Testimony: Asisa refuses to renew policy of customer who used her insurance
An Asisa policyholder says her health insurance was not renewed without explanation after she used it. The case revives the debate over Spain's private healthcare model.
English · Original discussion in Spanish · Published
Testimony: Asisa refuses to renew policy of customer who used her insurance
A policyholder took out Asisa insurance a year and a half ago, paid her premiums on time and was planning a pregnancy. In January she received a certified letter: her policy would not be renewed. No explanation given. Her husband went to the Valencia office and was told they did not have to give a reason. If the pregnancy arrives before January, no other insurer will accept her on the same terms: she will have to pay a surcharge for a pre-existing pregnancy. The case, shared on a consumer forum, sums up, according to the woman affected, the mechanism of Spanish private healthcare: the business is collecting the premium and paying out as little as possible in treatment.
The business of the healthy
The logic is simple and they don't hide it: a health insurer makes money from customers who don't get sick. When someone starts needing tests, specialists or treatment, the policy stops being profitable and the company can choose not to renew it. In the case described, the policyholder had needed several tests and treatments, which in the company's view made her policy loss-making. The office employee even suggested that you don't take out health insurance because you think you're going to need it. The question left hanging is: what, then, are you paying for?
The clause that forces you to pay a full year
Another account points to a different problem: the difficulty of cancelling. A policyholder of 25 years requested cancellation in writing after losing his job. Asisa's response was that a contract clause obliges him to keep paying until 31 December, a full year, even though he is unemployed. According to his account, the clause is buried in a 20-page contract written in obscure legal language. The company renews the direct debits every two months so they look like a new order and make it harder to cancel through the bank.
What the insurer pays each specialist
The discussion includes concrete figures on the fees insurers pay doctors. For a first specialist consultation, Sanitas pays 10 euros; Adeslas, 6; Asisa and Mapfre, 7. These are gross amounts, from which income tax and the clinic's percentage must be deducted. The conclusion drawn is that fewer and fewer professionals are willing to work on these insurance panels. The quality of the service, they argue, is a direct consequence of what is paid for it.
The advice the doctors themselves repeat
The recommendation several professionals in the sector have given their patients is unanimous: take the money from the monthly premium, put it in a piggy bank and, when the need arises, pay a private doctor directly. The average premium is around 44 euros a month, about 600 euros a year. Someone who pays that amount for years and barely uses the insurance builds up a fund that comfortably covers the occasional private consultation. The problem is the cost of the unexpected: an emergency with tests can exceed a year and a half of premiums.
It's not just Asisa
The cases repeat themselves at other companies. With Sanitas, a hepatitis C treatment was not covered on the grounds that it was outside the policy and ended up in the public health system. With Adeslas, a policyholder whose insurance was paid by her employer saw the company try to strip her seniority when she cancelled after a cancer diagnosis. The conclusion shared by those who have been through it is that the problem is not one particular brand but a model: private health insurance only pays off if you don't use it.
Public healthcare, the option gaining ground
Several accounts suggest that the public health system responds better in serious cases. For births, private care offers a private room and shorter waits, but also a higher chance of an unnecessary caesarean and fewer resources for complications: if the baby needs an incubator, it is transferred to a public hospital. With cancer, the cases described ended up in the public system after late diagnoses or refusals of coverage. The conclusion that emerges is that private insurance covers the predictable and cheap, and refers on the expensive and serious.
Against this backdrop, the question is not whether it's worth paying 44 euros a month. It's how many of those 44 euros go towards paying for treatment and how many go to advertising with smiling people.
A policyholder took out Asisa insurance a year and a half ago, paid her premiums on time and was planning a pregnancy. In January she received a certified letter: her policy would not be renewed. No explanation given. Her husband went to the Valencia office and was told they did not have to give a reason. If the pregnancy arrives before January, no other insurer will accept her on the same terms: she will have to pay a surcharge for a pre-existing pregnancy. The case, shared on a consumer forum, sums up, according to the woman affected, the mechanism of Spanish private healthcare: the business is collecting the premium and paying out as little as possible in treatment.
The business of the healthy
The logic is simple and they don't hide it: a health insurer makes money from customers who don't get sick. When someone starts needing tests, specialists or treatment, the policy stops being profitable and the company can choose not to renew it. In the case described, the policyholder had needed several tests and treatments, which in the company's view made her policy loss-making. The office employee even suggested that you don't take out health insurance because you think you're going to need it. The question left hanging is: what, then, are you paying for?
The clause that forces you to pay a full year
Another account points to a different problem: the difficulty of cancelling. A policyholder of 25 years requested cancellation in writing after losing his job. Asisa's response was that a contract clause obliges him to keep paying until 31 December, a full year, even though he is unemployed. According to his account, the clause is buried in a 20-page contract written in obscure legal language. The company renews the direct debits every two months so they look like a new order and make it harder to cancel through the bank.
What the insurer pays each specialist
The discussion includes concrete figures on the fees insurers pay doctors. For a first specialist consultation, Sanitas pays 10 euros; Adeslas, 6; Asisa and Mapfre, 7. These are gross amounts, from which income tax and the clinic's percentage must be deducted. The conclusion drawn is that fewer and fewer professionals are willing to work on these insurance panels. The quality of the service, they argue, is a direct consequence of what is paid for it.
The advice the doctors themselves repeat
The recommendation several professionals in the sector have given their patients is unanimous: take the money from the monthly premium, put it in a piggy bank and, when the need arises, pay a private doctor directly. The average premium is around 44 euros a month, about 600 euros a year. Someone who pays that amount for years and barely uses the insurance builds up a fund that comfortably covers the occasional private consultation. The problem is the cost of the unexpected: an emergency with tests can exceed a year and a half of premiums.
It's not just Asisa
The cases repeat themselves at other companies. With Sanitas, a hepatitis C treatment was not covered on the grounds that it was outside the policy and ended up in the public health system. With Adeslas, a policyholder whose insurance was paid by her employer saw the company try to strip her seniority when she cancelled after a cancer diagnosis. The conclusion shared by those who have been through it is that the problem is not one particular brand but a model: private health insurance only pays off if you don't use it.
Public healthcare, the option gaining ground
Several accounts suggest that the public health system responds better in serious cases. For births, private care offers a private room and shorter waits, but also a higher chance of an unnecessary caesarean and fewer resources for complications: if the baby needs an incubator, it is transferred to a public hospital. With cancer, the cases described ended up in the public system after late diagnoses or refusals of coverage. The conclusion that emerges is that private insurance covers the predictable and cheap, and refers on the expensive and serious.
Against this backdrop, the question is not whether it's worth paying 44 euros a month. It's how many of those 44 euros go towards paying for treatment and how many go to advertising with smiling people.
Summary of a discussion on Burbuja.info - Foro de economía, actualidad y política., translated from Spanish and reviewed before publication. Read the full discussion (39 replies).
More summaries
-
Sanitas patient waited 18 months for appointment that appeared upon paying
A Sanitas insured waited over a year and a half for an appointment that appeared when switching to private patient status. Users calculate the cost of premiums versus out-of-pocket fees.
-
Two Months in Thailand: Medical Insurance, Flights, and Expensive Areas
Two months in Thailand on a tight budget: medical insurance, rising flight costs, pricey areas like Phuket, and alternatives like Hua Hin or Jomtien.
-
Spanish 1970s Cookies: The Lost Taste of Childhood
Iconic Spanish brands like Cuétara and Fontaneda have changed. Palm oil, mergers, and quality cuts explain the decline of a national staple.
-
Shopper finds worms in blue whiting bought at €2.5/kg in Spain
A shopper in Spain reports worms in blue whiting bought at €2.5/kg, reopening the debate about anisakis in fish sold as fresh.
-
The 3-euro duty making AliExpress shopping more expensive
The EU applies a 3.63-euro charge per imported item, and some estimate prices have risen by 50%. What used to cost 2 euros now costs 5, and the corner shop wins.
-
Cheap diesel vs Repsol: 0.3 litres and a feeling
A test comparing Bon Area diesel with Repsol shows 5.5 litres versus 5.2 per 100 km. The saving tops 1,200 euros over 240,000 km, but the measurement isn't conclusive.