Pre-Existing Conditions and Sanitas Health Insurance: What You Need to Know
If you’re considering private health insurance in Spain with Sanitas, it’s crucial to understand how pre-existing conditions are handled. This is one of the most common concerns for expats with a medical history - and the outcome can affect what your policy will actually cover.
What Counts as a Pre-Existing Condition?
A pre-existing condition is any illness, injury, or health issue you’ve had before your policy start date. This includes:
- Chronic conditions (e.g., asthma, diabetes, hypertension)
- Previous surgeries or hospital stays
- Symptoms you've discussed with a doctor (even if undiagnosed)
- Any medication, treatment, or tests you've received
Sanitas defines these clearly in their health questionnaire. If something appears in your medical history, it will likely be reviewed during underwriting.
Can You Get Health Insurance with a Pre-Existing Condition?
Yes - you can apply. However, Sanitas uses full medical underwriting. This means they will assess your condition and may:
- Exclude it from coverage
- Offer coverage with an added premium (rare)
- Decline your application
Unlike some UK insurers, there is no moratorium system or automatic future coverage. Everything is decided up front, based on your honest answers.
How Sanitas Assesses Your Health History
When applying, you'll complete a detailed health questionnaire. The Sanitas medical team may follow up for clarification or request documents from your doctor. Based on your history, they will confirm any:
- Exclusions - stated clearly in your policy
- Accepted conditions - if any, with or without loading
- Declined applications - if the risk is too high
What Happens If You Don’t Declare a Pre-Existing Condition?
Not declaring a condition is serious. In these cicumstances you should contact us so that your application can be re-assessed. If you make a claim later for an undeclared condition, Sanitas can refuse to pay and may cancel your policy entirely. Always be honest and thorough - if in doubt, declare it.
Will Sanitas Ever Cover a Pre-Existing Condition?
In some cases, yes - Sanitas may choose to cover a specific condition with or without a surcharge. If a condition is excluded, there is no automatic inclusion after a waiting period, even if the condition remains symptom-free.
Unless you receive a written exception, your condition remains excluded permanently.
Why Does Sanitas Use This Approach?
Sanitas, like most Spanish insurers, uses a risk-based model to keep premiums fair. Covering existing health issues without assessment would raise prices for everyone. Their process helps keep private healthcare in Spain affordable and sustainable.
Frequently Asked Questions
- Does Sanitas cover pre-existing conditions?
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No, not automatically, all declared conditions are assessed on an individual basis
- Can I still get private health insurance in Spain with a pre-existing condition?
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Yes. You can apply for Sanitas health insurance even if you have a pre-existing condition.
- Is there a waiting period for pre-existing conditions to be covered later?
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No. There is no automatic inclusion of conditions after a symptom-free period.
- What happens if I forget to mention something in my medical history?
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Omitting a known pre-existing condition can lead to serious consequences.
- Will Sanitas ask for my medical records?
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Sometimes, yes. Sanitas may ask for documentation if clarification is needed.
- Will my premium be higher if I have a pre-existing condition?
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In most cases, no. Sanitas tends to exclude conditions rather than load premiums.
- Does this apply to all Sanitas plans - with or without co-payments?
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Yes, the rules apply across all plans regardless of copayment status.
- Can I switch to Sanitas from another insurer if I have a pre-existing condition?
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You can, but Sanitas will re-assess your history from scratch.
- Does Sanitas make any exceptions for residency or visa policies?
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No, all applicants must go through underwriting.
- How do I know if my specific condition will be covered?
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The only way to know is to apply and complete the health questionnaire.
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.
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