What you need to know
The Adeslas medical plan is available to all employees of PayPal Societas EU and PayPal Spain. Mercer administers the medical plan, which provides cover for you and your immediate family members: spouse / legal partner and children, who must live in the same house you do. Dental and vision benefits are included in the medical plan policy.
What’s covered
This type of insurance offers comprehensive medical services through a mixed system — you have the option to use either:
- Medical services through the insurer’s network of providers at a national level
- Any doctor / clinic (free choice) through a reimbursement scheme at a global level
If you have more specific questions about the plan’s cover, please contact Mercer.
Here are some of the more common services and how they are covered:
Medical
| Medical service | Cover |
|---|---|
| Annual medical limit | 250.000 € |
| Routine medical | In-network: 100% covered when services are provided by Adeslas network providers Out-of-network hospitalisation, other medical expenses, and reimbursement abroad: 90% |
| Inpatient | Hospitalisation: 1.670 € per day, up to 60 days per year ICU or Intensive Observation Unit: 2.170 € per day Surgery fees: 60.000 € Childbirth: 6.000 € per year Psychiatric hospitalisation: 6.000 € per year |
| Outpatient | General practitioner, paediatrician, and specialist visit: in aggregate up to 60.000 € Ambulance: 1.200 € per year Psychotherapy: 20 sessions, 3.000 € per year |
| Dental | 100% for dental cleanings and extractions 50% of the market cost of all other services |
| Vision | 100% cover, excluding surgery for refractive pathology, glasses, and contact lenses Medical assistance for preexisting illness is included |
Costs
Your medical plan cover is 100% paid for by PayPal. However, as a taxable benefit, the company pays the cost for the actual policy, but you are liable to pay tax on the value of the benefit.
Joining the plan
You may join the medical plan at any time. Simply fill out the Adeslas Health Enrolment Form and submit it to HR Hub (this page is only accessible within the PayPal firewall) via a webform. You do not need to complete the “Health Questionnaire” portion of the form since the policy covers pre-existing conditions. HR Hub will work on your application and confirm once it has been processed. You will receive a welcome pack from Adeslas within 7 to 10 days in your office.
When you need medical treatment
Consultations
You must request an appointment by calling the phone number provided in the Adeslas medical provider directory for each doctor.
Home consultations
Either your general practitioner (GP), paediatrician, or qualified nurse will visit you at home as long as you cannot go to the medical centre (doctor´s practice) due to health conditions. This visit should be requested before 10:00 so that the patient is seen the same day.
Emergencies
Emergency services are clearly identified within the Adeslas medical provider directory. In that section, you will find the address and phone numbers to request emergency assistance at home.
Diagnostic tests, hospitalisation, and other services
Please check the list of medical services requiring a prior authorisation when a physician prescribes you one of these services.
Services used through the reimbursement option
Before using any medical service through the reimbursement option, we recommend you check to see if the doctor / clinic is included within the Adeslas network of providers. If not, you can use the reimbursement option through that doctor / clinic. It’s very important to check this point as the reimbursement option can only be used for medical services outside the Adeslas network of providers.
Requesting reimbursement from the plan
To receive reimbursement for medical expenses, complete the Application for Medical Expenditure Refund form available on the Adeslas website and follow the instructions. Send the following documentation to Adeslas:
- Completed Application for Medical Expenditure Refund form
- Original invoice with confirmation of payment
- Clinical report (if you were admitted to a hospital)
- Original medical prescriptions (if applicable)
For more information about the reimbursement process, please visit HR Hub (this page is only accessible within the PayPal firewall).
Provider contact information
Medical
Mercer
MERCER CONSULTING, S.L.
A/A Prestaciones
Paseo de la Castellana, 216
28046 Madrid