What Spain's consulates actually require
Health insurance for a Spanish visa is a formal document requirement, not an optional extra. Every long-stay visa category — Non-Lucrative (NLV), Digital Nomad (DNV), Retirement, and Student — requires you to submit a certificate from a DGSFP-authorised insurer confirming that your policy meets the following minimums:
- Medical expense cover of at least €30,000 with no territorial exclusions within Spain
- No copayments — the policy must cover costs in full, not a percentage
- No waiting periods for standard conditions at the point of application
- The insurer must be registered with the DGSFP (Spain's insurance regulator)
- The certificate must be in Spanish, or accompanied by a certified official translation
- Your name and date of birth on the certificate must match your passport exactly
Most consulates also check that the policy start date aligns with your intended entry date and that the certificate references the correct policy period. Some — London, New York, and Los Angeles in particular — apply stricter interpretation to these requirements and have been known to query certificates from non-specialist intermediaries even when the underlying coverage is technically compliant. This is one reason the insurers on this site are chosen specifically for their established consulate acceptance track records.
You can read our full breakdown of the requirements by visa type in the NLV health insurance guide, the DNV guide, and the retirement visa guide.
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How we choose the right insurer for you
Not all insurers suit all applicants. We match on four primary factors, in this order:
1. Visa type. The NLV, DNV, Retirement, and Student visas all have the same coverage minimums, but the practical considerations differ. DNV applicants who are autónomo, for example, have no Social Security backup during the initial application period — making it more important that the private policy is comprehensive. Retirement applicants over 70 have fewer insurer options. Student applicants under 30 typically have the lowest prices across all insurers.
2. Age. This is the most decisive factor after visa type. Sanitas Residents Visa accepts new applicants up to age 75. Sanitas Platinum Visa caps at 64. Some insurers stop writing new policies at 60 or 65. For applicants over 65, ASSSA is often the only provider prepared to quote on a standard basis. Age determines which options exist before we start comparing prices.
3. Dental cover. Caser Adapta includes dental and repatriation as standard within its headline price. Sanitas Residents Visa does not include dental — dental cover is available as a separate add-on. For an applicant who wants dental included, the price gap between Sanitas and Caser often reverses once the dental add-on is factored in. We always ask, because it changes the comparison significantly.
4. Certificate urgency. Sanitas issues its certificate automatically and immediately once the policy is activated and payment is received — there is no waiting period for the document itself. Caser typically takes 1–2 business days. For applicants with imminent consulate appointments, Sanitas is usually the only viable option regardless of other considerations.
Which visa type are you applying for?
The six insurers on this site cover all major Spanish long-stay visa categories. Here is what changes by visa type:
The most common visa category on this site. NLV applicants must show passive income sufficient to live without working in Spain. Health insurance requirements are standard: €30,000 minimum, no copayments, DGSFP-regulated. Most applicants are well served by Sanitas or Caser depending on age and dental preference. NLV health insurance guide →
Coverage minimums are identical to the NLV, but autónomo applicants should note that Social Security is not an automatic fallback during the application period. Employed-by-foreign-company applicants may have different considerations. We ask about employment status in the form. DNV health insurance guide →
Retirement visa applicants are typically over 60, and some are over 70 or 75. Age restricts options significantly — ASSSA is often the best-placed insurer for applicants above 70 without an age-based premium increase. We always confirm current entry age limits before recommending. Retirement visa guide →
Student visa applicants are typically under 30, which gives access to some of the lowest premiums across all insurers. Sanitas has a dedicated International Students plan (age 14–35). Most standard visa plans also work. We match on duration, as many student policies are available for less than 12 months. Student visa guide →
Pre-existing conditions — what to expect
Health insurance for a Spanish visa does not require full medical underwriting in most cases. However, insurers handle declared pre-existing conditions differently, and the outcome depends on the specific condition, its management status, and the insurer.
Sanitas reviews each case individually. A declared pre-existing condition may be accepted with full cover, accepted with the condition excluded for a defined period, accepted with a premium loading, or in rare cases declined. Many applicants with stable, well-managed conditions — controlled hypertension, type 2 diabetes, historical cancer with clear records — are successfully placed. Full Sanitas review →
Caser follows a similar individual review process. Caser Adapta's inclusion of dental and repatriation as standard makes it worth asking about even where Sanitas might be the default choice, particularly if the condition is likely to be excluded by both — at which point the price difference matters more. Full Caser review →
Adeslas and DKV tend to apply more conservative underwriting to pre-existing conditions, with exclusions being the more common outcome. Both remain good options for applicants without declared conditions.
ASSSA is often the most flexible option for older applicants with managed conditions, particularly above age 65. Their no-age-based-premium-increase positioning means an older applicant with a managed condition may find better terms here than elsewhere. Full ASSSA review →
Tell us about your situation in the form. We handle pre-existing condition cases regularly and will advise on the most likely route before you commit to any application.
2026 indicative prices — all 6 insurers
The prices below are indicative starting prices for a standard NLV or DNV applicant aged 35, in the Resto zone (most of Spain outside Madrid and Barcelona). Actual premiums depend on your exact age, province of residence, and selected plan. All prices are monthly equivalents — some insurers quote annually.
| Insurer | From (age 35) | Dental included | Copayments | Max entry age |
|---|---|---|---|---|
| Sanitas | €67.76/mo | Separate add-on | None | 75 (Residents Visa) |
| Caser | €46.95/mo | Yes — included | None | Check at application |
| ASISA | ~€42.88/mo | Separate add-on | None | Check at application |
| Adeslas | ~€50/mo | Separate add-on | None | Check at application |
| DKV | ~€57/mo | Separate add-on | None | Check at application |
| ASSSA | Quote required | Separate add-on | None | No stated age cap |
Indicative prices. Premiums increase with age. Prices vary by province. Confirm exact premium at application. Data accurate to May 2026.
For a full carrier-by-carrier breakdown including network size, hospital infrastructure, and certificate process, see the insurer reviews hub or compare specific pairs: Sanitas vs Caser, Adeslas vs Sanitas vs DKV.
The certificate process — from enquiry to consulate
Understanding the certificate timeline matters because you cannot submit your visa application until the certificate is in your hand — and most consulates require the certificate to be dated within a few months of the appointment. Here is how the process typically works when you use this service:
- Submit your enquiry using the form above. Include your visa type, date of birth, and appointment date if you have one.
- Receive a recommendation within one business day — a specific insurer and plan with your exact premium based on your age.
- Confirm and purchase. We handle the application with the insurer on your behalf. Payment is typically annual upfront, or split 50%/50% for some plans.
- Certificate issued. Sanitas: automatically sent once payment clears — the same day in most cases. Caser: 1–2 business days. Other insurers: typically 2–5 business days.
- Submit to your consulate. The certificate is in Spanish and meets the required format. We confirm what to submit and whether anything else is needed for your specific consulate.
If your visa application is subsequently refused, most insurers offer a pro-rata refund of unused premium on production of the refusal letter. We include this in our recommendation so you know the cancellation terms before you purchase.
Common questions
The certificate must confirm the insurer is authorised by Spain's DGSFP, that the policy provides at least €30,000 in medical expense cover with no territorial exclusions within Spain, no copayments, and no waiting periods. It must include your full name, date of birth, and the policy start and end dates. The document should be in Spanish, or accompanied by a certified translation. Many consulates also require the insurer's NIF (tax ID) and a policy reference number on the certificate face. Certificates that omit any of these details — even if the underlying coverage is compliant — can be queried or rejected at the consulate.
We match on four factors: visa type, age, dental cover requirement, and certificate urgency — in that order. Visa type determines the priority considerations (autónomo DNV applicants need more comprehensive cover; retirement visa applicants over 70 have fewer options). Age determines which insurers will write a new policy at all. Dental changes the price comparison significantly — Caser Adapta includes it; Sanitas does not. Certificate urgency can override all other factors: if your appointment is tomorrow, Sanitas is the answer regardless of price. For most NLV applicants under 60, the decision comes down to Sanitas vs Caser depending on whether dental matters and what the budget is.
We aim to respond within one business day. For straightforward enquiries — standard age range, no pre-existing conditions, clear visa type — we often respond the same day. If your consulate appointment is imminent, note the date in the form and we will prioritise accordingly. For very urgent cases, email info@spanishvisahealthinsurance.com directly alongside the form submission.
No. There is no obligation at any stage. You can use the comparison information on this site independently and contact any insurer or specialist directly. If you use our enquiry form, we provide a recommendation and quotation — you decide whether to proceed. There is no fee for the advice, no pressure, and no follow-up if you choose not to go ahead. The partner links above (Sanitas and Caser) go directly to our specialist partners' own quote pages if you prefer to self-serve.
Yes. Pre-existing condition handling varies significantly by insurer and by individual medical history. Sanitas and Caser review each case individually and may accept with full cover, accept with the condition excluded, or apply a premium loading. Adeslas and DKV tend toward exclusions. ASSSA is often more flexible for older applicants with managed conditions. Tell us about your situation in the form and we will advise on the most likely route for your specific circumstances before you commit to any application.
Yes. If your consulate appointment is imminent, tell us the date in the form. Sanitas issues its certificate automatically and immediately once the policy is activated and payment is received — for urgent cases, Sanitas is the answer. Caser typically takes 1–2 business days. Contact us as early as possible if timing is tight. Note that certificates cannot be backdated, and the consulate requires the certificate to be current at the date of your appointment — not at the date of your future intended travel.
Yes. Select "2 applicants" in the form and enter both dates of birth. We will quote for both partners simultaneously. The consulate requires a separate certificate per person — there is no joint policy document — so each partner needs their own individual policy. We will make sure both certificates are in place before your appointments. If your dates of birth are significantly different, this sometimes affects which insurer is the best fit for each person — we will flag this if relevant.
The consulate does not endorse or reject specific insurers by name, but it checks that the insurer is DGSFP-registered and that the certificate meets coverage requirements. In practice, certificates from well-established Spanish insurers with dedicated visa products — Sanitas, Caser, Adeslas, DKV, ASISA, ASSSA — are accepted without issue at the vast majority of consulates. The risk of rejection arises most often with non-specialist international policies, travel insurance presented as health insurance, or certificates that omit required information such as the DGSFP authorisation reference.
The coverage minimums are the same as for the NLV — €30,000 minimum, no copayments, DGSFP-regulated. However, if you are autónomo (self-employed), Social Security does not automatically provide backup healthcare during the initial application period, making it more important that the private policy is comprehensive and active from day one. If you are employed by a foreign company, you may have access to employer health benefits which can affect what you need from the private policy. Tell us your employment status in the form and we will tailor the recommendation accordingly. Full breakdown: DNV health insurance guide →
Most Spanish health insurers offer a cancellation and refund on visa refusal, provided you cancel within the defined window and supply the official refusal letter. Sanitas and Caser both have established visa refusal refund processes. The refund is typically the unused premium pro-rated from the cancellation date — meaning the months you were covered are charged, and the remainder is returned. We include the exact cancellation and refund terms in our recommendation so you know what to expect before you purchase. A full guide to the refund process is available at visa refusal and health insurance refunds →
Data accuracy note. Prices are indicative for a 35-year-old in the Resto zone as of May 2026. Premiums increase with age and vary by province. Entry age limits and dental terms are confirmed at the point of application and are subject to change. This page is reviewed monthly. For exact current terms, always confirm directly with the insurer or via our quote form.