Exercise 1: Match a word
Instruction: Match each word with its definition.
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Exercise 2: Exam preparation (QR: Audio)
Instruction: Read the text, fill in the gaps with the missing words, and answer the questions below
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Aviso del seguro médico: uso de la póliza y atención fuera de la red
Fill in the gaps: aseguradora, pedir cita, tarjeta sanitaria, clínica, autorización, póliza, cuadro médico
(Health insurance notice: policy use and out-of-network care)
Si tienes un seguro médico privado, revisa que tu esté vigente y guarda la en el móvil o en la cartera. Antes de , consulta el : si vas a una fuera de la red, la visita puede no estar cubierta o quedar a tu cargo. En urgencias te atenderán, pero después la puede solicitar informes.
Antes de una prueba diagnóstica o de ingresar en un hospital, pregunta si hace falta previa. En la consulta lleva tus informes y los resultados recientes de análisis de sangre. Si el médico de cabecera considera que necesitas un especialista, solicita un volante de derivación. Para evitar problemas con reembolsos, no firmes documentos sin leer y no renueves la póliza sin comparar coberturas y copagos.If you have private health insurance, check that your policy is valid and keep your health card on your phone or in your wallet. Before booking an appointment, consult the provider directory: if you go to a clinic outside the network, the visit may not be covered or may be at your expense. In emergencies they will treat you, but afterward the insurer may request reports.
Before a diagnostic test or being admitted to a hospital, ask whether prior authorization is required. Bring your reports and recent blood test results to the appointment. If your primary care doctor considers that you need a specialist, request a referral form. To avoid problems with reimbursements, do not sign documents without reading them and do not renew the policy without comparing coverage and co-payments.
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¿Qué pasos recomienda el aviso para asegurarte de que una visita médica esté cubierta y evitar gastos inesperados?
(What steps does the notice recommend to make sure a medical visit is covered and to avoid unexpected expenses?)
Exercise 3: Listening
Instruction: Listen to the audio and answer the questions.
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| True | False | |
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(Normally, to see a specialist you first have to see your family doctor.) |
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(The policy will start to be valid next week, not today.) |
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(Except in emergencies, the patient pays for dentist visits.) |
Exercise 4: Multiple Choice
Instruction: Choose the correct solution
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1. Por favor, no ___ al paciente al especialista sin revisar antes la póliza del seguro médico.
(Please, do not ___ the patient to the specialist without first reviewing the health insurance policy.)2. Cuando vayas al centro de salud, no ___ la tarjeta sanitaria sin pedir cita antes.
(When you go to the health center, do not ___ the health card without making an appointment first.)3. Señora, no ___ al enfermo a una clínica privada si no está cubierto por el asegurador.
(Ma’am, do not ___ the patient to a private clinic if they are not covered by the insurer.)Exercise 5: Dialogue Cards
Instruction: Practice the conversation with your teacher or fellow students.
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Exercise 6: Discussion questions (QR: AI+)
Instruction: Speaking: translate and respond (QR: AI+)
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Useful expressions:
No autorices nada sin leer la póliza. / En mi caso, estoy cubierto por... / no estoy cubierto por... / Para pedir cita, normalmente llamo por teléfono o uso la app y llevo la tarjeta sanitaria.
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Has llegado a España por trabajo y necesitas usar tu seguro médico por primera vez. ¿Qué haces para pedir cita en el centro de salud o en una clínica y qué documentos llevas contigo?
You have arrived in Spain for work and need to use your health insurance for the first time. What do you do to book an appointment at the health center or at a clinic and what documents do you take with you?
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Estás pensando en contratar un seguro médico privado. ¿Qué aspectos miras en la póliza para saber si estás cubierto y si la póliza está vigente?
You are thinking about taking out private health insurance. What aspects do you look at in the policy to know whether you are covered and whether the policy is valid?
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Exercise 7: Writing correspondence (QR: AI+)
Instruction: Write a reply to the following message appropriate to the situation
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Asunto: Confirmación de cambio de póliza y autorización
Hola, Daniel:
Soy Laura Martín, de Atención al Cliente de SaludNorte. Hemos recibido tu solicitud para cambiar del seguro con copagos al plan completo. Para confirmar el cambio necesitamos:
- Tu número de póliza
- Indicar si el cambio debe estar vigente desde el 1 o el 15 del mes
- Si quieres mantener a tu médico de cabecera o cambiarlo
Además, nos has pedido una consulta médica con un médico especialista (oftalmología). Por favor, no autorices ningún pago en la clínica hasta que te confirmemos la cobertura.
Gracias,
Laura Martín
Subject: Confirmation of policy change and authorization
Hello, Daniel:
I’m Laura Martín, from Customer Service at SaludNorte. We have received your request to change from the insurance plan with co-payments to the full plan. To confirm the change we need:
- Your policy number
- Indicate whether the change should be effective from the 1st or the 15th of the month
- Whether you want to keep your primary care doctor or change it
In addition, you have asked us for a medical appointment with a specialist doctor (ophthalmology). Please, do not authorize any payment at the clinic until we confirm the coverage.
Thank you,
Laura Martín
Useful phrases:
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Quería confirmar que...
(I wanted to confirm that...)
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¿Podríais decirme si estoy cubierto/a para...?
(Could you tell me if I’m covered for...?)
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Por favor, no autorizaré... hasta que me lo confirméis.
(Please, I will not authorize... until you confirm it for me.)
Gracias por el mensaje. Confirmo que quiero cambiar al plan completo. Mi número de póliza es 58421L. Prefiero que el cambio esté vigente desde el día 1 del próximo mes. Me gustaría mantener a mi médico de cabecera, ya que conoce mi historial.
Sobre la consulta con el especialista en oftalmología, ¿podríais confirmar si estoy cubierto para las pruebas básicas en la clínica del cuadro médico? Por mi parte, no autorizaré ningún pago hasta recibir vuestra confirmación.
Un saludo,
Daniel
Hello, Laura:
Thank you for the message. I confirm that I want to switch to the full plan. My policy number is 58421L. I would prefer the change to be effective from the 1st of next month. I would like to keep my primary care doctor, since they know my history.
Regarding the appointment with the ophthalmology specialist, could you confirm whether I am covered for the basic tests at the in-network clinic? For my part, I will not authorize any payment until I receive your confirmation.
Best regards,
Daniel