Getting a Cancer Diagnosis in Spain: What Sanitas Covers and the Five-Year Rule

A cancer that is found after your Sanitas policy starts is covered on every plan with hospital cover. You see the oncologist from the first day of the policy. The scans, biopsies and pathology that confirm and stage it are paid by Sanitas to the hospital. So are the operation, chemotherapy in the day unit or on the ward, radiotherapy and reconstruction after a mastectomy. So are the tests that decide which drug you get, a second opinion from specialists anywhere in the world, psychology and nutrition. On a new policy the dates matter: complex scans wait six months, and chemotherapy, radiotherapy and hospital surgery wait ten, unless the cancer is life-threatening and unexpected. A cancer you already had when you applied is a different case, and since 2023 Spanish law draws a five-year line under it. If your policy is more than a year old, none of the dates apply to you.

This guide is for the moment after the words have been said. It covers what happens next in Spain, what Sanitas pays for step by step and what it does not, and what changes on a new policy. It also covers what to expect if you had cancer before you applied, and the practical side of work, money and support. The oncologists guide covers the specialty itself and where the oncologists are.

What to do this week

• Book the oncologist through the app or by ringing the hospital; no referral is needed. Our directory lists the network oncologists by province.
• Ask for the written report after every consultation and keep the scans; authorisations, the second opinion and the sick note all run on them.
• Send us the treatment proposal before it starts, on 952 835 600 or through the contact page. We check it against your policy and the dates, and we chase authorisations in Spanish.
• Register with the public health centre if you have not, for the sick note, medicines and, later, home palliative care. Registration needs an entitlement: Spanish social security contributions, an S1 at UK state pension age, or the paid convenio especial after a year on the padron. On a non-lucrative visa you have none of these at first, so Sanitas is your cover for everything.
• Ring the AECC helpline if you or your family want to talk to someone today; it is free and open around the clock.

What happens after a cancer diagnosis in Spain

Spain diagnoses about 300,000 new cancers a year and treats them in both public and private hospitals. What differs is the route. In the public system you are referred by your health centre doctor, seen at the hospital that covers your address, and treated free of charge if you are registered with the public system. Waits between each step vary by region and by the step, and you do not choose the hospital or the specialist.

With Sanitas you book the oncologist yourself, with no referral, at any hospital or clinic in the Sanitas network, and the oncologist in charge of you prescribes every test and treatment. Sanitas authorises the big items on the medical report and pays the hospital directly. You never see a bill for covered treatment, only the copayment if your plan has one. Our public versus private healthcare guide explains how the two systems sit side by side. Many people use both: Sanitas for the treatment, the public health centre for the sick note and for medicines at the pharmacy.

The words you will meet are oncologo (oncologist), biopsia, TAC (CT scan), PET-TAC, resonancia (MRI), quimioterapia and radioterapia. Hospital de dia is the day unit where chemotherapy is given. The informe is the medical report every authorisation runs on, and the autorizacion is the go-ahead from Sanitas that the hospital usually arranges for you.

What Sanitas pays for, step by step

Tests and staging

Blood tests, X-rays and ultrasound are simple tests, covered from the first day. CT, MRI, PET scans, endoscopy, nuclear medicine and biopsies under imaging are complex tests, covered with authorisation after six months on a new policy. A PET scan is covered for diagnosis, staging, checking the response to treatment and finding a recurrence, and a PET-MRI for cancer only. The PET scan guide and the MRI guide give the detail and the cost without insurance. Pathology on the tumour includes the tests that decide which drug you can have. They include BRAF, ALK, K-RAS, N-RAS, HER2, EGFR, C-KIT, ROS-1 and PD-L1, microsatellite instability in bowel cancer, MGMT in brain tumours, PIK3CA, and BRCA1 and BRCA2 in the tumour in ovarian cancer.

Genetic tests on you, rather than on the tumour, are covered in two cases: the BRCA1 and BRCA2 or hereditary breast and ovarian cancer panel, and the hereditary bowel cancer panel. Sanitas authorises them on a medical report where you meet its age or family-history criteria, such as breast cancer under 50, ovarian cancer or bowel cancer under 50. Other genetic tests on you are covered only where the result will diagnose a disease that nothing else can, or is essential to choose treatment. They are never covered where the chance of a diagnosis is below one in ten. Genome sequencing, exome studies and pharmacogenetics are excluded, apart from the DPD deficiency test before certain chemotherapy drugs, which is covered. The blood tests guide covers the laboratory side.

Surgery

An operation for cancer is covered in a Sanitas network hospital: the theatre, the surgeon and anaesthetist, the medicines used in hospital, a private room with a bed for a relative, and unlimited days. Bone grafts after tumour surgery, chest-wall meshes in cancer surgery, breast implants and expanders, and on the Mas Salud range the drug reservoir for chemotherapy, are among the implants Sanitas pays for. On a new policy a hospital operation waits ten months on the Mas Salud range and eight on Top Quantum. A minor operation done as a day case waits three months, or eight on Top Quantum.

Breast cancer surgery includes the operation on the affected breast and reconstruction afterwards with expanders and an implant or with a DIEP, TRAM or dorsal flap. A reduction or lift of the healthy breast to match is covered up to a year after the cancer operation, when a medical report supports it. Where a BRCA1 or BRCA2 result makes preventive surgery a treatment option, the operation and the reconstruction are covered, except on Top Quantum, which covers surgery and reconstruction only for a breast affected by cancer. The reconstructive surgery guide has the surgical detail.

Chemotherapy and drug treatment

Chemotherapy is prescribed by the medical oncologist in charge of you and given in the oncology day unit or as an inpatient, for as many cycles as you need. The drugs must be authorised for sale in Spain and used for the cancer named on their product licence, given by drip or injection or into the bladder. Chemotherapy into the abdomen for peritoneal spread from ovarian or digestive cancers, and into the spinal fluid for high-grade lymphoma or cancer in the lining of the brain, are covered too. The anti-sickness and protective medicines given during the session are included, and so is the test for DPD deficiency before certain drugs. Sanitas pays for the most efficient therapy available, using the generic or biosimilar version where one is authorised in Spain.

Excluded from the oncology cover are experimental and compassionate-use treatments, hormonal therapy, immunostimulants, immunosuppressants and gene therapy. Robotic surgery is excluded by the general conditions. So are CAR-T and other cell therapies, radioactive drugs other than iodine for thyroid cancer, and any drug used outside its licence. Sanitas Mas Salud policies issued since October 2025 carry one exception: robotic surgery for prostate cancer is covered when you pay a 7,000-euro contribution to the hospital. A medicine you take at home is not covered on any Sanitas plan. For breast and prostate cancer, hormonal therapy means the daily tablet or the regular injection that follows the main treatment. Sanitas does not pay for the tablet or injection itself, though your Sanitas oncologist prescribes and monitors it. You collect it on a public prescription if you are registered with the public system, or pay the pharmacy and claim half back with the pharmacy add-on. Biological medicines are among the exclusions, so the answer on an immunotherapy or targeted drug turns on the exact product. Send us the oncologist's proposal and we will check it against the policy before you start.

Radiotherapy

Radiotherapy for cancer is covered with Sanitas' written authorisation on the oncologist's report: intensity-modulated radiotherapy, 3D conformal radiotherapy, stereotactic radiotherapy of the brain and body, intraoperative radiotherapy, brachytherapy and radiosurgery for brain tumours. Top Quantum lists the same methods except stereotactic radiotherapy of the body. Proton beam therapy, neutron capture therapy and radioembolisation with microspheres are excluded. Radioactive iodine for thyroid cancer is covered; the nuclear medicine guide explains it. The wait on a new policy is ten months, six on Top Quantum.

Getting there and care at home

An ambulance to and from the day unit for chemotherapy and radiotherapy is covered when your physical state stops you travelling by taxi or car, authorised through the Sanitas 24-hour line. Nursing at home, home visits from a GP and home respiratory therapy are covered on a doctor's prescription. Physiotherapy after surgery follows the physiotherapy guide. Speech therapy after surgery or radiotherapy to the larynx is covered for up to 80 sessions a year on the full-cover plans, and 20 a year on Mas Salud Family. The speech therapy guide explains it.

Nutrition, psychology and a second opinion

A dietitian is covered when the oncologist prescribes it, because a cancer patient meets the medical condition the cover requires; the nutrition cover guide has the rules. Psychology sessions prescribed by the oncologist are covered: 15 a year on Mas Salud, Optima and Plus after six months, and 20 on Mas Salud Family with no wait. Top Quantum gives 20 after three months and Residents Visa 15 with no wait. A psychiatrist is covered from the first day on every plan except Avanza. The mental health cover guide sets it all out.

The second medical opinion cover applies to a serious chronic illness needing planned care, where new tests or treatment may be needed and the outlook for life is seriously at risk. You ring us on (+34) 952 835 600 and we open the second-opinion request with Sanitas. Sanitas tells you what to send, and your reports and scans go to leading specialists or centres anywhere in the world that Sanitas designates. You receive a written report with the experts' opinion and their credentials, and a Sanitas consultant physician manages the case and advises you throughout. It is not for an acute problem that needs an answer today.

Which plans, and what you pay

Everything above is on Sanitas Mas Salud, Optima, Plus, Mas Salud Family, Top Quantum, Residents Visa, Mas 90, Premium 500 and the Professional plans. Accede, Avanza and Unico are outpatient plans. They cover the simple tests, the oncologist on Accede and Unico, and scans on Avanza and Unico, but not chemotherapy, radiotherapy or a hospital stay. A person on one of them is treated for those in the public system, through the health centre referral, while the plan carries on paying for the consultations, blood tests and scans it covers. Moving up to a hospital plan after the diagnosis does not bring the cancer into cover: it is declared as pre-existing and excluded, and a new plan starts its waiting periods again. Optima, Plus, Accede, Avanza and Unico carry a copayment on each consultation, test and treatment session; Mas Salud, Mas Salud Family, Top Quantum and Residents Visa do not. The copayments guide has the amounts. On a plan without copayments you pay nothing at the hospital. To see the plans side by side, compare the plans on our calculator.

If your policy is new

Consultations and simple tests are covered from the first day. A complex scan waits six months. Chemotherapy, radiotherapy, a hospital admission and major surgery wait ten months on the Mas Salud range and eight on Top Quantum, where chemotherapy and radiotherapy wait six. Residents Visa has no waiting periods at all. If you held private health insurance with another insurer in Spain for at least a year before switching, Sanitas waives the waiting periods except childbirth; the waiting periods guide explains how.

One exception overrides all of them. The waiting periods do not apply to an illness that is life-threatening, unexpected and diagnosed after the date the cover started, provided the treatment is covered by the policy. An aggressive cancer found in month four of a new policy is treated on that basis. Unexpected means nothing pointed to it before you joined. If the symptom that led to the scan began before your start date, tell us the dates before the treatment proposal goes in, because Sanitas may treat it as pre-existing instead. A slow-growing cancer that is not an immediate threat to life keeps the ordinary dates. Sanitas decides on the oncologist's report, so ask for the urgency to be stated plainly and ring us on 952 835 600 before you agree a treatment plan. The emergencies guide covers what counts as an emergency.

If your policy is under six months old and a scan or biopsy is needed to confirm the diagnosis, see the oncologist now, which is covered from day one. Check your start date too, because the six-month line may be close. If it is not, have the scan done through your public health centre if you are entitled to public healthcare. Otherwise pay for that one scan or biopsy privately; the MRI guide and the PET scan guide give the prices. A diagnosis made on a test you paid for yourself still counts as diagnosed after the start date, and that report is what Sanitas reads when it decides whether the exception applies.

If you had cancer before you applied

A health insurance policy covers what arises after it starts. A cancer you already have when you apply, or its recurrence, is not covered by a new policy, and that is true of every insurer in Spain. What Sanitas asks on the health questionnaire is whether you have had, in the last five years, an illness that needed treatment; the pre-existing conditions guide explains the questions and the outcomes. Declare the cancer. Sanitas may accept you with that cancer and anything linked to it excluded, or decline, and everything unrelated is covered as normal.

Since 30 June 2023 Spanish law gives cancer survivors a right to be forgotten. Five years after the end of treatment intended to cure you, with no relapse in between, no insurer may refuse you because of the cancer. It may not put you through a different application process, charge you more or treat you differently. It may not ask you for information about it before you sign, and a clause that excludes you for a cancer that far in the past is void. Past that point the cancer is not declared and cannot be held against you.

Inside the five years, the timing is worth getting right. Radical treatment usually means the surgery, chemotherapy or radiotherapy intended to remove the cancer, and the five years run from the end of that. The law does not define the term, and Sanitas' own question covers treatment of any kind in the last five years. If you finished follow-on tablets more recently, tell us the dates and we will tell you what must be declared. If you need cover now, for a visa or for everything else, apply and declare the cancer. We will tell you plainly what Sanitas is likely to offer before you fill in a form. Once the five years pass, a clause excluding that cancer is void under Spanish law, so ask us at that renewal and we will have it taken off.

Recurrence and a second cancer

A cancer that returns is treated under the same cover as the first, with the oncologist reassessing and the tests and treatment authorised again on the new report. A new, unrelated cancer is covered in the same way. The only recurrence a policy does not cover is of a cancer that was already excluded when you joined. Follow-up after treatment, the scans and consultations that check for recurrence, is covered on the ordinary rules, with a PET scan covered where recurrence is reasonably suspected.

Coping with the diagnosis

Fear, anger, numbness and not sleeping are the normal response, and help is there from the first day if you want it. What helps most people is knowing the plan: who the oncologist is, what the next test is and when, and who to ring. With Sanitas that is the oncologist in charge of you and, for anything about the policy, us. Write the questions down before each appointment and take someone with you. Ask for the informe, the written report, after every consultation; it is the document every authorisation runs on and the one a second opinion needs.

If low mood, anxiety or sleeplessness persist and get in the way of daily life, say so to the oncologist, who can prescribe psychology sessions, or book a network psychologist by video through the app. The Take Care of Your Mind service in the app is there from the first day, and the Blua digital tools guide explains it. Family members on the same policy have the same psychology cover in their own right.

When cancer is advanced

If treatment stops working, the care that keeps you comfortable is a mixture of what Sanitas covers and what the public system does. Sanitas covers the oncologist, pain treatment and hospital admission for as long as it is medically needed. It covers nursing at home, GP visits at home and home respiratory therapy on prescription, and the psychology sessions of your plan. It does not cover admission for social reasons, once the acute phase is over and what is needed is care rather than treatment, and it has no hospice cover.

Spain's public system runs palliative care teams that visit at home, free of charge to anyone registered with it. The Ley de Dependencia gives a graded right to home help for people who can no longer manage alone. The palliative home teams need you to be registered with the public health system. The Ley de Dependencia needs five years of legal residence in Spain, two of them immediately before you apply. Keep both entitlements in place from the start. The Spanish cancer association, the AECC, runs a free 24-hour helpline that gives access to its psychologists, social workers and medical advisers. Its volunteers accompany patients and families in every province.

Work, money and paperwork

• Sick leave. Sick pay needs 180 days of social security contributions in the last five years, and contributions paid in another EU country or the UK normally count. An employee gets nothing for the first three days unless the collective agreement pays them. From the fourth day to the twentieth the pay is 60 per cent of the contribution base, from the employer to the fifteenth and from Social Security after that. From the twenty-first day it is 75 per cent. It runs for up to a year with a possible six-month extension. The self-employed are paid by their mutua from the fourth day. The sick note comes from the public health centre doctor, so take the Sanitas reports to your health centre.
• Medicines. Sanitas pays for the drugs given in hospital and in the day unit. Tablets and injections you take at home, including hormone tablets after breast or prostate cancer, are not covered on any plan. A public prescription makes them cheap at the pharmacy, and the pharmacy add-on pays half of what you spend without one.
• Travel. The European or Global Health Insurance Card covers medically necessary care on a trip, not planned treatment abroad. Sanitas covers you in Spain; the emergency assistance abroad cover on your plan covers an emergency on a trip, not a course of treatment. Tell us before you travel during treatment.
• Your visa. A residency visa asks for health insurance, not health. A diagnosis does not end your policy and does not stop it renewing each year in the ordinary way, so it still serves as the insurance a visa renewal needs. Keep the premiums paid and the plan unchanged if the visa needs a policy without copayments; the changing your plan guide covers what can change at renewal. If you are applying for a first visa with a cancer exclusion on the policy, ask us before you apply.

Screening for other cancers

Every full-cover plan carries a preventive medicine programme for healthy people: a specialist consultation, physical examination and basic tests for early diagnosis. Screening for the common cancers sits with the specialties. Mammography and gynaecological checks are in the gynaecology guide, and a CT colonography or colonoscopy from the age of 50, or earlier with a family history, in the gastroenterology guide. PSA and multiparametric MRI of the prostate are in the urology guide, mole checks in the dermatology guide, and blood cancers in the haematology guide. All are covered subject to their own waiting periods, and a complex test found abnormal leads straight to the oncologist. A cancer found after the start date is covered, subject to the waiting periods above; one found before it is not.

Frequently asked questions