Health Insurance in Spain with Pre-existing Conditions: What You Need to Know

How Spanish insurers handle pre-existing conditions

A preexistencia (pre-existing condition) is any illness or injury you had before the policy started. Sanitas's visa policy terms define it as anything you had before the date you signed the health questionnaire (Sanitas Residents conditions).

When you declare a condition, the insurer has four options. It can:

• accept you on normal terms, so the declared condition is covered like anything else
• exclude the condition with a named exclusión (exclusion clause), so you are covered for everything except costs linked to it
• raise the premium
• decline the application.

Rastreator, the Spanish comparison site, describes all four outcomes in its guide to pre-existing conditions, and names thyroid disorders, diabetes, asthma and hypertension as typical examples. With cancer, an insurer can exclude that specific cancer but not an unrelated one diagnosed later.

Policies differ in their default position:

• Sanitas's visa policy covers conditions you knew about if you declared them and Sanitas did not exclude them when the policy started.
• Adeslas Seniors excludes known conditions you did not declare. It also reserves the right to exclude conditions you did declare, or that its checks detect, when it accepts or renews you (Adeslas Seniors 2026).

The health questionnaire and your duty of disclosure

The cuestionario de salud (health questionnaire) is the core of the application. Your legal duty is set by Article 10 of the Ley de Contrato de Seguro (Law 50/1980 on insurance contracts):

1. What you must declare. Before signing, you must declare, following the insurer's questionnaire, every circumstance you know of that could affect its assessment of the risk. You are released from this duty if there is no questionnaire, or if the circumstance is not covered by its questions.
2. If you get it wrong. The insurer can cancel (rescindir) the contract by notifying you within one month of discovering the omission or inaccuracy. It keeps the premiums for the current period unless it acted deliberately or with gross negligence itself.
3. If you claim before then. The payout is reduced in proportion to the difference between the premium you paid and the premium you would have paid had the risk been disclosed. If you acted deliberately (dolo) or with gross negligence (culpa grave), the insurer pays nothing.
4. The cancer rule does not apply. Article 10.4 says you need not declare cancer five years after radical treatment ended without relapse. That rule is written for life insurance only.

Rastreator notes that if you claim in the first policy year for something that may have been pre-existing, the insurer may ask for a medical report.

After you join

Article 11.2 says that in personal insurance you do not have to report changes in your health during the policy, and those changes are never treated as an increase in risk. A diagnosis made after you join is a new condition, not a pre-existing one.

Exclusions must be in writing

Under Article 3, clauses that limit your rights must be highlighted in the policy and specifically accepted by you in writing. An exclusion for your condition should therefore appear in your condiciones particulares (personal policy terms) and carry your signature. Read its wording carefully. "Diabetes and its complications" excludes much more than "insulin therapy".

Does Article 89 protect you after a year?

Many guides say an insurer cannot challenge your policy one year after it starts. That comes from Article 89: an insurer cannot contest the contract once a year has passed since it was concluded, unless the policyholder acted fraudulently or the policy sets a shorter period.

Article 89 sits in the section on life insurance. Health insurance has its own section (Articles 105 and 106), and Article 106 applies only the accident-insurance rules to it, where compatible. The accident-insurance section in turn takes only Articles 83 to 86 and 87.1 from the life rules, not Article 89. The statute does not extend the one-year limit to health policies. Do not treat a year without problems as a cure for a non-disclosure. Disclose fully at the start.

Exclusions, loadings and waiting periods compared

These three terms are often confused:

A waiting period is not an exclusion. Adeslas Seniors, for example, applies eight months before hospital stays, whatever your health. Visa applicants usually need a policy with no waiting periods at all. See waiting periods and sin carencias.

Moratorium and no-questionnaire alternatives

Moratorium underwriting is offered by some international insurers; the Spanish policies we reviewed use a questionnaire instead. You skip the questionnaire, and conditions from the recent past are automatically excluded until you have had a set period without symptoms or treatment. Allianz Care describes a rolling two-year period free of symptoms and treatment, with availability depending on location and local regulation (Allianz Care). Check whether the plan is offered to Spanish residents and whether a moratorium policy meets your visa conditions.

Spanish products without a questionnaire exist, but their cover is limited:

• Sanitas Único needs no health questionnaire and covers consultations, tests and basic dental care, with co-payments from the seventh use each year.
• DKV Famedic Plus states that it covers conditions that existed before you joined, but it is outpatient only. It excludes surgery needing an operating theatre and hospital stays.

These work well as a top-up to public healthcare. They are not a substitute for full cover and are unlikely to satisfy visa conditions.

Pre-existing conditions and visa insurance

Consulates set conditions on the policy as a whole. The Buenos Aires consulate requires non-lucrative visa applicants to have cover for all risks covered by the Spanish public system, paying 100% of costs, with no co-payments and no waiting periods. The London consulate asks for cover of "all the risks insured by Spain's public health system".

Neither page says anything about exclusions for an individual's conditions. A policy with an exclusion can still produce a valid certificate, but the exclusion still applies once you live in Spain. If your condition needs regular specialist care, budget for paying privately for it until you gain public cover. Ask your consulate directly if you are unsure whether an exclusion on your policy is acceptable.

The non-lucrative visa guide has the full certificate requirements.

Public routes with no medical underwriting

Public healthcare does not assess your health:

• Social Security (workers and the self-employed) and their recognised beneficiaries are covered whatever their medical history. See public healthcare for workers and autónomos.
• S1 holders, such as UK and EU state pensioners, are covered on the same basis as Spanish nationals.
• The convenio especial under Real Decreto 576/2013 costs €60 a month under 65 and €157 from 65. It requires a year's continuous residence, padrón registration and no other public entitlement. The regulation sets no health questionnaire or exclusions. It gives access to the basic public portfolio "with the same guarantees" as other insured people, and the Ministry of Health says it has no co-payments or waiting periods. You pay the full cost of outpatient prescriptions.

For someone with a serious or expensive condition, the convenio especial is often the best long-term answer once the first year is over. See convenio especial healthcare.

Before you apply

1. Gather your medical records, diagnoses and current medicines, with dates.
2. Answer every question on the questionnaire fully and in writing. Keep a copy.
3. Ask for the insurer's decision in writing before paying, including the exact wording of any exclusion.
4. Compare the same condition across two or three insurers, because outcomes differ.
5. If the policy is for a visa, check the certificate wording against your consulate's list.

A broker can submit one set of medical details to several insurers. To compare prices properly, see how to get quotes in Spain.