General Information
Purpose: |
The purpose of Social Security medical assistance is to provide the medical and pharmaceutical services required to preserve or restore the health of its beneficiaries, as well as their capacity to work. |
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Insured parties: |
Insured status is granted to people in any of the following circumstances:
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Beneficiaries / Requirements: |
Status as a beneficiary of an insured party is granted to people in any of the following circumstances, among others:
They shall have beneficiary status if they fulfil the requirements of:
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Contents: |
The list of National Health System benefits includes benefits for public health, primary care, specialist care, emergency care, pharmaceutical products, orthotics and prosthetics, dietary products and healthcare transport. The benefits are provided through a range of techniques, technologies and procedures that include the portfolio of common services, which is separated into the following types:
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Duration: |
Insured persons and their beneficiaries, for as long as the pathology continues. In the case of workers who are no longer affiliated with Social Security and their family members, the duration varies according to the period for which contributions have been made. |
Deadlines: |
Entitlement to health care for both the insured person and their dependants begins the day of affiliation in the Social Security System and becomes effective on the day after applying for active contributor status in the appropriate Scheme. |
Refusal / Expiry: |
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Forms: |
The application form for recognition of entitlement to health care, both for the future insured person and the beneficiaries. |
Documentation: |
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Where to process it: |
At any Social Security support and information centre, the provincial offices of the Social Marine Institute (ISM) or through the e-Office, if they have a digital certificate. |
Competent body: |
The granting and control of insured or beneficiary status will be the responsibility of the National Social Security Institute (INSS) or, where appropriate, the Social Marine Institute (ISM). The entitlement to health care shall be provided by the competent health authorities; the health centres in the autonomous communities will provide access to health care benefits by issuing individual health insurance cards. |
Other important information: |
Other circumstances and special situations Medical Assistance: consult eligibility and issue of the document that accredits eligibility Provisional replacement certificate (CPS). Scheduled medical treatment in another member state Special Social Security Schemes. |