Agreement for healthcare abroad
MUFACE provides healthcare for its members and beneficiaries go to another country and live abroad through the Healthcare abroad agreement.
Muface has been providing healthcare cover abroad through the insurance company DKV ever since 1 January 2012.
Below, we will take a look at:
- Healthcare abroad agreement between DKV and MUFACE
- Claims for healthcare provided by the agreed organisation
- Subjects that can also be associated with this Agreement
The healthcare abroad agreement signed with DKV is based on the principle of healthcare cover for those people who are protected, in any country around the world, including Spain.
Its care content is equivalent to the healthcare benefits offered in Spain to everyone protected by MUFACE and, therefore, includes:
- The total cost of medical care, surgical and non-surgical hospitalisation, and any other stay or treatment in a Health Centre for the same care that would be provided in Spain.
- The total cost of medications and other pharmaceutical products administered while hospitalised.
- The cost of the medications and other pharmaceutical products dispensed on an outpatient basis, minus the amount the policy holder would have had to pay in Spain. If in doubt, its is understood that this is 30% of the price paid.
- It should be remembered that mutual society members and their beneficiaries cannot use MUFACE prescription books, even when the care is received in Spain.
- The total cost or corresponding financial aid in cases of orthoprosthesis.
- The same dental benefits that are covered in the agreements signed with insurance companies for care within Spain. Dental prostheses not included in this cover may be submitted to MUFACE for direct cover through the scaled system established in Order APU/2245/2005 and updated in the Resolution of June 26, 2014.
- For ocular benefits, that are also not included in the Agreement, the regulations indicated in the previous paragraph apply.
- Healthcare transport and evacuation, as well as the repatriation of the mortal remains or ashes of a mutual society member or beneficiary, in accordance with the conditions set out in the Agreement.
Reimbursement of the cost of healthcare received
For care abroad, the system of general cover is that of reimbursement for the cost of healthcare received. Nevertheless, in situations of foreseeably high costs, such as hospitalisation and the treatment of serious chronic diseases, the Agreed Organisation will proceed, according to that established in the Agreement, to pay directly, and if necessary to advance funds or make advance payments to the healthcare providers, avoiding, as far as possible, the beneficiary having to make the initial payment for the care received. In addition, DKV has a catalogue of hospitals and healthcare providers in the majority of the countries to which mutual society members may travel, which they can go to without having to pay for the service.
Assistance in Spain
For care in Spain, mutual society members and their beneficiaries who are part of the Healthcare abroad agreement must go to the providers arranged by DKV. They will be able to choose between all the doctors and centres that appear in the specific Provincial Catalogues of Providers offered by DKV for the Healthcare in Spain Agreement. In the event of an emergency in Spain, call the organisation's emergency phone number: 900 300 799.
Similarly, DKV has an appointment management service in Spain, aimed at offering members and beneficiaries the possibility of managing issues related with their health during their stays in this country. You can get in contact with this service in the following ways:
- E-mail: email@example.com (link sends e-mail)
- Telephone: +34 902 499 160
Claims relating to the healthcare provided by the organisation can be presented in writing to the MUFACE Representative Office for the Personnel Abroad (hereinafter Representative Office), accompanied by however many documents are needed to justify these.
Once a claim is received, the Representative Office, if it initially considers that there are sufficient reasons in this respect, will immediately take the necessary steps with the Organisation to satisfy the claim, in which case it will be filed without further formalities and the solution adopted will be noted. In the event the aforementioned efforts are not successful, the Representative Office will formalise the appropriate file and send it to the Department of Health Services that will proceed to include it in the agenda of the immediate meeting of the Foreign Joint Commission.
In any case, all the channels for challenge, contemplated in Act 39/2015, of October 1, of the Common Administrative Procedure of Public Administrations, are available.
For more information on the cover and procedures in this agreement, please contact:
- MUFACE Office for staff abroad:
- de la Provincia Nº 1, 6º
- Telephones 91 379 98 53 and 91 379 92 51
- Fax 91 366 28 09
- E-mail: firstname.lastname@example.org
- DKV information:
- DKV telephone for assistance to mutual society members abroad: +34 902 499 160
- E-mail: email@example.com
- Internet: www.dkvseguros.es
To consult the list of professionals and medical centres in Spain you can use the various communication channels that DKV offers its member and beneficiaries:
- Website www.dkvseguros.es in the exclusive space "Find your practitioner”
- Member helpline: 902 499 600
- Via a mobile or PDA with access to the internet by going to the address movil.dkvseguros.com
The only phone number for emergency assistance in Spain is 900 300 799.
Other subjects that can be associated with this Agreement are:
- Visiting teachers in schools in the United States and Canada.
- Retired mutual society members that have their permanent address in a European Union country.
- Mutual society members in a special services situation who have been authorised to carry out a mission for fixed period of longer than six months in International Organisations, Governments, foreign Public Organisations, or in international cooperation programmes, and who do not enjoy healthcare cover via the corresponding Organisation, Government, Public Organisation, or Programme.
- Mutual society members and their beneficiaries travelling and living abroad as Seconded National Experts (SNE) for a period of more than six months:
They may apply to the MUFACE Representative Office for personnel abroad to subscribe to the Healthcare Abroad Agreement in force at any time, provided that their situation as a SNE is, or is expected to be, for longer than six months, counting from the date of the request.
Documents necessary for requesting inclusion
- Form AB-1 (Membership, cancellation and variation in holders), duly completed and signed.
- Certificate issued for this purpose by the personnel body or by the person in charge of the unit to which the official is assigned, or a copy of the appointment or award of the position as a SNE. In both cases the planned duration of permanence in this situation must be accredited.
- MUFACE membership document, health card from the medical organisation to which the member is currently affiliated, and the in-use prescription book.
The healthcare for civil servants it is also very important abroad. This is why they should be familiar with various related topics:
Our coverage sets us apart
DKV 24-hour doctor
Remote medical advice.
Quiero Cuidarme free app.
From your mobile through the private customer area.
Online medical video consultation app.
For mutual society members and their relatives.
DKV Health and Well-being Club
Discounts on healthcare services.
Exclusive offers for mutual society members and relatives