Complex diagnostic tests and treatments, transfers via ambulance, prostheses and implants, psychotherapy sessions, preventive programmes or checkups and hospital admissions.
Some specific authorisations must be requested in writing for an assessment of our medical team.
Specialist consultations do not require authorisation; the Medi-card medical card is sufficient.
When requesting authorisation for hospitalisation or surgery, information on the doctor, clinic or hospital, admission date and prescription must be supplied.
You must keep the authorisation number in order to carry out the test or procedure requested.
- By phone: 902 499 499.
- Through the Customer Private Area.
- With the assistance of anyone who appears in your DKV branch with your card and the prescription for the medical test.
No. If your policy has copayments, some months you will also be charged for the medical procedures that were carried out. You can check all policy receipts in the Customer Private Area
It is the amount you must pay for each medical procedure performed, based on the type of insurance you have contracted. You can see the amount of these copayments in the ?Medical Procedure Groups and Copays Table? of the particular and/or special conditions of your policy.
In these cases,at your nearest branch they can tell you the best way to pay your bill.
The duration of the contract is annual and can be extended, but the payments may be made monthly, quarterly or every six months. A small surcharge will be added in this case.
The increase in your policy premiums is due to increased medical costs, the cost of new diagnostics and the new developments that DKV adds to its range of services every year. See video
It is a contract that includes the rights and obligations of DKV and the insured party or policyholder. It is also called “General Terms and Conditions” and “Special Terms and Conditions”.
- DKV Medicard.
- Medical directory book.
- General Conditions: a book containing all the clauses (rights, obligations, coverage, etc.) that apply to your contract and which are common to all clients.
- Particular Conditions: documentation with contract terms and conditions for your particular situation, such as name and surnames of the policy holder, address, date of effect of the policy, premium, etc.
- DKV Medi-Card® health insurance card: that identifies you as a DKV Seguros customer gives you access to the contracted services.
- Information about the DKV Health Care Network and how to access your medical directory.
Contracts are extended automatically every year, unless one of the parties does not wish to do so and provides notification thereof at least one month in advancebefore the expiry of the policy.
DKV Seguros is specifically authorised to apply, process and give to entities of the group insurance the policy holder's and/or insured party's personal data.
As regards the health data of the insured party, this information may be transferred to a third party when necessary for the sole purpose of managing health care benefits, health prevention and promotion plans and additional services covered by the insurance .
DKV Seguros is also authorised to send the policyholder and/or insured person information about health care benefits, health prevention and promotion plans and goods or services which may be of interest to them.
The policyholder and/or insured person may contact DKV Seguros to consult this data and update, correct or cancel it in accordance with Organic Law 15/99 on the protection of personal data. You may exercise your rights of access, rectification, cancellation and opposition of this data in these ways:
- Call 902 499 499 to include a phone number, change an address, fax, email or make minor changes (no more than one letter) in first or last names.
- Through the Customer Private Area You can change the phone, email, postal address, password, correspondence type, payment period of bills and bank account.
- If they're major changes, like date of birth, passport number, full name, etc., you'll need to request it in writing by fax: 902 499 000, by email firstname.lastname@example.org or going to the nearest branch.
No. You have free access to specialists. You must request authorisation from DKV only for complex diagnostic tests, treatments and hospitalisation.
Whenever, due to the sick person’s condition, travel to a clinic or hospital is impossible. Practitioners may also make house calls if this is prescribed by a DKV physician.
Extractions, treatments and teeth cleaning. What’s more, DKV offers you a guide to dental services at very competitive prices.
Yes, from the first day that the policy becomes effective, except for some services that have a qualifying period, like surgery, hospitalisation, childbirth or transplants.
The DKV Medi-Card® health insurance card identifies you as a DKV Seguros member to the health professionals you can consult under the insurance contract and is of personal and non-transferable use.
On the back, you'll find various telephone numbers: customer service, assistance abroad or 24-hour emergency service. Don't forget to sign it!
Yes. The DKV Medicard is the means by which you identify as being insured by DKV Seguros.
The health insurance card has no expiry date, so you'll need a new one only in the case of damage or loss.
To receive the daily allowance, you must provide
- The documentation proving your inability to work, i.e., the leave of absence form from Social Security.
- The medical information needed to assess your case.
- The statement of claim that you'll find in the duly completed documentation that was given to you when you signed the policy. If you lack these, you can provide a letter written by your doctor that includes the identification of the doctor him- or herself, the identity, age, profession or activity of the insured person, the illness causing the temporary disability and its causes and background, the likely start date of the process, the date from which the insured party is unable to develop his or her professional activity and the prognosis of the duration of the ailment.
You can send us this documentation through your nearest branch.
The period in which one is entitled to the payment of this benefit is different to Social Security's leave-of-absence period , as DKV covers only total disability for the profession that has been declared in the policy.
Compensation ends when you can return to your professional activity, even partially, regardless of whether you remain on leave for Social Security, or may not have been fully cured.
On health insurance policies
A pre-existing condition is a health condition (e.g., pregnancy), alteration or organic disorder that existed before the time of the insurance was contracted, regardless of whether there is a medical diagnosis.
Unless otherwise detailed in the policy, pre-existing conditions are excluded from insurance coverage.
When you take out your insurance contract, you must declare any injury, congenital pathology, diseases, diagnostic tests, treatments and even any symptoms that could be considered as the beginning of a pathology.
- 902 499 799 for private policies.
- 900 499 700 for Muface policies.
The periods of time from the date the policy enters into force during which some coverage does not take effect. You can consult the waiting period in your policy's general and particular conditions or contacting the company.
When using resources that are not part of DKV Seguros' network, you must pay, without refund, all expenses that may arise, except in cases of unjustified denial of assistance and in those of urgent assistance of vital importance, in accordance with the terms of the Health Care Assistance Agreement in effect
Provision of health care during the temporary trips abroad is done through Muface.
Find more information at:
- In your provincial Muface branch.
Reimbursement of medical bills
If you have a reimbursement policy, you can freely choose the physicians and centres of your choice, even if they are not included DKV's health care network. You pay the bill to the health care professional or centre and DKV will reimburse the cost in accordance with the percentages and limits established in the particular conditions of your policy.
How to apply for reimbursement
- Through the Customer Private Area you can send the bill by filling out a form and attaching an image of the invoice. If the bill is less than 250 euros, there is no need to send us the original invoice.
If the request is made through the private area, you can check on it in the same place.
If the request is made by mail or in the branch, you can call 902 499 499 or the nearest branch.