Pre existing conditions and health insurance in Spain: what actually happens

Almost every day someone writes to me with the same worry: "I have a pre existing condition and I need insurance for my visa. Are they going to turn me down?".

The honest answer is that it depends on your case, but it does not depend on luck. There is an actual procedure, with actual stages, and you can know a lot before you sign anything. Here is the whole thing, because I would rather you know now than after your file is already in.

First things first: insurance is not the last document of your visa

This is the mistake I see most. People gather the criminal record certificate, the medical certificate, the proof of funds, and leave the insurance until the end because they assume it is a five minute formality.

When there is a pre existing condition, it is not. There is a medical assessment involved and that takes days. If you leave it until the last minute and the company asks for more information, or comes back with an exclusion that does not work for immigration, you have no room left to manoeuvre.

Put it among the first things you sort out.

What counts as a pre existing condition

More than people think. It includes:

• An illness already diagnosed, even if it is under control today.
• A medication already prescribed that you are still taking.
• A condition that does not affect your daily life but is in your medical history.
• Symptoms or tests in progress, even without a final diagnosis.

It does not matter if it seems minor to you. If it is in your medical history, you declare it.

The real step by step

This is how the process works when you handle it with me:

1. Policy application and medical questionnaire

The application starts and this is where the condition is declared. This is the key moment and it is not skipped.

2. You always declare the condition. No exceptions

I want to be very clear here. Companies do find out when someone has lied on a medical questionnaire. And when that happens, either the condition gets excluded or the policyholder is removed from the policy, with any costs already incurred left to the client. Then come the misunderstandings, the "this company treated me badly, they threw me out". That is not what happened. What happened is that nobody was told. Declare it from the start and that problem does not exist.

3. A professional medical panel assesses your case

It is not decided by your agent or by an algorithm. There is a team of doctors reviewing each application, one by one.

4. They call you for a medical interview

They ask what exactly the condition is, how long you have had it, how you manage it, whether you are on treatment and what follow up you have. It is a conversation, not an interrogation.

5. They give you the decision, and they give it to you quickly

There are four possible outcomes:

• Standard acceptance. Your policy is issued with no added conditions.
• Acceptance with a loading on the premium. That condition is covered too, but the price goes up somewhat compared with the quote your agent gave you. They tell you exactly how much.
• Acceptance with an exclusion. You are insured, but that specific condition stays outside the cover. They tell you straight away, during the phone interview itself.
• Refusal. It is not the usual outcome, but it happens, mostly in cases with several conditions at once or serious active processes.

6. You only pay after that

And this puts a lot of people at ease: up to this point you have paid nothing. It is not that you get a refund, it is that you have not been charged yet. Once the company accepts you, we proceed with payment so the policy is active and in force, and that is when you get the proof and the certificate you need to present to immigration.

Asking costs you nothing. Hiding information does.

Watch out for exclusions if the insurance is for your visa

This is the part almost nobody checks and the one that causes the most trouble.

For immigration and consulate procedures, the policy has to meet specific requirements:

• Full cover, equivalent to the Spanish National Health System.
• No copayments, meaning nothing extra to pay for each appointment or service.
• No waiting periods, with cover from day one.
• Repatriation included.
• A certificate issued for the consulate or for immigration.
• Annual validity, paid upfront.

Consulates systematically reject policies with copayments, waiting periods or material exclusions that leave the applicant without real cover during the validity of the visa.

In plain terms: being accepted with a significant exclusion does not automatically mean that policy works for your visa. Your specific case has to be looked at before assuming anything.

And no, travel insurance does not work

I repeat it because people arrive having already bought one and having lost the money.

Travel policies have spending limits, deductibles and copayments, and they do not cover pre existing conditions. Immigration asks for a full health policy, equivalent to the Spanish public system. Presenting travel insurance usually ends in refusal.

What to take away from all this

• Always declare your pre existing condition. Always.
• Start the insurance process early, not on the last day.
• You pay nothing until the company accepts you.
• If you are accepted with an exclusion, check whether that policy works for your visa before assuming it does.
• Travel insurance is not health insurance.

Let us look at your case

I am Angélica Melo, exclusive Sanitas agent based in Úbeda, working across all of Spain. Every day I work with people preparing their move from the United States, the United Kingdom and Latin America.

If you have a pre existing condition and want to know how your case would be assessed and what documents you will need, message me and we will go through it calmly, in English or in Spanish.

WhatsApp: +34 742 060 375

Email: ajmelo.agenteexclusivo@sanitas.es