Find out if your insurance company will reimburse you for therapy, and how to go about it
Are there any insurance companies that reimburse psychotherapy sessions provided by a private practice like SINEWS?
Most of the “seguros medicos de reembolso” (medical insurance companies that offer policies with reimbursement) will reimburse psychology, speech therapy and rehabilitation therapies (which could include occupational therapy services) provided in a center like SINEWS.
The most common type of policy in Spain is the “seguro de asistencia sanitaria o cuadro medico”(where a premium is paid and the insurance company provides a somewhat wide range of services or diagnostic tests).
This type of insurance may also cover psychotherapy services, but a psychologist must be chosen from the insurance companies’ list of providers. That is, this type of insurance policy will NOT reimburse the services received from a private practice like SINEWS.
With the type of insurance that is “seguro de reembolso”, a premium is paid to the insurance company and an specific amount of money is available to spend on medical and therapy services that will be reimbursed (For example, an insurance policy with 150,000€ of reimbursement means one is eligible to receive private health care up to that amount). With this type of policy, any therapist can be chosen and one is able to go as often as needed. The bill is then sent by the patient to the insurance company and reimbursement will be received according to the agreed limit (usually between 80% and 100% of the cost).
Which insurance companies offer policies for reimbursement of health care expenses?
Almost all insurance companies offer this type of policy, and almost all of these policies cover basic psychology services: brief psychotherapy treatments like the ones in SINEWS
(other types of long-term therapy treatments such as psychoanalysis, are often excluded).
Here is a list of some examples:
- DKV Top Health
- ADESLAS Extra 150.000
- AXA Wintherthur Optima Plus
- Caser Prestigio
- Mapfre Medisalud
- Sanitas Mundi 100.000
- Mutua Madrileña Mutuasalud Global
- Cigna Reembolso
If your company is not listed, we recommend that you contact it to inquire about conditions.
Are there limits for the reimbursement of psychotherapy?
Yes, in general the insurance covers a limited number of sessions per year (Usually between 15 and 20).
In some cases, the option to request more sessions is available if medicine is prescribed (a new psychiatric report must be submitted) and new authorization from the company obtained.
Depending on the company, between 80% to 100% of the cost is reimbursed, or a co-pay per psychotherapy session is established which will typically range between 9 and 12 Euros per session.
What are the steps I need to take to get reimbursement?
In general, all companies have conditions for reimbursement of Psychotherapy
Do not forget about student insurance!
- Psychotherapy must be prescribed by a psychiatrist or pediatrician- who are medical doctors
It is therefore necessary to make an appointment with the medical doctor (which the insurance company will reimburse if the policy covers it, but it will be necessary to pay in advance) who will write a report stating that psychotherapy treatment is indicated. This report will be submitted to the insurance company by the patient.
Since this policy allows for the patient to see the doctor of their choice, it is not necessary to choose from a list of doctors provided by the insurance company.
In SINEWS our medical doctors have extensive experience in writing these reports.
- Processing the authorization with the insurance company
In order to receive authorization from the insurance company, it is necessary to submit the psychiatrist’s report along with the bill for the consultation.
Sometimes a patient doesn’t realize that the insurance company will reimburse the cost until after they’ve had several sessions. If at the beginning of treatment there was a consultation with the psychiatrist, a report can be issued at a later date which would Make it possible to recover a portion of the money already spent.
- Presenting the bills for the psychotherapy sessions
Insurance companies are reimbursing money increasingly faster in order to provide higher quality customer service.
Some of our clients have been pleasantly surprised to find out that school insurance for their children in secondary education, and also at the university level in some cases, would cover some sessions of psychotherapy prescribed by a medical specialist.
Do not hesitate to contact your insurance company to find out about reimbursement for health care services because most of us are not well informed.