Andorra: Healthcare System

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Andorra is situated in south-western Europe between France and Spain; it has a population of 83,888. For 715 years - between 1278 and 1993 - Andorra was a unique co-principality ruled by leaders of France and Spain. In 1993 Andorra governance was reformed into a parliamentary democracy. For many years Andorra has been a home for banking and economic freedom. Currently Andorra has an estimated 10 million tourists visiting the country each year, which accounts for roughly 80% of the countrys gross domestic product.

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The provision of healthcare in Andorra is good. After the Andorran Constitution was implemented in 1993 - establishing a parliamentary co-principality - the country adopted a new approach to the provision of healthcare services.

Andorra's healthcare and social security system framework is similar to the system applied in France.

The governance of the Andorra health sector comes under the responsibility of several entities: the General Council, the SAAS (the National Health Service - Servei Andorrà dAtenció Sanitària), the Ministry of Health and Welfare (Ministeri de Salut i Benestar) and the CASS (the Social Security Office - Caixa Andorrana de Seguretat Social).

The Llei General de Sanitat (the General Health Law) was enacted in 1989 which defines the role of each government body and identifies their respective functions for overseeing healthcare in Andorra.

Under Andorran healthcare legislation, the General Council must protect the rights of citizens and residents, must guarantee equal access to social services and must regulate pharmaceutical products and health care professionals, providers and services.

The General Council in Andorra - the central government - is mainly focused on policy making for Andorras healthcare services. The CASS is responsible for collecting funds and monitoring fees applicable to healthcare service provision, while the autonomous public institution - the SAAS - is authorized to manage all of Andorra's publicly funded healthcare.

The creation of the Ministry of Health and Welfare in 1993 was introduced to oversee the key issues covering the regulation of health services, healthcare planning, the general provision of healthcare services and the supervision of the SAAS.

In 2002, it was estimated that 92% of the population residing in Andorra were covered by the Andorran Social Security System (CASS). If means testing shows that an Andorran citizen is unable to pay for public healthcare services, these will be provided free of charge to the individual at the governments expense.

The social security scheme in Andorra plays a big role in the provision and funding of healthcare in Andorra, the CASS and government being the main source of finance, but private financing also plays an important role in funding. The CASS will reimburse 75 percent of all outpatient medical expenses and 90 percent of hospital expenses in Andorra.

The Andorran healthcare system relies on contributions from the population in employment, employers and people in receipt of pension payments in Andorra to fund the country's healthcare services.

Workers on less than the minimum wage are required to make regular contributions, while it is voluntary for the unemployed and self-employed workers to make contributions to the social security scheme.

There are about 8% of citizens in Andorra not enrolled with the CASS. Employees will need to contribute up to 9% of their salaries, with the employer required to contribute a further 7% to the CASS. New employees working for an Andorran company in the country will need to be registered with the CASS.

The private healthcare sector in Andorra predominately consists of prime healthcare providers. General practitioners (GPs) and medical specialists generally attend to both public and private financed patients.

In the past a large proportion of Andorran citizens would seek medical treatment outside the indigenous healthcare system, but in recent years there has been a trend towards greater use of the Andorran healthcare system.

The Andorran healthcare network is comprised of a state-owned hospital with nearly 200 beds, 10 healthcare centres, 54 pharmacies, ambulatory care and a private geriatric centre (Centre Geriàtric Sant Vicenç dEnclar) with 50 beds.

Private sector medical professionals are permitted to work in both public and private healthcare facilities. Approximately a quarter of Andorran residents visited medical facilities outside the countrys healthcare system, with the same proportion of the population holding private insurance alongside the CASS.

Primary healthcare in Andorra is delivered through either the ten state-run healthcare centres or through a private doctor who operates from their own healthcare facility. Part of Andorran primary healthcare provision involves nursing services, community care, home care, immunization, rehabilitative care and health awareness.

Andorran healthcare centres provide preventive care, first aid, antenatal and child care, home care and family planning and counseling. In the case of urgent treatment an appointment is not required; home visits are also undertaken.

Andorran health centres and the CASS have an agreement in place where patients make co-payments for each visit. Citizens of Andorra may receive primary healthcare free of charge if deemed appropriate by the social services. The Andorran government may also provide some public healthcare programmes - such as vaccinations - through primary care centres.

Hospital care in Andorra is provided through one hospital - the Andorran Hospital Centre (CHA) - which is state owned and managed by the SAAS. The CHA will provide patients with a range of medical care from basic healthcare services to specialized care.

The Andorran healthcare system does not solely rely on healthcare provision within its own countrys facilities, as specialist care from other nearby countries for uncommon and complex medical procedures and illnesses may be utilized. Private Doctors have the right to use the hospital diagnostic, surgical and treatment facilities; in return they will be on-call for medical emergencies.

Secondary care is predominately confined to the private healthcare sector. Private doctors will provide patients with a variety of healthcare services, including orthopaedics, dialysis, diagnostics, rehabilitation and emergency treatments and outpatient healthcare. Doctors working in the private sector in Andorra may also hold contracts with the CASS to provide healthcare services.

If you plan to participate in any adventure actives while in Andorra - such as trekking, skiing or mountaineering - you are advised to take adequate precautionary measures to ensure you do not put yourself at unnecessary risk.

It is also recommended that you include any activities specifically in your international insurance policy for Andorra to ensure you are covered if medical treatment is required as a result of an accident and injuries sustained.

As a foreign national you are required to pay for all medical costs in Andorra. Patients in Andorra can be assured that the Andorran healthcare system can provide adequate care for routine treatments.

However, for uncommon or rare medical procedures, the Andorran healthcare systems rely on the expertise of the Spanish and French healthcare systems to provide patient care.

Although Spain and France are in close proximity, the cost of emergency transportation can be costly and it is recommended that all visitors to Andorra obtain comprehensive Andorran international health insurance giving them full coverage, including emergency medical evacuation.

If you are looking for peace-of-mind knowing that medical costs will be covered in case of an accident or illness for yourself and your family while traveling to Andorra, an international medical insurance plan will be the optimal solution for you.

Plans can be tailored-made to give you flexibility, meet your individual needs, and may include benefits such as travel, maternity, dental and many other conditions. Should you require further information on Andorra, global medical insurance, or to receive a free consultation, please do not hesitate to call one of our expert advisers now.