Comparison

ASSSA vs Sanitas Health Insurance

Two visa-compliant Spanish insurers with very different strengths. Here’s how to choose between ASSSA and Sanitas for your Spanish visa.

Updated April 2026 · 8-min read
Key takeaways
  • ASSSA — best for age 65+ and pre-existing conditions, with lifetime premium lock on many plans.
  • Sanitas — best for English-speaking support, digital tools and younger applicants in major metros.
  • Both are DGSFP-authorised and visa-compliant for NLV, DNV, Student and Retirement visas.
  • Under age 50 they cost roughly the same; ASSSA wins decisively at 65+.

Quick verdict

Choose ASSSA if: you’re over 60, have a pre-existing condition, want premium stability into retirement, or you’re a long-term resident planning to renew repeatedly.

Choose Sanitas if: English-language support matters, you want the best digital experience, or you’re under 55 and value Bupa’s international backing.

Side-by-side comparison

  • Ownership: ASSSA is a specialist Spanish insurer (independent); Sanitas is owned by Bupa (UK).
  • Founded: ASSSA ~1935; Sanitas 1954 (Bupa since 1989).
  • Pre-existing conditions: ASSSA is the most flexible carrier in Spain. Sanitas is stricter.
  • Age limit for new applicants: ASSSA up to 75+; Sanitas typically stops at 69.
  • English support: Sanitas leads by a wide margin. ASSSA has some English brokers but less consumer-facing support.
  • Digital tools: Sanitas leads (high-rated app, telehealth). ASSSA is functional but less polished.
  • Lifetime premium lock: ASSSA offers this on select plans; Sanitas does not.
  • Hospital network: Sanitas larger nationwide; ASSSA strong in Costa Blanca and Murcia.
  • Monthly premium, age 35: ASSSA ~€55; Sanitas ~€55.
  • Monthly premium, age 65: ASSSA ~€180; Sanitas ~€220 (if accepted).
  • Monthly premium, age 72: ASSSA ~€260; Sanitas typically declined.

ASSSA: detailed profile

ASSSA is a specialist insurer that focuses almost exclusively on individual and family health cover for residents of Spain, including expats. It was one of the first carriers to market visa-compliant plans specifically for non-EU residents.

Its signature feature is the lifetime premium lock — on many ASSSA plans, once you’re insured, your premiums increase only with general inflation, not age penalty. This matters enormously for retirees who plan to hold the policy for decades.

ASSSA is also the most accommodating Spanish carrier for applicants over 65 and those with pre-existing conditions. Diabetes, hypertension, asthma and controlled heart conditions are routinely accepted, often with only modest surcharges.

Sanitas: detailed profile

Sanitas, owned by Bupa, is a full-service Spanish insurer with the benefit of global Bupa integration. Its Milenium clinics and preferred hospital network give high-quality urban care in Madrid, Barcelona and coastal cities.

Where Sanitas dominates: English-language service, digital tools (mobile app, telehealth, online claims) and international cover for frequent travellers.

Sanitas is notably stricter on pre-existing conditions than ASSSA. Complex conditions may be excluded outright. Age limit for new applicants is ~69.

Which wins on key scenarios?

Retiree, age 67, good health, NLV applicant: ASSSA. Better price, higher acceptance likelihood, lifetime premium lock.

Digital nomad, age 32, no conditions: Sanitas. Better digital tools, competitive pricing, strong English support.

Applicant with controlled diabetes, age 55: ASSSA. Much more likely to accept without exclusions.

Family of four relocating to Madrid: Sanitas (English support, pediatric network, Milenium clinics).

Applicant in Costa Blanca aged 62: ASSSA (strong regional presence, age-friendly pricing).

How they compare to the other majors

Frequently asked questions

Is ASSSA cheaper than Sanitas?

Not under age 40 — they’re roughly comparable. ASSSA becomes noticeably cheaper from age 55 onwards and is the clear winner at 65+.

Which is better for pre-existing conditions?

ASSSA by a wide margin. Sanitas is strict; ASSSA is the most flexible major carrier in Spain for this.

Which has better English support?

Sanitas. Its customer service and online portal are available in English. ASSSA often relies on brokers for English communication.

Can I use both?

You only need one visa-compliant policy. Some residents use ASSSA for their primary cover plus Sanitas for a travel rider, but that’s unusual and unnecessary for most visa applicants.