The General Mutuality of Civil Servants of the State (MUFACE), as an entity that is in charge of the management of the Special Regime of Social Security of civil servants of the State, lends to its mutualists and (a) the provision of health care, in accordance with Articles 12 (1) (a), 16 and 17 of Royal Decree-Law 4/2000 of 23 June 2000 on the recast of the law on the social security of civil servants of the State.

The General Regulation of Administrative Mutualism, approved by Royal Decree 375/2003 of 28 March, in its Chapter V, Section 7, provides for the coverage of health care outside the national territory, empowering the Mutual to establish the terms, conditions and forms of management of the service, implementing the mechanisms and duration of the coverage according to the character of the stay abroad and the administrative situation of the mutualist.

On the other hand, the entry into force of Regulation (EC) No 987/2009 of the European Parliament and of the Council of 16 September laying down rules for the application of Regulation (EC) No 883/2004 of the European Parliament and of the Council The Council of 29 April on the coordination of social security systems extends the application of the provisions of Articles 19, 27.1 and 35 of Regulation 883/2004, as well as Articles 22, 23, 25, 32, 62.1, 66, 67 (paragraphs 1, 4, 5, 6 and 7), 68 and 69, and point B of Annex 2 to Regulation 987/2009, to the holders and beneficiaries of the special social security scheme of officials of the General Administration of the State.

Also Royal Decree 81/2014 of 7 February, laying down rules for ensuring cross-border healthcare, and amending Royal Decree 1718/2010 of 17 December 2010 on medical prescription and orders for supply, comes to complete the transposition into the Spanish legal order of Directive 2011 /24/EU of the European Parliament and of the Council of 9 March 2011 on the application of the rights of patients in care cross-border healthcare.

This Resolution is issued in order to regulate the situations, conditions and terms of health care outside the national territory, giving public knowledge of the content and the system of granting of benefits to the holders and beneficiaries of this special scheme, in accordance with the provisions of Law 19/2013, of 9 December, of transparency, access to public information and good governance.

The regulation of the health care of holders and beneficiaries of MUFACE outside the national territory should be adapted to this new context and, to this end, in the exercise of the powers conferred by Article 11. of Royal Decree 577/1997, of 18 April, establishing the structure of the governing bodies, administration and representation of the General Mutuality of Civil Servants of the State (MUFACE), informed by the General Council on the terms laid down in Article 3 of the Royal Decree, I have:

1. Scope. -With this Resolution, the coverage of the provision of health care that can be specified by the collective protected by the Mutuality during their stay abroad, the extent and content of which must be for reasons or circumstances, personal or professional, to motivate such a stay and its duration, distinguishing the following assumptions:

a) Mutualists who are destined to be outside the national territory or who provide services outside the national territory for a period of more than six months in accordance with the rules of the Civil Service, and other cases assimilated.

(b) Mutualists temporarily displaced outside the national territory for professional reasons related to the Civil Service not included in the previous paragraph, or for private reasons.

2. Mutualists who are destined to be outside the national territory or who provide services outside the national territory for a period of more than six months in accordance with the rules of the Civil Service. Other assumptions assimilated.

2.1 Protected Subjects:

(a) Mutualists in active service or service in other public administrations destined outside the national territory, occupying any job that has been the form of provision.

(b) Mutualists in active service or service in other public administrations who provide services abroad, while maintaining the position of work on national territory, for a period of more than six years uninterrupted months.

(c) Mutualists in special services, as provided for in points (a) and (j) of Article 87 (1) of the Basic Staff Regulations, approved by Law 7/2007 of 12 April (EBEP), which have been designated members of the institutions of the European Union or of international organisations and when they acquire the status of officials at the service of international organisations, provided that:

1. They are not covered by the provisions of the abovementioned institutions or organisations.

2. The provision of services of the mutualist is usually carried out outside the national territory. This requirement shall be deemed to be met if the stay abroad is longer than six months each calendar year.

3. The mutualist has his home address abroad.

d) Mutualists who have been authorised to carry out a mission for a given period of more than six months in international bodies, foreign governments or public entities or in international cooperation programmes [article 87 (1) (b) of the EBEP] and do not enjoy health care coverage through the relevant body, government, entity or programme.

e) Mutualists who are destined in a foreign country to cause low in the active service by retirement or permanent disability declaration and remain without formal interruption residing outside Spain.

(f) retired mutual or pension recipients of permanent incapacity and those who receive a pension from the mutualist who has been a beneficiary of the pension, who set up his or her home in a country of the European Union, the European Economic Area or Switzerland.

(g) Mutualists who are on leave of absence for the care of relatives or for reasons of gender-based violence, provided that the residence abroad is extended for more than six months and is directly linked to the circumstances which have led to the situation of surplus. The coverage period by this mode will be extended:

-Excedence for care of relatives. Mutualists in this situation shall be entitled to this mode of coverage for a maximum of three years for each deceased subject.

-Exceding for reason of gender-based violence. Mutualists who are in this situation shall be entitled to this mode of coverage for up to eighteen months when the legal proceedings so require.

h) Mutualists accompanying their spouse, or person with whom they live in the same relationship of affectivity and with a stable character, and be a member of the mutual association in one of the cases referred to in (a), (b), (c) and (d) above.

i) The beneficiaries of the above. In the event of the death, separation, divorce or invalidity of the mutualist's marriage, the beneficiaries shall maintain this mode of coverage provided that they continue to reside abroad, which retain the conditions required to be beneficiaries of the health care of MUFACE, and credit that they are not entitled to receive the provision of healthcare in the country of residence by the legislation of the same.

2.2 Delivery Content: The protected collective, under the previous heading, shall be entitled to health care with a content similar to that provided on national territory, in accordance with the common portfolio of services of the National Health System and the complementary service provided for in the specific provisions applicable to this special scheme.

2.3 Form of benefit: MUFACE will facilitate healthcare in the country of destination or residence, in Spain, the over-coming in any other country of the world and the cross-border through the concert that subscribes to the effect with an insurance entity.

At the concert the parties ' reciprocal rights and obligations, as well as the modalities, form, conditions of the assistance and the causes by which the same will be provided to the protected subjects defined in the Previous section 2.1, all in accordance with current regulations and in terms and with the scope provided for in this Resolution.

The portfolio of services provided in the portfolio should guarantee, under conditions of equivalence with that provided on national territory, the contents of the portfolio of common services of the National Health System, and include the pharmaceutical supply and orthopaedic provision, without prejudice to any other provision which may be provided for.

2.4 Application and documentation: The mutualist or, where appropriate, the beneficiary with a document assimilated to that of affiliation who is in one of the cases provided for under the heading 2.1 must apply to himself and his beneficiaries the attachment to this mode of coverage. To this end, the Mutual Fund shall have at its offices a standard model of application, also accessible through its website, which must necessarily be accompanied by the documentation specified therein for the purposes of crediting the situation that causes the attachment.

3. Mutualists temporarily displaced outside the national territory for professional reasons related to the Civil Service not covered by paragraph 2 or for private reasons.

3.1 Types of displacements outside the national territory for the purpose of the temporary limit of health coverage by the Mutuality: In accordance with the provisions of Article 87.3 of Royal Decree 375/2003 of 28 March 2003, The General Regulation of Administrative Mutualism is approved, the following types of displacement are distinguished outside the national territory, as well as the duration of the same for the purposes of their health coverage through MUFACE:

(a) Displacements of the mutualist for professional reasons related to the Civil Service and the beneficiaries who move with it.

The mutualists when the posting is carried out under a Public Service rule, provided that they do not give rise to the application of the provisions under heading 2, as well as the beneficiaries accompanying them, shall be entitled to the coverage of the health care that they require in the country of travel for the duration of their professional stay in the country.

(b) Displacements abroad for private reasons of the mutualist and beneficiaries with a maximum duration of two months.

Mutualists and their beneficiaries, accompanying or moving separately, shall be entitled for a maximum period of two months from the start of the posting to the coverage of health care urgent or not demorable.

3.2 Content of the benefit: The benefit will have an analogous content to that provided on national territory, in accordance with the common portfolio of services of the National Health System and the complementary one established in the specific provisions applicable to this special scheme. In the case of medicinal products and medical devices, those that are financed by the National Health System will be covered by the coverage and will be applied to the cost of the purchase of the user's contribution. corresponds as if the dispensation had been produced on national territory.

In the event that healthcare costs are covered, in whole or in part, by insurance or protection system, either public or private, MUFACE will only pay the difference to the expenses not met by the person. To this end, the applicant shall provide the supporting documentation of the coverage.

In no case will transportation expenses be paid for international transfers or accompanying expenses.

Any expense derived from assistance is excluded from this coverage mode when the assessment of the pathology in question and other circumstances of any concurrent order are inferred by the intentionality of circumventing the health services allocated by MUFACE on national territory, using the movement to use means outside the national territory. In addition, the costs incurred after the maximum coverage time set under heading 3.1 shall not be covered for each displacement scenario.

3.3 Form of benefit: The coverage of the benefit shall be made by the reimbursement of expenses incurred by healthcare, subject to the accreditation of the amount by the submission of the invoices originals.

To determine the euro value of the refunds, the exchange rates in force on the day on which the payment of the invoice materializes will be taken into account, in accordance with the Bank of Spain's announcement published in the BOE. If no official change exists for that day, the corresponding one shall be taken into account the nearest day.

3.4 Application and documentation: For the reimbursement of the expenses of the mutualist or, where appropriate, the beneficiary with a document assimilated to that of affiliation may make the application in the Provincial Services or the Delegated Offices, by completing the standard form available for this purpose and accessible through the website, which must be accompanied by the documentation specified therein for the purposes of crediting the type of movement, diagnosis, treatment and content of the assistance, as well as the other circumstances necessary for the assessment and resolution of the file.

Medical reports, prescriptions and invoices must have been issued outside the national territory and shall be duly translated if they have been issued in a foreign language.

4. Coordinated implementation of other hedging mechanisms.

4.1 European Health Insurance Card (TSE): On the movements of mutualists and their beneficiaries jointly or separately, for any reason, to countries of the European Union, European Economic Area or Switzerland, the use of the European Health Insurance Card (TSE) issued by the Mutuality, or its provisional replacement certificate (PSC), shall be compatible with the other coverage mechanisms covered by the above headings.

Where the public health system of the State of residence, in which the TSE/CPS is used, is subject to some form of partial financing by the user, the holders and beneficiaries may apply for the reintegrated from the same to MUFACE in the terms set out in heading 3, or in the case of the subjects under heading 2.1 to the agreed insurance institution at the time of the assistance.

4.2 Transfrontier Health Care: In the terms set out in the additional provision of Royal Decree 81/2014 of 7 February 2014 laying down rules to ensure health care In the case of the Spanish Government, it is not possible to apply the law to the public health system, which is to be used for the purposes of the law. Health of its Autonomous Community, or INGESA, for the cities of Ceuta and Melilla, both for the obtaining the prior authorisation as for the reimbursement of expenses in accordance with the fees they apply.

On the other hand, holders and beneficiaries who are affiliated to any of the agreed insurance entities shall be required to contact the entity for the purpose of obtaining prior authorization and for the reimbursement of expenses that will apply the fees stipulated in the concert.

In any event, as provided for in the second paragraph of Article 1 of the Royal Decree, cross-border healthcare is of subsidiary application in respect of the coverage mechanisms regulated under the headings 3 and 4.1, except the application is expressly requested.

5. Entry into force and repeal. This resolution shall enter into force on the day following that of its publication in the 'Official Gazette of the State', and the statement AM-10/1989 of 11 December 1989 on the health care system in the outside and any other internal provisions of the Mutuality which are contrary to the provisions of the same.

Madrid, June 26, 2014. -Director General of the General Mutuality of Civil Servants of the State, Gustavo Emiliano Blanco Fernández.