CONDITIONS GUIDE

Pre-existing Conditions Health Insurance Spain

How Spanish carriers handle pre-existing conditions — what’s covered, what’s excluded, and your options.

By Bruno Bianchi, Founder of SpainGuru (150K+ members)

Updated April 2026 • 8 min read

The short answer

Yes, you can get health insurance in Spain with pre-existing conditions. All four major carriers (Adeslas, ASSSA, Sanitas, DKV) accept applicants with common conditions like hypertension, diabetes, asthma, and high cholesterol. The condition may be excluded from coverage or result in a premium surcharge, but you will still get a visa-compliant policy. More serious conditions (recent cancer, organ transplants) may require specialist broker negotiation.

How Pre-existing Conditions Are Handled

When you apply for health insurance in Spain, every carrier requires a medical questionnaire (cuestionario de salud). You must declare all existing conditions, medications, and recent treatments. Based on your answers, the carrier will take one of four actions:

✓

Full Acceptance

Condition covered at standard price. Common for well-controlled conditions.

⚠

Exclusion

You get the policy, but the specific condition is excluded. Most common outcome.

€+

Loading (Surcharge)

Premium increased by 10–50%. Condition may or may not be covered.

✗

Decline

Application rejected. Rare — usually only for very serious recent conditions.

Common Conditions: What to Expect

Condition	Typical Outcome	Notes
Hypertension (controlled)	Accepted / Exclusion	Usually accepted if well-controlled with medication
Type 2 Diabetes	Exclusion	Diabetes excluded but everything else covered
Asthma	Accepted	Mild/moderate asthma rarely causes issues
High Cholesterol	Accepted	Usually no impact on coverage or pricing
Depression/Anxiety	Exclusion	Mental health treatment may be excluded
Previous Cancer (5+ years ago)	Exclusion + Loading	Cancer excluded, 10–30% surcharge. Broker recommended.
Recent Cancer (under 5 years)	Likely Declined	Very difficult. Specialist broker essential.
Heart Surgery/Stent	Exclusion + Loading	Cardiac conditions excluded, possible surcharge
Hip/Knee Replacement	Exclusion	Joint excluded, rest covered normally

Which Carrier Is Most Flexible?

Each carrier has a slightly different approach to pre-existing conditions:

ASSSA

Most flexible overall. Experienced with older applicants and complex medical histories. Best choice if you have multiple conditions.

DKV

Generally accommodating. Known for accepting applicants that other carriers decline. Good alternative to ASSSA.

Sanitas

Moderate flexibility. Tend to exclude rather than decline. Good for mild to moderate conditions.

Adeslas

Strictest approach. Most likely to decline complex cases. Best for applicants with no or mild conditions.

Critical: Never Hide a Pre-existing Condition

Spanish insurance law allows carriers to void your entire policy if you fail to disclose a pre-existing condition on your medical questionnaire. This means if you need treatment for any condition — even one unrelated to what you hid — the carrier can refuse to pay and cancel your policy.

This would also leave you without valid insurance for your visa, potentially affecting your residency status. Always declare everything. An exclusion is far better than a voided policy.

Tips for Getting Approved

✓ Use a specialist broker. They know which carriers are most flexible for specific conditions and can present your case in the best light.
✓ Get a letter from your doctor. A brief letter confirming your condition is well-controlled and stable can make the difference between exclusion and full acceptance.
✓ Apply to multiple carriers simultaneously. Each carrier assesses risk differently. If Adeslas declines you, ASSSA or DKV may accept you.
✓ Apply early. The younger you are when you first enrol, the fewer conditions you will have, and the lower your base premium. Carriers cannot cancel existing policies due to new conditions that develop after enrolment.

Frequently Asked Questions

Will an exclusion affect my visa application?

No. Consulates require you to have a valid cuadro médico policy — they do not check whether specific conditions are excluded. A policy with exclusions is still visa-compliant as long as it meets the core requirements (no copays, no waiting periods, nationwide coverage).

What if I develop a new condition after I am already insured?

Any condition that develops after your policy start date is covered as a new condition, not pre-existing. The carrier cannot exclude it or cancel your policy because of it. This is another reason to enrol as early as possible.

Can I get an excluded condition covered later?

It depends on the carrier. Some carriers review exclusions after a period (usually 2–3 years) and may lift them if your condition has been stable. Others maintain exclusions permanently. Discuss this with your broker when choosing a carrier.

Need Help with Pre-existing Conditions?

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