Health Insurance In Spain With Pre-Existing Conditions >> 2024 Guide

Many people planning a move to Spain have pre-existing conditions but still need private healthcare insurance. The Affordable Care Act in the US underwrites pre-existing conditions for many, but the Spanish healthcare system operates differently. There is no guarantee of coverage for non-Spanish citizens, and many private healthcare insurers will not cover those with pre-existing conditions. But don’t despair – we have you covered with solutions for health insurance in Spain with pre-existing conditions.

For more general information, see our guide to Private Health Insurance in Spain.

What Is A Pre-Existing Condition For Health Insurance In Spain?

A pre-existing condition is any health issue or illness an individual has been diagnosed with or treated for before enrolling in a new health insurance plan. In Spain, private health insurers often assess these conditions differently than in the US. This assessment can lead to increased premiums, coverage exclusions, or waiting periods for treatment related to these conditions. It can also significantly impact the type and cost of the coverage available to Expats.

Pre-existing Conditions Likely To Impact Insurance Premiums:

1. Cancer – Recent or ongoing cancer treatment can have a high cost of care and medication.
2. Heart Disease – Conditions such as coronary artery disease or heart failure can be high risk.
3. Diabetes – Especially if poorly controlled, diabetes can often lead to other health complications.
4. Chronic Respiratory Diseases – Conditions like COPD (Chronic Obstructive Pulmonary Disease) or severe asthma require ongoing treatment.
5. Autoimmune Diseases – Diseases such as rheumatoid arthritis or lupus require long-term treatment and management.
6. Stroke – A history of stroke indicates a high risk for future medical issues.
7. HIV/AIDS – While treatable, HIV/AIDS involves continuous care and medication.

Conditions Generally Not Serious Enough To Significantly Impact Premiums:

1. Seasonal Allergies – Common and easily manageable with over-the-counter or prescription medication without significantly affecting premiums.
2. Minor Asthma – Mild asthma, especially if well-controlled and without recent hospitalizations, typically does not heavily impact premiums.
3. Past Fractures – Previous broken bones that have healed without complications are unlikely to affect insurance premiums.
4. Mild Acne – A common skin condition that is generally not seen as impacting overall health costs significantly.
5. Non-Recurring Migraines – Infrequent migraines that do not require ongoing treatment are not likely to raise premiums.
6. Common Digestive Disorders – Conditions like occasional acid reflux or irritable bowel syndrome (IBS) without severe complications.
7. Past Infections—Past infections that you have fully treated and resolved, such as chickenpox or urinary tract infections, typically do not influence insurance costs.

Pre-Existing Conditions: Spain Public Healthcare vs Private HealthCare

Spain has an excellent public healthcare system covering all pre-existing conditions. However, many Expats, including retirees in Spain, are not eligible for the public medical system. In addition, for many visas, you’ll need specific qualifying private health insurance.

Special Considerations For Visa & Residency Applications

The Spanish Immigration Service has a particular set of attributes for a private health insurance policy for visa and residency applications.

Spanish Visa & Residence Permits That Require Private Health Insurance

These are some of the most popular Spanish visa types that require medical insurance.

• Non-Lucrative Residence Visa
• Digital Nomad Visa
• Self-Employment Work Visa
• Student Visa
• Golden Visa (Investor Visa)
• Family Reunification Visa
• Work Permit or Visa
• Au Pair Visa

Policy and Cover Requirements For Visa & Residency Applications

There are seven requirements for a visa or Spanish residency permit application. The first one is the most important for this article.

1. No Exclusions for Pre-existing Conditions: Spain’s immigration authorities require a policy that covers pre-existing conditions without exclusions or waiting periods.
2. Full Coverage: It should cover many medical services without significant limitations.
3. No Co-payments: The policy should not include co-payments.
4. Coverage for All Territories in Spain: The policy must be valid nationwide.
5. Validity Period: The insurance policy must be valid for the duration of the visa or residency.
6. Issued by an Insurer Authorized to Operate in Spain: The insurance company must be licensed to operate within Spain.
7. Documented Proof in Spanish: Applicants must provide documented proof of the insurance policy in Spanish.

What Happens If You Don’t Disclose Pre-Existing Conditions?

Not disclosing pre-existing conditions when applying for private health insurance or during the immigration process to Spain can have significant repercussions. Here’s an overview of the potential consequences in both contexts:

Insurance Repercussions

1. Policy Cancellation: If an insurance company discovers that you did not disclose a pre-existing condition at the time of application, they may consider it a breach of the insurance contract. This could lead to the cancellation of your policy, leaving you without coverage.
2. Denial of Claims: Insurers could refuse to pay out claims related to the non-disclosed condition, arguing that the policyholder misrepresented their health status. You could be stuck with high medical costs out of pocket for treatments related to that condition.
3. Increased Premiums or Retroactive Charges: In some cases, the insurer may adjust your premiums retroactively instead of outright cancellation. This change means you’ll pay more for your coverage than initially quoted.

Immigration Repercussions

1. Impact on Residency Application: For residency or visa applications that require proof of health insurance the conseques may not be immidiate. Failing to disclose pre-existing conditions might not directly affect your immigration status, assuming the insurer provided coverage. However, if your insurer cancels the insurance due to nondisclosure, this could invalidate your health insurance requirement for immigration, potentially affecting your legal status.
2. Renewal Complications: Issues with health insurance, including cancellations or disputes over coverage, can complicate the renewal of visas or residency permits. Consistent and valid health insurance coverage is often a requirement for renewal, and any interruptions in coverage could be problematic.

Case Study: Partner Insurer Approach

We asked one of our Health Insurance partners to describe how they manage applications from people with pre-existing conditions. Thank you to Ciaran O Toole for his insights.

Policy Design & Coverage Options

• Ciaran’s company has access to some of Spain’s top insurance companies. They use DKV and ASISA for Moving to Spain clients, both of which offer policies that meet 100% of the Spanish visa requirements and include and cover pre-existing conditions.
• Both DKV and Asisa have dedicated medical review teams that meticulously assess the specifics of pre-existing conditions and tailor pricing accordingly for each applicant.

Assessment Process

The necessary information and details required for evaluating pre-existing conditions typically include:

• Date of birth
• What is the condition/conditions?
• Date of diagnosis
• Current medications being taken
• Frequency of required check-ups or treatments
• History of any illnesses or complications resulting from the condition

We collate the information and pass it to the medical review team, who will assess it thoroughly. Depending on the nature and complexity of the pre-existing condition, medical reports may be requested to facilitate a comprehensive evaluation. Following this assessment, the team will determine the pricing tailored to the individual’s circumstances.

The medical review team determines the premiums based on the provided information and the specific pre-existing conditions. Both companies offer unlimited financial coverage and extend their coverage throughout Spain, including the Canary and Balearic Islands. If any exclusions are deemed necessary following the assessment, they will be communicated to the applicant. Importantly, with both companies, there are no waiting periods.

Ciaran O Toole – Spanish Health Insurace Expert & Moving to Spain partner.

Case Examples

Both companies have successfully provided coverage to numerous customers with diverse pre-existing conditions, including but not limited to high blood pressure, diabetes, lupus, and cancer. Their policies are designed to encompass and address these pre-existing conditions, offering comprehensive coverage.

However, it’s crucial to recognize that each case is unique, and the extent of coverage depends on factors such as the severity of the pre-existing condition and the outcome of the evaluation conducted by the medical review team.

Many customers encounter difficulties in obtaining health insurance coverage, often due to pre-existing conditions or age limitations. However, both DKV and Asisa offer solutions to these challenges by including coverage for pre-existing conditions in their policies. These initiatives help bridge gaps in coverage and ensure that a wider range of customers can access essential health insurance benefits.

Health insurance costs vary among individuals based on their pre-existing conditions and age. Understandably, polices covering pre-existing conditions will have higher premeiums than those without.

Ciaran O Toole – Spanish Health Insurace Expert & Moving to Spain partner.

How To Get Healthcare In Spain With A Pre-Existing Condition.

There are two ways: the easy way and the hard way.

The Easy Way: Get Quotes Using Our Health Quote Tool

Use our simple tool to get no-obligation quotes from our insurance partners. Some of the companies we recommend specialize in finding Spanish Private Health Insurance for people with pre-existing conditions and have many happy Expat clients. We have included may different companies in our quote tool so that there is always at least one insurer that can provide a policy and coverage that meets the requirements for Spanish Immigration applications.

As we negotiate directly with the Health Insurance companies, our clients get discounts that you wouldn´t get if your went directly to the insurer or used a broker.

The Hard Way: Research and Compare

• Extensive Research: Research various health insurance providers in Spain catering to Expats. Look for policies that explicitly state their handling of pre-existing conditions.
• Comparisons: Compare different insurance policies’ terms, coverage, and premiums. Please pay particular attention to how they deal with pre-existing conditions, including any waiting periods, co-payments, or exclusions.
• Visa and Residency Requirements: Ensure you fully understand the health insurance requirements for your specific Spanish visa or residency permit. Your insurance and policy documentation should meet these requirements.

Solutions for Health Insurance In Spain With Pre-Existing Conditions

We are delighted to have found two great solution for our clients. They provide quality policies at reasonable prices for an under-served group of people who want to move to Spain. We hope that this guide and our partner’s policies can help you live your Spanish dream.

FAQs >> Health Insurance Spain With Pre-Existing Conditions

Additional Resources

1. European Observatory on Health Systems and Policies – Spain Country Health Profile 2021.
2. US Government Pre-Existing Condition Definition.
3. Impact of Pre-Existing Conditions.
4. How does the Spanish Healthcare System work?
5. How to find quality private medical insurance in Spain