Cancelling, Renewing or Switching Health Insurance in Spain

How renewal works

Spanish private health insurance is an annual contract that renews itself. Under article 22 of the Insurance Contract Act (Ley 50/1980), the policy sets the term, and it can provide for tacit renewal (prórroga tácita) for periods of up to one year at a time. Most health policies do exactly that.

The term usually runs for 12 months from the start date or until 31 December, according to Sanitas. Paying monthly does not make it a monthly contract. The expiry date is in your particular conditions (condiciones particulares), and it is that date, not your payment date, that counts for notice.

The notice rules

Article 22 sets minimum notice periods for opposing renewal (oponerse a la prórroga):

Notice must be written. Article 22, as amended by Ley 20/2015, also requires these conditions to be highlighted in the policy.

In practice, insurers send the new premium about two months ahead, usually by letter. Sanitas's own conditions, for example, say that it can change the premium and co-payments at each renewal, must tell you in writing at least two months beforehand, and that you can then either accept or give one month's notice to leave.

For a policy ending on 31 December, your notice must arrive by 30 November.

How to cancel properly

1. Find the expiry date in your particular conditions.
2. Write to the insurer: your name, NIE or passport number, policy number, and a clear statement that you oppose the renewal of the policy from its expiry date.
3. Send it in a way you can prove: burofax (a certified fax/letter service from Correos), registered post with acknowledgement of receipt, or the insurer's online channel with a written acknowledgement. Some insurers accept a recorded phone call; if you use one, ask for a reference number and written confirmation.
4. Keep the proof and the confirmation.

Stopping the direct debit is not a cancellation. Under article 15, if a later premium goes unpaid, cover is suspended one month after the due date and the contract is extinguished only if the insurer does not claim the premium within six months. Until then you can be pursued for the debt.

Getting out early

Early cancellation is generally not possible, and premiums paid in advance are generally not refunded. The exceptions Sanitas lists are:

• a policy bought online or by phone, which you can withdraw from within 14 calendar days of signing
• a change to the price or cover by the insurer during the term
• a reduction in your risk that the insurer does not reflect in the next premium

Can the insurer refuse to renew?

Yes. This is the point most people get wrong. Spanish law does not prohibit a health insurer from declining to renew. Article 22 applies to both parties, and the only legal requirement on the insurer is two months' written notice.

Several things limit how it is used in practice:

• Industry good practice. UNESPA, the insurers' association, has a good-practice guide on health insurance that member insurers can sign up to. According to Rastreator and Selectra, adhering insurers commit not to cancel because of serious illnesses diagnosed during the policy (such as cancer, certain heart disease or chronic kidney failure), or to cancel customers over 65 with more than five years' cover and no missed payments. The guide is voluntary, not law.
• The insurer's own wording. Some policies give you more than the law does. DKV says on its Residentes page that after more than three years the policy is maintained for life, and its product information document says that in the individual version DKV will not cancel from the third year onwards if you meet your obligations. Look for wording like renuncia a la facultad de oponerse a la prórroga (waiver of the right to oppose renewal) when comparing.
• The courts. Some judgments have treated a non-renewal without good reason as contrary to good faith. Sepín reports a 2010 Barcelona Audiencia Provincial ruling where an insurer ended a ten-year policy just as the insured's health deteriorated. This is case-by-case and not a general rule.

The more common problem is a large premium rise. The consumer organisation OCU said in November 2025 that renewal "is not guaranteed" and that insurers can raise premiums sharply without transparent criteria. It has asked the DGSFP and the Health Ministry for rules requiring insurers to publish their age-based premium tables and limits on increases.

Insurers can also end a policy for non-payment, or for failing to declare health conditions you knew about when you applied (article 10). If you hold a visa or residence permit that depends on private cover, a non-renewal also affects your visa renewal, so act as soon as a notice arrives.

Switching insurer without a gap

Switching is a new contract. The new insurer will ask health questions, can exclude pre-existing conditions and can decline. Your existing acceptance does not transfer. See pre-existing conditions.

The safe order, which Sanitas also recommends in its switching guide:

1. Two to three months before expiry, check your expiry date and notice deadline.
2. Compare policies on cover, network, co-payments, exclusions and waiting periods. Our comparison checklist helps.
3. Apply for the new policy and get written acceptance, the final terms and the start date.
4. Only then give written notice to your current insurer.
5. Set the new start date as the day after the old cover ends.

If you are in the middle of treatment, check that your specialist and hospital are in the new network, and ask whether ongoing authorisations will be honoured.

Keeping your waiting periods

Waiting periods (carencias) usually restart with a new insurer. Mapfre gives typical figures of eight months for surgery, hospitalisation and childbirth, and six months for MRI and other high-tech tests. Many insurers will waive them for customers transferring from comparable cover. See waiting periods and sin carencias.

• Sanitas will remove waiting periods (except for childbirth) if you have held full-cover health insurance with another Spanish insurer for at least a year. You send the previous policy's particular conditions (or a card showing your start date) and your latest receipt.
• Mapfre requires continuous cover, with no day uninsured between policies, plus the old policy conditions and recent receipts. It then checks that the old cover was equivalent before removing waiting periods for services you already had.

Get the waiver confirmed in writing in the new policy before you cancel the old one. Sanitas's waiver excludes childbirth, and Mapfre notes that cover for a birth is very hard to obtain once you are already pregnant, so time any switch carefully if you are planning a pregnancy.

If an insurer handles a cancellation badly or keeps charging after a valid notice, the route is the insurer's customer service department and then the DGSFP: see complaints and rejected claims.