Reimbursement of psychologists in Spain

The psychologist in health insurance policies

Today, it is quite possible to find a health insurance policy that includes access to psychological sessions and visits to the psychologist’s office as an additional specialty. But the conditions can change a lot from one company to another. And in more ways than one. It’s not just that they have a “vast medical directory” and hundreds of centers. It is the quality of service that is most important. Especially when it comes to limitations.
The most influential difference is the number of annual psychological consultations included in the “special treatment” coverage. In the case of Sanitas, which also offers this service in its most basic health insurance, there are fifteen per year. But there are those who offer up to twenty, such as Adeslas or Caser (in the Salud Prestigio modality, for example).
A solution that can be offered, whether you do not have more sessions available or your policy does not cover the psychologist, is to extend the help with additional sessions, but at a lower price. Sanitas does this, for example.
Psychology sessions included in the health insurance policy
Other solutions can be added, such as telephone counseling. Some companies, such as MAPFRE or AXA, include this guarantee in the coverage of their medical policies, regardless of the level of protection. An exclusive service for their policyholders. Regardless of your company, if you have chosen health insurance with a medical directory, you will have a list of professionals in the field of psychology to choose from. And it’s usually extensive.
But if you’d rather go with a psychologist you already have a referral from or who has been recommended to you, and who doesn’t work with the health insurance company you’re considering purchasing a policy with, you can choose a reimbursement policy. You have some great options, such as Masalud Antares: all of their policies include individual psychiatric and counseling services under excellent conditions. Because it is a service without co-payment and with reimbursement (90% of the cost of eight sessions per year).

What are the important exclusions to psychological coverage?

The protocol is usually repeated from company to company. There is an initial assessment by a professional who is usually covered by your policy, as long as it 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 begin to reveal themselves. There are insurance companies, such as Asisa, that do not cover – as part of these sessions – couples therapy, nor any group therapy: only individual therapy. On the other hand, they offer you access to centers where you can consult them.
DKV is one of the most complete 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 school failure – adjustment disorders – stress, bereavement, divorce -, and psychiatric illnesses such as schizophrenia. In all cases, thirty sessions are offered per year and insured.
You should keep in mind that, in addition to group therapy, there are other common exclusions from psychology or psychotherapy coverage. This is the case for some 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

Medicare 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, etc.
You can usually see a psychiatrist if you need a diagnosis, as you would any other specialist. In addition, the psychiatrist is the first step in accessing 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 medical insurance psychiatric coverage, but it is subject to conditions: there is a maximum number of admission days per year (usually 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

This is an informative article with no guarantee of accuracy.