Private Health Insurance in Spain with Pre-Existing Conditions: How Sanitas Decides
How does Sanitas decide on a pre-existing condition?
You can get private health insurance in Spain with a pre-existing condition; whether the condition itself is covered is decided at underwriting. Sanitas reviews the medical history you declare and decides one of four things: accepted, accepted with the condition excluded, accepted with a loading (rare), or declined. Exclusions are permanent; there is no moratorium.
- Exclusions: written into the policy and lifted only by a written exception.
- The questionnaire: five questions plus height and weight; a yes goes to the Sanitas risk department, which normally phones you before the policy starts.
- Price: most people with a declared condition pay the standard tariff for their age and province, because Sanitas prefers an exclusion to a loading.
- Switching insurer: after a year insured in Spain, or with Bupa, Sanitas waives its waiting periods except childbirth, but your medical history is assessed again from scratch.
- Visa applicants: the same underwriting as everyone else; consulates check the level of cover, not personal exclusions.
Who arranges it: HealthPlan Spain is an authorised Sanitas agent (agent code 22395) in Marbella that arranges Sanitas policies in English, at the same price as buying direct from Sanitas.
This guide explains what counts as a pre-existing condition, exactly what Sanitas asks, what it can decide, and what to do if you need the policy for a visa, are switching insurer, or are declined.
What counts as a pre-existing condition?
A pre-existing condition is any illness, injury or health problem you had before the policy start date. That includes:
- Chronic conditions such as asthma, diabetes or high blood pressure
- Previous surgery or hospital stays
- Symptoms you have discussed with a doctor, even if nothing was diagnosed
- Any medication, treatment or tests you have had or have booked
If it appears in your medical history, declare it. The questionnaire, not your own view of how serious it is, decides what has to be disclosed.
The five questions Sanitas asks
The health questionnaire on the Sanitas application asks each person to be insured the same five questions, along with their height and weight.
- Do you have, or have you had, a disease or accident in the last five years that required medical treatment?
- Have you ever been, or are you due to be, admitted to hospital or undergo surgery?
- Are you currently receiving medical treatment?
- Have you recently had any medical tests, or do you have any scheduled?
- Do you continually or repeatedly suffer any undiagnosed condition or pain?
A yes to any of them is not a rejection. It means that answer goes to the Sanitas risk department for a personal assessment.
Does private health insurance in Spain cover pre-existing conditions?
Sanitas uses full medical underwriting: everything is decided up front, before the policy starts, based on your answers. There are four possible outcomes.
| Outcome | What it means for you |
|---|---|
| Accepted | The condition is covered like anything else on the policy. |
| Accepted with an exclusion | Sanitas prefers this to a loading. The policy covers everything except the condition named in the exclusion, which is written into your policy and is permanent. |
| Accepted with a loading | Rare. The condition is covered and the premium is increased to reflect it. |
| Declined | If the risk is too high, Sanitas may not offer a policy at all. |
Unlike some UK insurers, there is no moratorium option and no automatic future cover. Sanitas does not revisit an exclusion after a symptom-free period; it stays unless you receive a written exception.
How the assessment works
You complete the questionnaire as part of the online application. If any answer is a yes, the Sanitas risk department phones you to go through it and, where it needs more detail, asks for a report from your own doctor. Everything is decided before the policy starts, and any exclusion is written into the policy itself, so you know what is and is not covered from day one.
If you need the policy in place by a particular date, for example a visa appointment, talk to us about your timeline first.
Pre-existing conditions and waiting periods are different things
People often confuse the two. A pre-existing condition exclusion is about something you already had; a waiting period is a delay before certain new treatments are covered on a policy that was accepted. They are handled separately.
| Pre-existing exclusion | Waiting period | |
|---|---|---|
| Applies to | A condition you declared | Specific new treatments for everyone |
| Decided | Case by case, at underwriting | Fixed in the policy terms |
| Ends | Never, unless lifted in writing | After the stated months |
| Waived on transfer | No, history is reassessed | Usually, after a year insured in Spain (childbirth excepted) |
The full list of waiting periods is in its own guide, including the emergency rule that overrides all of them.
What happens if you do not declare a condition
Not declaring a known condition can undo the whole policy. If you claim later for something you should have disclosed, Sanitas can refuse the claim and cancel the policy. If you realise after applying that you left something out, contact us so the application can be reassessed. When in doubt, declare it.
If you need the policy for a visa or residency
Visa and residency applicants go through the same underwriting as everyone else; there are no exceptions for the purpose of the policy. The consulate requirement is full cover with no copayments, which Sanitas Mas Salud meets. If a condition is excluded, the exclusion is written into that policy and limits the treatment you can claim for once you arrive. If you have a condition that needs ongoing care, read the visa health insurance requirements and talk to us about your condition before you book the appointment.
Switching insurer with a pre-existing condition
If you have been insured in Spain for at least a year, or with Bupa, Sanitas can waive its waiting periods when you transfer, with the exception of childbirth. It does not carry over your old insurer's underwriting: your medical history is assessed again from scratch, and a condition your current policy covers may be excluded on the new one. You are told before the policy is finalised, so get that decision before you cancel the old policy. Details are on the page about switching to Sanitas from another insurer.
Can private health insurance deny pre-existing conditions?
Yes. Sanitas can exclude the condition you declared, and if the risk is too high it can decline the application. A declined application is not the end of the road, though. Residents who work here and pay into Spanish social security are entitled to the public system, and residents who do not qualify that way may be able to buy into it through the convenio especial. Our guide to public healthcare in Spain explains who is entitled and what private cover adds on top.
What it costs with a pre-existing condition
Because Sanitas prefers exclusions to loadings, most people with a declared condition pay the standard tariff for their age and province. At age 30 to 39 in mainland Spain that standard tariff runs from €29.00 a month with copayments to €116.82 for full cover on the 2026 price list. The price-by-age table is in our guide to how much health insurance costs in Spain.
Frequently asked questions
- Does private health insurance in Spain cover pre-existing conditions?
-
Not by default. Sanitas, like most Spanish insurers, underwrites the medical history you declare and decides case by case. A declared condition is accepted, accepted with that condition excluded from cover, or, if the risk is too high, the application is declined. A loading on the premium is possible but rare. Everything else on the policy is covered as normal.
- Can private health insurance deny pre-existing conditions?
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Yes. The insurer can exclude a specific declared condition from cover, and if the risk is too high it can decline the application altogether. An exclusion applies only to the condition named in it; the rest of the policy is covered as normal.
- How much does private health insurance cost for expats in Spain?
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On the 2026 Sanitas tariff a healthy adult aged 30 to 39 living in mainland Spain pays between €29.00 and €116.82 a month, depending on the province and on whether the plan has copayments. Prices rise with age; the full price-by-age table is in our cost guide.
- Can I get international health insurance with a pre-existing condition?
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Sanitas international plans are full Spanish health policies first, and worldwide reimbursement follows the policy's standard terms and waiting periods. You must declare any pre-existing condition when you apply, and the underwriting decision carries through to treatment abroad. Some UK insurers use moratorium underwriting instead; Sanitas does not.
- Can I get private health insurance in Spain with a pre-existing condition?
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Yes. You can apply for Sanitas health insurance with a pre-existing condition. Declaring it does not mean rejection: what you declare goes to the Sanitas risk department, which normally phones you to discuss it, and the outcome is settled before the policy starts.
- Is there a waiting period after which a pre-existing condition is covered?
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No. Sanitas does not use moratorium underwriting. An excluded condition stays excluded for the life of the policy unless Sanitas agrees in writing to lift the exclusion. Waiting periods are a separate rule that applies to certain new treatments on any accepted policy.
- Will my premium be higher if I have a pre-existing condition?
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Usually not. Sanitas prefers to exclude a condition rather than charge extra for it, so most people with a declared condition pay the standard tariff for their age and province. A loading is possible but rare. See how much health insurance costs in Spain for the 2026 prices.
- What happens if I do not declare a pre-existing condition?
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If you claim later for an undeclared condition, Sanitas can refuse the claim and cancel the policy. If you realise after applying that you left something out, contact us so the application can be reassessed before it matters.
- Does this apply to visa and residency policies?
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Yes. Visa and residency applicants are underwritten in exactly the same way as everyone else; there are no exceptions. If a condition is excluded, the policy still carries that exclusion. Consulates check the level of cover, not personal exclusions, so the visa application is not affected.
- Can I switch to Sanitas from another insurer if I have a pre-existing condition?
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You can. If you have been insured in Spain for at least a year, or with Bupa, Sanitas can waive its waiting periods on transfer, with the exception of childbirth. Sanitas still reviews your medical history as if you were a new applicant, so a condition your current insurer covers may be excluded on the new policy. Check that before you cancel anything.
Want to know if your condition will be covered?
The only way to find out is to request a quote and complete the health questionnaire. Compare Sanitas health plans and get a quote in minutes.
