Generali Salud Elección Reembolso Policy Conditions & Tiers (English)
The four reimbursement tiers of Generali Salud Elección — 50, 150, 300 and 600 — compared, in plain English.
With the reimbursement option you can use any doctor, specialist, clinic or hospital you like — in Spain or anywhere in the world — pay the bill, and claim a percentage of it back from Generali. (You can still use the Generali network instead, in which case Generali pays the provider directly and there is nothing to reclaim.)
For a plain-English overview or a quote, see our health insurance in Spain page or contact our team. As an authorised exclusive Generali agent, Turner Insurance can explain any clause below.
Part 1 — The reimbursement add-on
How reimbursement works ↑ top
- You choose the provider. Any doctor, specialist, clinic or hospital, in Spain or abroad — you are not limited to the Generali network.
- You pay, then claim back. Generali reimburses a percentage of the reasonable & usual cost — 80% on the 50 and 150 tiers, 90% on the 300 and 600 tiers — up to the per-item sub-limits below. The part not reimbursed (the franquicia) stays with you.
- From age 65, unless otherwise agreed, the reimbursement rate becomes 50% on every tier.
- Annual limit. Each tier has an overall annual cap (the number in its name, in thousands of euros) and sub-limits per type of cost.
- Hospitalisation is covered for up to 365 days (psychiatric hospitalisation 60 days/year).
The four tiers compared ↑ top
All figures are the maximum reimbursable per insured per year, before the franquicia is applied. “No sub-limit” means the cost is met up to the overall annual cap.
| Reimbursement tier | Reembolso 50 | Reembolso 150 | Reembolso 300 | Reembolso 600 |
|---|---|---|---|---|
| Annual sum insured | €50,000 | €150,000 | €300,000 | €600,000 |
| % reimbursed (to age 64) | 80% | 80% | 90% | 90% |
| % reimbursed (from age 65) | 50% | 50% | 50% | 50% |
| Hospital room, per day | €150 | €300 | €450 | €600 |
| ICU, per day | €300 | €600 | No sub-limit | No sub-limit |
| Day hospital, per day | €150 | €200 | €350 | €500 |
| Surgeon & theatre fees | By surgical scale | By surgical scale | €27,000 | €54,000 |
| Maternity (birth / multiple or C-section) | €1,500 / €2,000 | €2,500 / €3,000 | €4,000 / €5,000 | €7,200 |
| Out-patient care, annual cap | €7,500 | €15,000 | €30,000 | €60,000 |
| GP / primary consult | €35 | €90 | €150 | No sub-limit |
| Specialist consult | €90 | €195 | €300 | No sub-limit |
| Diagnostics & special treatments | €42,500 | €135,000 | €270,000 | €540,000 |
| Physiotherapy / rehab | €1,500 | €1,500 | €3,000 | €3,000 |
| Psychiatric / psychology | €3,000 | €3,000 | €5,000 | €5,000 |
| Dental | €250 | €250 | €400 | €400 |
| Ambulance | €600 | €900 | €1,500 | €3,000 |
| Internal prostheses | €1,500 | €3,000 | €6,000 | €12,000 |
| Newborn congenital conditions | €6,000 | €6,000 | €10,000 | €10,000 |
| Preventive medicine | €500 | €500 | €1,000 | €1,000 |
Your own Particular Conditions are what bind — check them for the exact figures and any agreed variations.
Part 2 — Choosing, visas & the base cover
Which tier should I choose? ↑ top
- Reembolso 50 / 150 — reimburse 80%; lower premiums; sensible if you mostly use the Generali network (paid directly) and want free choice as a backup.
- Reembolso 300 / 600 — reimburse 90% with much higher limits and (on 600) no per-consultation sub-limit; the choice if you want to use private specialists or hospitals of your choice, including abroad, with a small gap.
The right tier depends on how much you expect to use free choice rather than the network, and on your budget. We can model both for you.
Is reimbursement good for a residence visa? ↑ top
Usually not, on its own. Spanish consulates require a policy with full cover and no co-payment or reimbursement gap for the non-lucrative and digital-nomad visas. Because a reimbursement tier pays back 80–90% and leaves you the rest, it generally does not meet the “no co-payment” rule. For a visa, the policy to look at is Salud Opción Premium, which can be taken sin copago (no co-payment) with full cover — see our non-lucrative visa insurance and digital nomad visa insurance pages.
The cover, waiting periods & exclusions ↑ top
Everything else — the specialities covered, the medical network, the waiting periods (3 months for surgery and complex tests, 8 months for maternity, waived for emergencies and accidents), the travel-assistance cover, the exclusions and the claims process — comes from the Salud Elección general conditions. Read them in full on our Salud Elección policy conditions page.