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In the case of Spain’s Non-Lucrative Visa, some people on the Digital Nomad Visa and the Student Visa, you will need to prove you have private health insurance as part of your visa application process.
Even EU-citizens who want to come and live in Spain will have to get private health insurance if they’re not working or self-employed straight away when they arrive. This is a condition to be granted the green residency card.
The conditions of most visas state that the medical coverage from the insurance company must offer the same conditions as the Spanish national health system.
This means that only certain policies will be accepted for visa and residency purposes, usually ones without any excess or co-payments or long waiting periods.
But what if you have any pre-existing health conditions, can you still get private health insurance and be granted a visa or residency card?
This is a tricky question to answer because ultimately whether you can get private health insurance and meet all the requirements for your chosen visa will depend entirely on your personal circumstances, and of course your type of pre-existing condition.
Many people applying for the Non-Lucrative Visa are retirees who don’t plan on working, but who have sufficient savings or passive income such as pensions to support them. Statistically because they’re older, those applying for this visa have many more pre-existing conditions than younger people looking at other visa options, which include being able to work.
Health insurance is typically granted on a case-by-case basis. When you apply, you’ll have to list all your present and past health conditions, including any surgeries you’ve had and medications you take. A doctor will then likely look over this and give you a call to discuss before deciding what coverage will be offered to you.
The Local Spain looked through various Spanish visa Facebook groups to find out how people have navigated this problem and what they have done.
A post in the Spanish NLV Facebook page said: “Most insurers will not cover pre-existing conditions and will give you a page with any exclusions, separate from the paperwork for the visa, this has worked for a number of people”.
This suggests that you can still be granted health insurance, just with specific conditions or body parts excluded, which can still be used to get your visa.
READ ALSO: The best private healthcare for foreigners in Spain
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Another wrote: “Yes, terrible trouble so far. ASSA and Catalana Occidental are the only two who haven’t declined us out of hand. Both will require some exceptions/out of pocket or a waiting period or both. But each is compliant with NLV requirements”.
Another member also said: “I used Mapfre – they’ll have an over-prime but they won’t reject you right away like Adeslas and Sanitas did”.
Those who are applying for Spain’s Digital Nomad Visa and are not registering as autónomo (self-employed), or whose country does not have a social security agreement with Spain, have also been finding it challenging getting private insurance if they have any health issues.
One person on the Digital Nomad Visa Spain Facebook group said: “Mine excluded pre-existing conditions – very disappointed to learn that, even after years, it’ll still be an issue”.
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While another one said “As soon you mention a pre-condition, you will be rejected. Some companies are willing to accept you with co-pay or other conditions, but those are not DNV compatible”.
Others simply encouraged applicants to pay out of pocket whenever they needed help for their specific conditions that weren’t included.
One said “Need doctor for pre-existing condition: we just went to our local doctors and registered as a paying customer. We were billed by letter, and it cost about €50 for an appointment. For Sunday emergency room treatment plus 5 dressing changes, €170”.
Another agreed “If you are paying out of pocket you can go anywhere. The visit will be very affordable, even at the private hospitals. Depending on what kind of treatment you need, you will pay between €50-250”.
This approach is rather risky, however, as you may not be granted the visa under these conditions and if it’s for a serious condition and you need surgery you may not be able to afford it out of pocket.
Find out which health insurance policy works for you. Photo: rdne / Pexels
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Others recommended using insurance brokers to navigate the system and help you find an insurer that will work for your situation.
Obviously, the insurance policies that will be best for you may not be the ones that members recommended above, but it’s worth keeping them in mind and investigating for yourself.
According to consultant company Selectra in Madrid, pre-existing conditions can include anything from chronic ailments and pathologies to previous disabilities and illnesses. “They address all diseases that a person currently suffers from (whether or not they manifest symptoms) or those that may manifest again in the short, medium or long term”.
Mostly these health issues will be found out through the questionnaire the company gives you when enquiring about signing up. Finding insurance without a prior health questionnaire is difficult, however, according to Selectra for some policies from certain companies it is possible to avoid this procedure.
They suggest Caser Seguros, Adeslas and DKV as three companies with policies that don’t require you to fill out these forms beforehand.
The problem is that the first two are policies with co-payments, which means you’ll have to pay extra when you are seen by a doctor or get treated. These types of policies will usually not be accepted for visa and residency purposes.
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A lot of people in both Non-Lucrative Visa and Digital Nomad Facebook groups also recommended DKV as a good insurer who will cover for pre-existing conditions. But keep in mind, you need to read the terms and conditions very carefully to ensure this company will work for you and meet your specific needs.
According to Selectra, the types of pre-existing conditions that will not be covered by insurers include neurodegenerative diseases such as Alzheimer’s or Parkinson’s, cancer, diabetes, multiple sclerosis, kidney and coronary failure, obesity, lupus, HIV/AIDS, paraplegia or tetraplegia and lung diseases such as asthma.
Article 10 of the Insurance Contract Law in Spain states that the policyholder must inform the company of all circumstances related to his or her health that may influence the risk assessment. This includes all diseases that one suffers from or has suffered from.
Some companies may still grant you a policy, even when you’ve divulged all your conditions, but will include an exclusion is a clause that limits the use of certain contracted coverages. Sometimes this type of coverage will be accepted by the authorities for visa purposes, but it’s typically on a case-by-case basis.
Selectra also recommends DKV Mundicare as an insurance company that will accept certain pre-existing conditions without exclusions.
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READ ALSO: Paying for public healthcare in Spain: the pros and cons of the ‘convenio especial’
The Local Spain also contacted the client service team at the charity Age in Spain to ask what some of their members do in the situation that they need medical insurance and have certain health conditions, and if they’ve found it difficult to be granted a visa.
They responded saying that they are “unaware of any ways to ‘get around’ the requirement to have the comprehensive healthcare cover. Some people are waiting until one of the couple are of pension age and therefore they become entitled to an S1 for the NHS to cover their healthcare in Spain”.
They have also I heard anecdotally that some people have bought policies with their pre-existing conditions excluded and they have been granted a Non-Lucrative Visa.
“Some insurance companies will consider cover for pre-existing conditions, but the policies can be very expensive,” they continued. But, once the immigrant has been in Spain for one year, they suggest applying to join the convenio especial.
READ ALSO: Paying for public healthcare in Spain – The pros and cons of the ‘convenio especial’
The convenio especial (which translates to ‘special agreement’) allows foreigners in Spain to pay a monthly sum into the country’s public health system to have access to it, even if they don’t pay into Spain’s social security system through work or a pension.
Those under 65 pay €60 per month for it and those over, pay €157 per month.
The problem is that you can only get this if you’ve been living in Spain for one year already. So, it may help you get health coverage, but it won’t solve the issue of needing it to be granted a visa.
Therefore, you can get a very expensive policy that includes pre-existing conditions for one year to meet your visa requirements and then switch to the cheaper convenio especial or get a policy that excludes certain health conditions and hope that they don’t need it in one year and then again switch over as the convenio especial will cover everything.
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Healthcare in Spain: the steps to apply for the S1 form for UK state pensioners
For those wanting to move to Spain from the UK, another option for health cover in order to be granted visas is the S1 form. The S1 form is essentially proof of entitlement to health cover in Spain, which is funded by the UK government. It entitles you and any dependents to healthcare in another EU country, on the same basis as citizens from those countries. It’s only available to those who are non-UK residents.
The UK Government state this is mainly for those who have a UK State Pension or another qualifying exportable benefit. You may also be entitled to an S1 form if you’re a frontier worker and work in one country but live in another.
It’s worth keeping in mind that for the Digital Nomad Visa, sometimes UGE (the body who grants the visas) won’t accept S1 forms for this type of residency so it’s a gamble. It will most likely be applicable for those applying for the Non-Lucrative visa instead.