SimpleCare Health Plan



FEATURES AND COVER
Individuals

  • We have the Health-Care plan you need

Features and covers

Among the basic features of “ECG” basic, you have access to primary care, specialized medical assistance and in case of hospitalization, for both consultations as well as diagnostic tests and treatments.

  • Primary care: general medicine, pediatrics, ATS (Registered Nurse), emergency care services.
  • Access to every kind of specialist, with no waiting lists: paediatric surgery, ophthalmology, gynaecology, orthopeadics, internal medicine, urology, oncology, obstetrics, dermatology, general and gastrointestinal surgery, etc.
  • Diagnostic tests and therapeutic services. Clinical analysis, anatomic pathology, aerosol therapy and ventilation therapy, chemotherapy, radiology etc.
  • Extensive health-care network. You will also receive special and personalized treatment in our network of preferred affiliate centres.
  • Psychology: “ECG”, basic cover, allows you to seek individual therapy with doctors specializing in mental health, such as anorexia, stress, depression, marital counseling, insomnia, etc.
  • 12-hour “ECG”: With just a phone call, you can talk to a medical professional about any question you might have regarding you or your family’s health. Coming soon to selected areas

Advantages

  • Exclusive attention in Essential Care Group Hospitals and Centres: Hospital Santa Elena, Hospital Quiron, Hospital Premuim, Hospital Santi Novo Petri, Chip Hospital, Hospital Parque San Antonio,
  • Preferential attention in many of our affiliate centres. With our Health-care Directory online at www.simplecarehealthplan.com or www.getsimplecare.com, you can easily locate the Medical Centres and Hospitals where you will receive exclusive and preferential treatment for being a client of Essential Care Group.
  • Discounts on Supplemental Dental: you will be able to access services such as root canal therapy, prosthesis, orthodontics, paediatric dentistry, aesthetic dentistry and many more.
  • Health-care services: for all Essential Care Group clients, access to services such as refractive surgery, cosmetic solutions, fertility treatment or medical check-ups, with favorable prices. Find out more or call us at 952 768 315.
  • No waiting: with the magnetic card, your family doctor or specialist will see you without any wait.

Terms and conditions of enrollment

No Age limits

  • You can enroll in Essential Care Group at any age.
  • There is no maximum age limit to remain on the policy.

No Pre-Existing Condition Exclusions

  • You can enroll in Essential Care Group with any pre-existing condition.

Waiting periods

Waiting periods indicate the time that must pass between enrollment in health care and the possibility of requesting the use of stated health-care services.

  • There are no waiting periods.

Sharing in the costs of services:

Sharing in the costs of services, deductible or co-payment, is a measure implemented by the majority of health insurance companies to bring about the responsible use of medical services.

  • The insured pays a minimum amount established for each use of health-care services.
  • General raises in premiums are avoided, resulting in a savings for all clients thanks to the distribution of said costs according to individual use of services.
  • Essential Care Group lets you know about the co-payments for services for each provider through their Customer Service Department, in the Client’s Area on their website, as well as through quarterly communications sent to the contact address of the policy.

Sample of co-payments established for Essential Care Group members are:

  • ATS (Registered Nurse) and high-frequency services: 21.45€
  • General medicine, Paediatrics , Internal medicine, Cardiology, Orthopeadics, Ophthalmology, Neurology, Urology, Neumology: 27.89€
  • House-call: 55,20€
  • Emergency ambulance (UVI-Movil): 229,20€ plus 0.72 KM
  • Ambulances: 55,20€ plus 0.72 KM
  • Psychiatry: 27,89€
  • PET SCAN: call
  • Magnetic resonance imaging “MRI”: call
  • Computed Axial Tomography “TAC”: call
    Costs for the use of services may vary according to the different medical network providers and are subject to change.

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