For social alarms, each Autonomous Community determines the price of the tele-alarm service and the requirements for users to qualify for the different discounts available. Prices therefore vary between regions. However, each Autonomous Region establishes different discounts according to the type of user and generally the service is not paid at 100% of the cost.
The discounts applied to the tele-alarm service provided by the Autonomous Community of Andaluc√≠a can be used as an example:
- 100% Discount, free of charge: holders of the Andaluc√≠an Government ‚Äúsesentaycinco‚ÄĚ Gold Card who live alone or who live only with another holder of a gold card; holders of the Andaluc√≠an Government ‚Äúsesentaycinco‚ÄĚ Card at any level, who are aged over 80 and who live alone; persons in dependent situations, aged over 80, regardless of their economic ability; persons in dependent situations, aged under 80, with an economic ability of less than 75% of the Public Income Indicator with Multiple Effects (IPREM).
- 80% Discount, a cost of 3.60 Euros/month: holders of the Andaluc√≠an Government ‚Äúsesentaycinco‚ÄĚ Gold Card who live with people who are not holders of the card; persons in dependent situations who are aged under 80, with an economic ability equal to or more than 75% of the Public Income Indicator with Multiple Effects (IPREM).
- 40 % Discount, a cost of 10.80 Euros/ month: holders of the Andaluc√≠an Government‚Äôs ‚Äúsesentaycinco‚ÄĚ Card who are not included in any of the situations above.
For more advanced telecare, where the service provider is a public entity, the service costs the same as the basic tele-alarm. Everything is included in this service: the tele-assistance service, the rental of devices and their maintenance. Each Autonomous Community sets its own charges as per the tele-alarm service.
Home telehealth services are at a very early stage of development and generalised charging/reimbursement principles appear not yet to have been established.¬† If telehealth to become mainstreamed it will need to fit within the publicly funded, universal, free health services at the time of use model in Spain.¬† Within this, there is devolution of health affairs to the Autonomous Communities.¬†¬† Most services are provided in publicly owned facilities (primary care centres and hospitals), staffed with public employees.