# Health Insurance in Spain for one year visa —*pre-existing conditions, Obamacare, etc



## cerulean (Aug 21, 2015)

My wife and I are thinking of moving to Spain to Spain and enrolling in a greater-than-six-month CELTA/Spanish language program. We'd get an NIE and teach English part time.

For this we'd need the 1-year Spanish student visa, which includes the necessity of proof of health insurance. In any case, as I'm over 50 and she's over 40 we'd want to have good health insurance in any case.

Currently we're enrolled in the ACA through NY — we have Health Republic of NY — and we both have pre-existing conditions (nothing major but things that need to be 'monitored' periodically, as they say). 

I saw a blog post that said trying to buy international insurance can be very difficult, expensive and often exclude pre-existing conditions. That blog said to purchase Spanish health insurance, in Spain.

What are the best options for us?

Thanks for any help!


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## xabiaxica (Jun 23, 2009)

cerulean said:


> My wife and I are thinking of moving to Spain to Spain and enrolling in a greater-than-six-month CELTA/Spanish language program. We'd get an NIE and teach English part time.
> 
> For this we'd need the 1-year Spanish student visa, which includes the necessity of proof of health insurance. In any case, as I'm over 50 and she's over 40 we'd want to have good health insurance in any case.
> 
> ...


Spanish health insurance would certainly be more affordable, but pretty much all would exclude pre-existing conditions 

If you use the advanced search function you'll find lots of discussions about health insurance, including for non EU citizens


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## cerulean (Aug 21, 2015)

xabiachica said:


> Spanish health insurance would certainly be more affordable, but pretty much all would exclude pre-existing conditions
> 
> If you use the advanced search function you'll find lots of discussions about health insurance, including for non EU citizens


Thanks. How does anyone manage it then? Almost everyone comes with some history, some pre-existing condition — unless they're very young.


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## Elyles (Aug 30, 2012)

Damn, a New Yorker! Yeah,with preexisting conditions it is difficult but not impossible. My wife and I retired here about three years ago from the mountains of Wyoming. We had Sanitas health insurance which we are ending Oct 1. They have a number of options on policies! As with most Spanish insurance providers, they may have a rider on time limits for preexisting conditions. Try Adelsas as well. You can spend a fortune on health nsurance but it is not necessary. After a year of residence, you will qualify for Convenio Especial or more simply, the ability to buy into the care system (Seguridad Social) for about 60€ a month for under 65 y/o and about 160€ a month for over with no preexisting clauses. It does not cover pharmaceuticals though but they are dirt cheap here compared to the U.S. Medical costs are as well, and provided at high quality. I must admit, I was pretty pissed with Sanitas until recently when I was ordered for spinal surgery and in the last month of the policy they paid for it. Good luck on getting a visa to teach English here! Most of the people on this site are Brittish and the healthcare laws are a bit different for them!


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## cerulean (Aug 21, 2015)

Elyles said:


> Damn, a New Yorker! Yeah,with preexisting conditions it is difficult but not impossible. My wife and I retired here about three years ago from the mountains of Wyoming. We had Sanitas health insurance which we are ending Oct 1. They have a number of options on policies! As with most Spanish insurance providers, they may have a rider on time limits for preexisting conditions. Try Adelsas as well. You can spend a fortune on health nsurance but it is not necessary. After a year of residence, you will qualify for Convenio Especial or more simply, the ability to buy into the care system (Seguridad Social) for about 60€ a month for under 65 y/o and about 160€ a month for over with no preexisting clauses. It does not cover pharmaceuticals though but they are dirt cheap here compared to the U.S. Medical costs are as well, and provided at high quality. I must admit, I was pretty pissed with Sanitas until recently when I was ordered for spinal surgery and in the last month of the policy they paid for it. Good luck on getting a visa to teach English here! Most of the people on this site are Brittish and the healthcare laws are a bit different for them!



Thanks! —*There's nothing major or life-threatening as to pre-existing conditions we have, just the normal things as one gets past 50 that one can't really not have insurance for in the worst case scenario. Do you know if Sanitas has some reasonable way of making it work with pre-existing conditions? I'm not sure specifically what the rider might entail. I can look into it though. The convenio would be perfect, but the first year is the issue. — Yes, I don't think we're going to get a visa to teach english, per se, but a visa to learn how to teach english, which allows for some limited earning, up to 20 hours a week I think. After that we can see…


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## xabiaxica (Jun 23, 2009)

For a student visa to be extended you'd have to be enrolled in another approved course, and that extension is far from guaranteed. More likely you'd have to return home and start again. 

Take a look at our FAQ sticky thread above. There are links to some comparison sites for insurance, and a section about visas, too

I'm not sure being here on a student visa would qualify for the convenio, tbh, since it isn't a resident visa per se


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## Elyles (Aug 30, 2012)

If you have a Skype account you can call Sanitas easy (34) 902 102 400. Just say: ¿Puedo hablar con alguien que habla ingles por favor? They would be happy to answer your questions in English. They also have a web page in English. Just search Sanitas en ingles. I don't know where you plan on settling but here in Aragon we can and have been taking free Spanish classes for foreigners here for three years. If you don't speak any Spanish, you will be lost. In re to Obamacare, the Republicans in Congress have done nothing but complain the past seven years and waste our tax dollars. Nothing has been done in re to Medicare portability which would in effect reimburse the Spanish government at a higher rate than what they would normally receive. (¡Que pena!) What a shame! You will find this site more than helpful with some very knowledgable people on here. You will find Xabiachica probably the person offering the most direct advice.


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## Elyles (Aug 30, 2012)

What you will also discover is that most Spanish insurance companies require an NIE but a few like Sanitas allow for passport numbers to be used


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## tjsmom (Dec 28, 2015)

Hello Elyes - 
I know your post is a few months old, but your situation looked somewhat similar to mine and I was as hoping you might have some advice for me. My husband and I are from California and will be applying for our Spanish non-lucrative resident visas in a couple of months. 

I'm in the process of securing Spanish medical insurance so that we have the required proof when submitting our visa paperwork to the consulate. Sanitas will insure us, but our pre-existing conditions will be excluded from the policy. This was expected and we plan to "self-insure" for any medical costs associated with the pre-existing conditions. 

However, my big concern is whether the consulate could potentially reject our request for a visa, if the proof of health insurance letter states that the policy has an exclusion for these pre-existing conditions. I'm not sure if the policy letter that Sanitas will provide us with will specifically state the exculsions or if it will be more general in stating that we have a policy with them, note the max $ coverage for the plan, no copays/deductables, etc. 

Question - Given that you and your wife had pre-existing conditions when applying for your Spanish Visas, can you tell me if this was raised as an issue, and if so how did you deal with it?

Thank You!


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## Elyles (Aug 30, 2012)

Wasn't any issue here. Just get Proof from Sanitas that you are insured. Talk to Sanitas about it but it is my belief that the exclusions will not be stated. The Spanish government just doesn't want to pay for your illness so you might want to show how you can cover it.


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## tjsmom (Dec 28, 2015)

Thanks very much for your quick response and advice. Fingers crossed!


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## Elyles (Aug 30, 2012)

Where you guys going to be by-the-way?


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## Melissa58275 (Apr 14, 2014)

Cerulean, this may be too late...I know your post is several months old. But I thought I'd bring your attention to another potential health insurance snag that you should be aware of. The ACA is a fuzzy on the question of some expats responsibility to meet the individual health care insurance mandate. If you are a "bona fide" expat, your are clearly considered to have met the requirement ( people say that they are "exempt", but that's short-hand. The law really says they are considered to have met the requirement.) The problem arises for folks like me...and possibly you....who are not already established expats and who MAY not qualify as one (for tax purposes). The rules on this are complicated but essentially come down to this: Either you can not be in the US for more than 35 days (including any day you traveled) over a 12 month period or you have to prove that you do not intend to come back to the US...by, for example, buying a home overseas, selling your US residence, establishing long term residence overseas, etc. This last is complicated and would almost certainly not apply to you if you are doing a student visa thing.

So...you're probably not going to be considered an expat, which means you must buy US insurance or pay the penalty. The rub, of course is, that you have to buy Spanish insurance to get your visa here, but it won't count toward your ACA obligation. 

The above info is what I have come to understand after many phone calls, consultations, web searches, etc. BUT, I caution that I am neither a health insurance law or tax expert and essentially gave up trying to get any further clarification around May of last year. Since then, It's possible that the regs have been clarified and the situation for "part-time" or temporary expats who are out of the US for a lengthy but not indefinite period has been clarified. I hope so. But I urge you to look into it to be sure. 

By the way...I did an intensive 4 week CELTA class (in Germany) at the beginning of 2015. It was great and I have been teaching in Germany. Now that I'm moving to Spain, I don't expect to be able to use it, however, as it is far more difficult to get a work permit for a non-EU citizen here. 

hope this is helpful.


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## tjsmom (Dec 28, 2015)

Hi Elyles - we are going to Valencia.


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## Elyles (Aug 30, 2012)

As US citizens we had no problem getting Sanitas and had it for three years. They only require a passport number. Many Spanish companies however require NIE. It has nothing to do with expat status. Sanitas can cover you in the US as well for a minimum fee through United Healthcare. If residents of Spain for one year you can qualify for Convenio Especial that allows for foreigners to buy into the Spanish Seguridad Social or Spanish healthcare system. If under 65 years of age, the cost is only about 57€ a month but rises to 160€ if over that age. It does not cover prescription benefits however. We have that coverage now and are very pleased with it. Have fun in Valencia. We prefer the Pyrenees, where there are less English Speakers.


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## Ifn (Jan 29, 2017)

Elyles said:


> As US citizens we had no problem getting Sanitas and had it for three years. They only require a passport number. Many Spanish companies however require NIE. It has nothing to do with expat status. Sanitas can cover you in the US as well for a minimum fee through United Healthcare. If residents of Spain for one year you can qualify for Convenio Especial that allows for foreigners to buy into the Spanish Seguridad Social or Spanish healthcare system. If under 65 years of age, the cost is only about 57€ a month but rises to 160€ if over that age. It does not cover prescription benefits however. We have that coverage now and are very pleased with it. Have fun in Valencia. We prefer the Pyrenees, where there are less English Speakers.


Just an update on Sanitas: On the day I was closing on the sale of my apartment in NY, I spoke to Sanitas about finalizing my insurance. I had been in touch with them for 6 months prior, reviewed their plans, etc. But, when I spoke to their medical dept, I was told because I had pre existing conditions, Of Any Sort, I was not eligible for coverage. I asked if I could not be covered for the pre existing conditions and was told absolutely not. And that NO Spanish company would insure me. I ended up buying expensive insurance from Aetna that did not cover the pre existing conditions but only has a 5 year look back. Needless to say, I dont want to keep paying if I can get insurance in Spain, but it sounds like the rules may have changed.


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## Elyles (Aug 30, 2012)

Ifn said:


> Just an update on Sanitas: On the day I was closing on the sale of my apartment in NY, I spoke to Sanitas about finalizing my insurance. I had been in touch with them for 6 months prior, reviewed their plans, etc. But, when I spoke to their medical dept, I was told because I had pre existing conditions, Of Any Sort, I was not eligible for coverage. I asked if I could not be covered for the pre existing conditions and was told absolutely not. And that NO Spanish company would insure me. I ended up buying expensive insurance from Aetna that did not cover the pre existing conditions but only has a 5 year look back. Needless to say, I dont want to keep paying if I can get insurance in Spain, but it sounds like the rules may have changed.


I don’t know what happened to my original note but the price is 57 € a month for under65 and 150€ over and we both have pre existing conditions. As a matter of fact, I was in the ER most of the evening for chronic pain issues and my wife will be given a new hip under this plan. It is not a Spanish company, but through the Seguridad Social dept of the regional government where you live. It has nothing to do with insurance rules. Contact your local representative for Seguridad Social


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## Ifn (Jan 29, 2017)

Elyles said:


> I don’t know what happened to my original note but the price is 57 € a month for under65 and 150€ over and we both have pre existing conditions. As a matter of fact, I was in the ER most of the evening for chronic pain issues and my wife will be given a new hip under this plan. It is not a Spanish company, but through the Seguridad Social dept of the regional government where you live. It has nothing to do with insurance rules. Contact your local representative for Seguridad Social


Thanks for quick reply. I have read that Spain does not offer their government health insurance to expat retirees ice they came after 2012. I will do a lot more sleuthing once I get there.
I loved Jaca when I visited it. But Ill be living in Madrid.


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## Elyles (Aug 30, 2012)

Too many people in Madrid for my taste. Ilived around Houston for over 30 years till we moved to the Mountains of Wyoming for the ski culture then retired here. We love living where English is a foreign language. If ever here again, please visit.


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## xabiaxica (Jun 23, 2009)

Ifn said:


> Thanks for quick reply. I have read that Spain does not offer their government health insurance to expat retirees ice they came after 2012. I will do a lot more sleuthing once I get there.
> I loved Jaca when I visited it. But Ill be living in Madrid.


That simply isn't true.

Once you have been a registered, legal resident you can buy in to state healthcare using the _convenio especial_


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## Elyles (Aug 30, 2012)

Once you have been a registered legal resident for (1 year ) you can buy into the program but you must go through your department of Seguridad Social. Some autonomous areas do not have this program but most do. I andafew others on this site are successfully on the program.


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## Ifn (Jan 29, 2017)

Elyles said:


> Too many people in Madrid for my taste. Ilived around Houston for over 30 years till we moved to the Mountains of Wyoming for the ski culture then retired here. We love living where English is a foreign language. If ever here again, please visit.


Since I'm from NY, Madrid is wonderfully sized for me. Yes, I said I loved Jaca.....but it was chilly! But i will look you up if or when I get back there


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