One of the most idiosyncratic aspects of the Andorran public sector is the CASS, Caixa Andorrana de Seguretat Social, the equivalent of social security/health service. It is undoubtedly the most confusing aspect and one of the most important implications for residence in Andorra. On this we will write a lot, but today we will start giving the guidelines on the basic functioning of health in the country.
First, Andorran health is copay. The CASS returns 75% of the amount of normal treatment and 90% in the case of surgery and hospitalization (there are other special cases that are simply omitted). I emphasize that the treatment is paid in full by the user and, subsequently, CASS returns a part of the cost. This is not always the case, being the opposite example hospitalization, but generally is how it works. CASS also pays for some things that are not covered by most health care systems, such as certain dental or ocular issues (although they are less frequent each day).
The CASS problem is that until a few years ago the medical profession in Andorra was totally closed and some professionals had very little reliability and took advantage of their monopoly situation. Currently the Andorran medical system remains quite opaque. This causes many residents of the country to distrust local medicine and prefer to be treated in neighboring countries. This is with the problem that the CASS has to authorize the visit to a foreign specialist or the user will have to take charge of the total costs.
How do you usually solve this problem? With insurance, either complementing the part that does not put the CASS, getting access to spanish medic professionals or with international and/or more complete solutions. In many places living without additional insurance is uncomfortable, in Andorra it can also be risky. In the end this produces a market dedicated to health insurance very prolific in the country.