Health Insurance Claim Spain

How to Make a Health Insurance Claim in Spain

With Generali private health cover, most treatment is not a “claim” at all — you use your cuadro médico (the network of approved doctors, specialists and clinics) and Generali settles directly with the provider. You only file a formal claim in two situations: when you use a doctor outside the network and want a reembolso (reimbursement), or when a treatment needs prior authorisation.

Step by step

1. Using a network doctor or clinic? Just book, show your Generali card and ID — there is nothing to pay and no claim to file.
2. Need a scan, surgery or hospital admission? These usually need an autorización first. The clinic often requests it, or we can arrange it with Generali for you.
3. Used a non-network doctor? Pay the bill, keep the itemised invoice (factura) and medical report, and submit them for reimbursement through the MI GENERALI app/portal — or send them to us.
4. Emergency? Get treated first. For private cover, call the Generali assistance line as soon as you can and keep every document.

What you will need

• Your Generali policy number and health card
• The itemised factura and the medical report or prescription
• Your Spanish bank details (IBAN) for any reimbursement

In-network care is cashless. Reimbursement claims are normally paid into your Spanish account within a couple of weeks once Generali has all the paperwork. If a treatment is declined or an authorisation is delayed, you have the right to ask Generali for the reason in writing — and we can challenge it on your behalf.