The Secretary of State for Public Administration, Clara Mapelli, presided over the signing of the healthcare agreement between Muface and the insurance companies Adeslas and Asisa for the years 2025, 2026, and 2027. This significant agreement, which came into force on May 1, 2025, marks the end of a prolonged negotiation process that had left many civil servants uncertain about their healthcare options.
The new agreement, valued at a total of 4.808 billion euros, represents an increase of more than 1.2 billion euros compared to the previous contract. This financial boost aims to ensure better healthcare services for over 1 million mutual members, including 734,000 policyholders and 280,000 beneficiaries. The agreement will run until December 31, 2027, providing essential healthcare coverage during this period.
After months of negotiations, criticism, and uncertainty, the new healthcare concert has finally been established, with Asisa and Adeslas as the only insurers that opted to participate in the bidding process executed by the government. The previous offers had been rejected by major insurance companies due to concerns over inadequate premiums.
According to the latest data, more than half of the mutual members are women, with the most common age group being between 15 and 44 years old. The remaining members, totaling approximately 1.5 million, have initially opted for public healthcare, but this situation can change during designated periods for switching entities.
One of the most notable changes in the new agreement is the introduction of a second period for the ordinary change of entity. In addition to the existing January window, mutual members can now also request a change in June. This allows them to switch between public and private healthcare options, or to change between the two insurance companies. Furthermore, a special period for changes has been opened from May 1 to May 31, 2025, allowing mutual members to make decisions regarding their healthcare coverage.
For those previously insured by DKV, which will no longer provide services under this agreement, they must make a decision this month. If they do not switch to either Adeslas or Asisa, they will automatically transition to the Social Security system.
The new agreement also introduces the creation of the Commission of Benefits and Healthcare Quality. This commission will be responsible for informing the entities about regulatory projects or other provisions affecting the Common Portfolio of Services of the National Health System. It will establish common guidelines or protocols for certain techniques, technologies, or procedures and conduct studies aimed at improving processes that impact healthcare quality.
Additionally, the agreement includes provisions for hospital rehabilitation services for the prescription of prostheses subject to special protocols. It will also adapt dental health services to the plan for expanding the common portfolio of dental health services in the National Health System. In pharmacy, protocols will be promoted for the non-presential dispensing of medications.
As this new chapter begins for Muface, the future of the mutuality has been secured until the end of 2027. However, what happens beyond that date remains uncertain. The Independent Authority of Fiscal Responsibility (AIReF) has suggested that new civil servants should be directly integrated into the public healthcare system, as a significant percentage of them already prefer public provision.
In a recent report, AIReF highlighted that about 72% of new mutual members choose public healthcare, a trend particularly evident among certain groups, such as teaching staff. This proposal is not for immediate implementation but suggests that any transition should be contingent on strengthening the National Health System and evaluating the determinants of waiting lists.
In summary, the new healthcare agreement between Muface and the insurers Adeslas and Asisa marks a pivotal moment for civil servants in Spain. With enhanced financial resources and new options for healthcare coverage, the agreement aims to provide stability and reassurance to over a million mutual members. As the healthcare landscape evolves, the focus will remain on ensuring quality services and adapting to the changing needs of its members.
