Temporary travel to the outside world

Health Care Abroad

In case of needing health care during a temporary travel abroad, MUFACE may be requested to Reimbursement of expenses caused by such assistance, when it has been caused by an accident, illness, pregnancy or childbirth which arose or was unforeseeably aggravated during his stay abroad.

Temporary travel abroad covered may take place for professional reasons covered by public service regulations which, in general, do not exceed six months, or for private reasons, In this case a maximum period of two months is covered.

Assistance can be received, by free choice, through the public or private health resources available in any country in the world.

The following situations are excluded from coverage:

• That the assistance received or the expenses claimed are included in some type of health coverage abroad, by a public or private entity, national or foreign, including private insurance.
• That, from the assessment of the pathology in question and other concurrent circumstances of any order, an intentional purpose is established to evade the health services that correspond to it, using travel to use means other than these.
• That the assistance has been received after the maximum period of coverage fixed for each travel event has elapsed:
  • Travel of a working mutualist for professional reasons related to the Public Service (including the beneficiary persons who also move in the same travel) who will be entitled to the coverage of the health care they need in the country of travel for the whole period of their professional stay in it.
  • Travel abroad for private reasons. It shall be entitled, for a maximum period of two months from the start of the journey, to cover health care of an urgent or non-delaying nature.
• GUIDE TO TEMPORARY TRAVEL ABROAD FOR MUTUALISTS

If you are going to travel to European territory, See all the information about the countries covered by the European Health Insurance Card regime and their Provisional Replacement Certificate, as well as their validity periods.

On request, MUFACE provides the certificate that certifies the health care coverage, duration included, depending on the type of travel and in the strict terms of this section, which you must read carefully. This certificate can be requested at the MUFACE offices and also with Cl@ve, electronic certificate or DNIe at the electronic headquarters:

• Certificate of Health Care Coverage Abroad

The content of the benefits covered is equivalent to the health care provided within the national territory, according to the common portfolio of services of the SNS and the complementary portfolio established in the specific provisions applicable in this special regime:

• The total cost of medical care, surgical and non-surgical hospitalizations, including fixed surgical prostheses and medicines and other pharmaceutical products applied in hospitals, as well as any other service of stay and treatment in a health center with a content equivalent to that which would be provided in Spain.
• The cost of medicines and other pharmaceutical products dispensed on an outpatient basis with the same contribution regime applicable in the national territory.
• The total cost or financial aid that corresponds in the cases of supplementary benefits, according to Order APU/2245/2005, of 30 June.

In the case of mutualists in administrative status of special services who carry out missions for a term longer than six months or who acquire the status of officials in the service of International Organizations, as well as the persons ascribed as beneficiaries in their affiliation document, they will also have coverage of MUFACE, in addition to that they have through the Agency, if they justify that it does not have the same content and extension as that managed by this Mutuality. Likewise, in the case of having any type of insurance that covers all or part of the expenses must be declared, being subsidiary the coverage of the Mutuality.

All the mutualist collective (holders and beneficiary persons) regardless of their attachment to a public or private Entity.

The system is configured as a refund of the accredited expenses. The right to the recognition of these benefits is prescribed at five years, from the date of the causative event. The prescription will be interrupted, in addition to the claim before the General Mutuality, for the ordinary reasons established in article 1973 of the Civil Code.

In person or by postal mail at the Provincial Addresses or Delegated Offices of MUFACE, and also in the records of article 16.4 of Law 39/2015, of 1 October.

Additionally, through the Common Electronic Registration (REC), with digital certificate or DNI-E.

In all cases:

• Declaration signed by the holder, stating the reasons and duration of the trip abroad and briefly describing the facts, accompanied by the documentation accrediting its content, such as that relating to the start of the trip
• When travelling for professional reasons, a copy of the document that proves it must be accompanied.
• Translation into Spanish, or where appropriate the official language of the Autonomous Community of all documents issued in foreign language (Article 15 of Law 39/2015, of 1 October, on the Common Administrative Procedure of Public Administrations).
• If any type of insurance is available, documentation accrediting the extension and content of your coverage.

For each case, the documentation to be provided is the one indicated in the Model of Request

If the reimbursement refers to supplementary benefits (orthoprosthetic material, dental, eye and other benefits) the model of application to be used is that of Supplementary Benefit File, attaching the documents, if applicable translated, which are indicated therein.

Resolution of 26 June 2014the General Mutuality of Civil Servants of the State, which regulates health care outside the national territory.