Decision guide · Insurance and physiotherapy
Getting physiotherapy reimbursed in Spain: the specialist's prescription your insurer asks for
Many people living on the Costa del Sol have an international or a reimbursement policy and never use it for physiotherapy, because they don't know how it works or they find out too late, halfway through their sessions. Here is what your insurer will ask for, in which order to do things, and which part is mine as the doctor.
The short answer
With a reimbursement policy you pay for the consultation and the sessions, submit the documents and your insurer pays back the share your contract sets. Almost all of them require a prescription signed by a medical specialist before you start.
Three documents: the medical report with the diagnosis, the physiotherapy prescription and the itemised invoices. This guide covers how to get each one and in what order.
Step 1 · How reimbursement works
Network cover and reimbursement are not the same thing
It is the first confusion, and the most expensive one. Check your policy before anything else.
Network-only policy
- You see the professionals contracted by your insurer
- You don't pay at the time, or only a small co-payment
- Outside the network, nothing is reimbursed
- The most common type of Spanish policy
If your policy is network-only, this guide won't help you with my consultation.
Reimbursement policy
- You choose any doctor and any physiotherapist
- You pay for the consultation and the sessions
- You submit the report, the prescription and the invoices
- The insurer pays back a percentage, with caps
Most international policies work this way, and so do the higher tiers of Spanish insurers.
Examples of policies that reimburse
International plans such as Bupa Global, Cigna Global, Allianz Care or AXA Global Healthcare usually reimburse out-of-network specialist care and physiotherapy, within the limits of each plan. Among Spanish insurers, reimbursement products carry names like Sanitas Premium, DKV Mundisalud or Adeslas Extra.
One important point: at the clinics where I consult I see patients privately, not as a network provider for these companies. You pay for the consultation and your insurer pays you back the share set in your policy. If you are not sure which type you have, look at your policy terms or ask your insurer whether it reimburses out-of-network care and what it covers under rehabilitation and physiotherapy.
Step 2 · What they ask for
The three documents your insurer will want
Every company has its own claim form, but the underlying paperwork is almost always the same.
Medical report
- A clear diagnosis with its ICD-10 code
- What was examined and what the ultrasound showed
- Signed by a medical specialist
Physiotherapy prescription
- Treatment prescribed and its goal
- Number of sessions and frequency
- Dated before the first session, signed, with registration number and specialty
Invoices
- The consultation invoice
- Physiotherapy invoices itemised by session and date
- With the physiotherapist's name and registration number
On top of that, many policies require pre-authorisation, sometimes called a guarantee of payment, before treatment starts: you send the report and the prescription, the insurer approves a block of sessions, and then you submit the invoices. Prescriptions also expire: some companies won't accept one older than six months.
Step 3 · In which order
The order that avoids surprises
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1 · Read your policy
Look for rehabilitation or physiotherapy: the percentage reimbursed, the cap per session or per year, whether a specialist's prescription is required and whether pre-authorisation is needed.
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2 · Specialist consultation before the first session
I examine you, use ultrasound where it adds information and we leave with a diagnosis. If physiotherapy is indicated, I prescribe it there and then: you take the report, the prescription and the consultation invoice. I consult inside several physiotherapy clinics, so it can be at the same place where you will be treated.
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3 · Pre-authorisation, if your policy requires it
Send the report and the prescription to your insurer and wait for the block of sessions to be approved. If your policy doesn't require it, you can start straight away.
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4 · Sessions and invoices
Your physiotherapist plans and adjusts the treatment within their own field. Keep every invoice, itemised by session: they go in with the prescription.
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5 · Review at the end of the block
We look at how you have progressed and whether more sessions are needed. If so, I renew the prescription with what is indicated at that point, not with what is left in your policy.
Physiotherapist and rehabilitation doctor bring different things to the same process: I provide the medical diagnosis and the prescription your insurer requires; your physiotherapist provides the treatment. More on how we work together in working with physiotherapists.
Step 4 · When it won't work
Will this route work for you?
Yes, all in order
- Your policy reimburses out-of-network care and includes rehabilitation or physiotherapy
- You see me before the first session
- You keep every itemised invoice
Possibly, but clear it up first
- You've already started without a prescription: I can prescribe the remaining sessions, with the real date
- You don't know whether pre-authorisation is required: ask before your second session
- Your prescription is from a non-specialist: check whether your insurer accepts it
No, and I'd rather tell you now
- Your policy is network-only: nothing is reimbursed outside the network
- You want a back-dated prescription for sessions already done: I won't sign it
- You want a set number of sessions without being examined: the prescription comes from the examination
Orientativo: no sustituye a una valoración médica. Ante la duda, consulta.
If you only remember three things
- Reimbursement means you pay and get a share back; network cover is a different thing.
- The prescription is signed by a specialist, before you start, with a diagnosis and a number of sessions.
- Keep every itemised invoice: without them there is no claim.
What this route is NOT
- …treatment at no cost: you get a percentage back, with caps.
- …a way to get more sessions than are indicated.
- …something that can be done with an earlier date.
- …a substitute for the assessment: the prescription comes from the examination, not from the policy.
Done properly, it is a benefit you are already paying for in your premium.
Keep going
How we do it at the consultation
- Assessment with ultrasound, report with diagnosis, prescription and invoice in the same visit
- Which clinics and how to book
How many sessions does insurance cover?
- Blocks of 10 or 20, caps and renewal
- What the insurer looks at when a block ends
Working with physiotherapists
- What each of us brings to the same process
- How we coordinate the plan
Clinics and phone numbers
- Málaga, Torremolinos, Fuengirola, Rincón de la Victoria, Alhaurín de la Torre
- Addresses, hours and booking
Reimbursement policy and want to get it right from the start?
I examine you, use ultrasound where it adds information and, if physiotherapy is indicated, you leave with the report, the prescription and the invoice for your insurer. At the same clinic where you will be treated.
Not in Málaga? Online consultation by video call: I review your case and your scans and tell you what I suspect and what the next step is, in writing. Book an online consultation →
¿Prefieres ver antes dónde paso consulta? Ver las clínicas y sus teléfonos
Frequently asked questions
Who can sign a physiotherapy prescription for my insurer?
For reimbursement and international policies, almost always a medical specialist: a rehabilitation doctor, an orthopaedic surgeon or a rheumatologist, depending on the problem. As a specialist in Physical Medicine and Rehabilitation, prescribing physiotherapy is at the core of my specialty. A GP's note is accepted by some companies and not by others: check your policy.
What must the prescription include?
The diagnosis with its ICD-10 code, the treatment prescribed and its goal, the number of sessions and the frequency, the date, my signature, my registration number and my specialty. It goes together with the medical report, where I explain what I examined, what the ultrasound showed and why I reached that diagnosis.
Do I need pre-authorisation before starting?
Many policies do require it, sometimes called a guarantee of payment: you send the report and the prescription, the insurer approves a block of sessions, and then you submit the invoices. Others let you start and claim afterwards. It is written in your policy terms under rehabilitation or physiotherapy; five minutes of reading save a lot of trouble.
Can you write the prescription over a video call?
If you are going to be treated at one of the clinics where I consult, in person is better: I examine you, use ultrasound and you leave with everything the same day. If you already have a physiotherapist elsewhere or you live far away, you can book the online consultation: if the video call and your reports or scans allow me to assess you and prescribe, I email you the report with the prescription and the invoice. If they don't, I tell you. It is never automatic, and the report states that the assessment was done by video consultation.
I have already started my sessions without a prescription. What now?
Book as soon as you can. I can assess you and prescribe the sessions still to be done, dated on the day of the visit. What I don't do is sign a prescription with an earlier date to cover sessions already done: it is a medical prescription and it has to reflect what happened. Whether your insurer reimburses the earlier sessions depends on your policy.
Will the consultation itself be reimbursed?
Usually yes: a specialist consultation is normally covered with its own percentage and cap. You take the invoice for the consultation together with the report, so you can submit it with the rest of your documents.
Percentages, caps and deadlines are those of your policy. This guide explains how the process works; it does not replace your policy terms.