty, such as Adeslas or Caser (in the Salud Prestigio modality, for example).

One solution, whether you don't have more sessions available or your policy doesn't cover the psychologist, is to extend the help with additional sessions, but at a lower cost. Sanitas does this, for example.

Psychology sessions included in health insurance policy

Other solutions can be added, such as telephone advice. Some companies, such as MAPFRE or AXA, include this guarantee in their medical policies, whatever the level of protection. An exclusive service for their policyholders. Whatever your company, if you've chosen health insurance with a medical directory, you'll have a list of professionals in the field of psychology to choose from. And it's usually extensive.

But if you'd rather opt for a psychologist you already have references for or who has been recommended to you, and who doesn't work with the health insurance company you're considering taking out a policy with, you can choose a reimbursement policy. You have some very interesting options, such as Masalud Antares: all their policies include psychiatric services and individual psychological assistance under excellent conditions. Because it's a service without co-payment and with reimbursement (90 % of the cost of eight sessions per year).

What are the main exclusions to psychological coverage?

The protocol is usually repeated from one company to the next. There is an initial assessment by a professional who is usually covered by your policy, provided he or she covers the specialties of psychology and psychiatry. It is the practitioner who will decide which therapy is most recommended for the insured.

At this point, the differences between companies start to become apparent. There are insurance companies, such as Asisa, which do not cover - as part of these sessions - couple therapy, nor any group therapy: only individual therapy. On the other hand, they offer access to centers where you can consult them.

DKV is one of the most comprehensive in terms of psychological coverage, since it includes clinical psychology among its guarantees. With insurance such as DKV Mundisalud, it is possible to access treatment for eating disorders - anorexia and bulimia - as well as learning disorders - hyperactivity and academic failure - adjustment disorders - stress, bereavement, divorce - and psychiatric illnesses such as schizophrenia. In all cases, thirty sessions are offered and run each year.

You should bear in mind that, in addition to group therapies, coverage for psychology or psychotherapy may include other frequent exclusions. This is the case for certain specific treatments, such as psychoanalysis. In any case, you can always find a company that offers you access to this treatment through a network of agreements with psychoanalysis clinics or offices, as with any other specialty or specific therapy.

Health insurance: coverage for psychiatry and psychology

Health insurance also covers psychiatry.

Psychology and psychiatry are two different specialties, because they deal with different problems. In the case of psychiatry, it is necessary when dealing with mental disorders that are more problematic than those usually treated by psychotherapy sessions, such as schizophrenia, bipolarity, addiction, and so on.

You can usually consult a psychiatrist if you need a diagnosis, just as you would any other specialist. Moreover, the psychiatrist is the first port of call for access to psychotherapy sessions: he or she is the one who must advise treatment (or not).

Psychiatric hospitalization is one of the usual benefits offered as part of a medical insurance policy's psychiatric coverage, but it is subject to conditions: there is a maximum number of admission days per year (normally 50) and, in most cases, it is only considered for chronic patients and those experiencing an acute flare-up of their mental illness.

In some insurers, the day hospital service (for admissions of less than 24 hours) also admits patients with some form of psychiatric emergency.