Health Insurance With No Copay for Spanish Visa — What It Means and Which Plans Qualify

What is a copayment (ticket moderador)?

A copayment — known in Spanish as a ticket moderador or copago — is a small fee charged to the patient at the point of receiving care. Typical amounts are €3 to €15 per GP visit, €5 to €20 per specialist appointment, or a small per-item charge on prescriptions.

Copayments are common in domestic Spanish health insurance plans. Spanish insurers use them to discourage unnecessary consultations and keep premiums lower. They are not unusual in the context of everyday private health cover in Spain — but they are completely incompatible with the NLV visa insurance requirement.

The other two cost-sharing mechanisms you must also avoid:

• Franquicia (deductible/excess) — you pay the first €X of any claim before insurance contributes.
• Coseguro (co-insurance) — you pay a percentage of every claim (e.g. 20% of each bill).

All three — copago, franquicia, and coseguro — are banned for NLV-qualifying insurance. The policy must cover 100% of eligible costs from the first euro, with no cost-sharing by the insured.

Why copayments disqualify a policy for the Spanish visa

Spanish immigration regulations require that visa applicants demonstrate comprehensive private health coverage that imposes no financial cost on the applicant when they receive care. The policy must protect the applicant from all medical costs in Spain.

This requirement exists because Spain does not want visa holders to become a burden on the public health system due to insufficient private coverage. A policy with copayments could deter someone from seeking care they need — or leave them with medical debts. The state requires genuinely comprehensive coverage.

The consulate checks that the certificate explicitly states coverage has no deductible, no copayment, and no co-insurance. The Spanish phrase that should appear on your certificate is:

"sin franquicia, sin copago y sin coseguro"

The domestic plan trap — how applicants buy the wrong product

The most common mistake is purchasing a domestic Spanish health insurance plan after finding it through a general comparison website. These plans are designed for Spanish residents and typically include copayments to keep premiums low — they are marketed similarly to visa-grade plans but do not qualify.

Examples of plan types that commonly include copayments:

• Adeslas Plus or Adeslas Módulos — lower tiers include copayments. Only the specific NLV-grade Adeslas product qualifies.
• DKV Módulos — a modular plan allowing customers to add copayments to reduce premiums. Not visa-grade.
• Any plan advertised at "from €25–€40/month" — almost universally copayment-based. The floor for compliant no-copay coverage is approximately €55/month for a healthy adult in their 40s.

How to identify a no-copay plan before you buy

Before purchasing any health insurance for a Spanish visa, ask the following questions explicitly — by email, so you have a written record:

1. Does this policy have any copayments (ticket moderador) for GP visits, specialist appointments, or tests?
2. Does this policy have any deductible or excess (franquicia)?
3. Does this policy have any co-insurance (coseguro)?
4. Will the certificate explicitly state "sin copago, sin franquicia, sin coseguro"?
5. Is this policy specifically suitable for the Spanish Non-Lucrative Visa (visado de residencia no lucrativa)?

Any hesitation on items 1–3, or a "yes" answer, means the policy does not qualify. Any reputable insurer or broker will confirm all five points clearly in writing.

Which plans qualify — the visa-grade products

All six major private health insurers in Spain offer at least one NLV-qualifying product. The key is ensuring you buy the right tier within each insurer's range:

Prices indicative for a healthy adult aged ~40. Always confirm in writing with the insurer or broker that the specific product has no copayments, no deductible, and no co-insurance before purchasing.

Does Sanitas have copayments?

No — the Sanitas Residents plan and Sanitas Platinum plan both have zero copayments, zero deductibles, and zero co-insurance. These are the products designed specifically for Spanish visa applicants and long-term expats. Sanitas also sells domestic products in the Spanish market that include copayments — you need the Residents or Platinum plan specifically.

Sanitas Residents from €67.76/month. Sanitas Platinum from €107.23/month. Both generate an instant certificate upon activation that includes the required sin copago, sin franquicia, sin coseguro language for consulate submission. The BUPA backing provides additional credibility at demanding consulates.

For the cheapest no-copay option: Caser (via 247expatinsurance.com) from approximately €55/month for under-70s; ASSSA from approximately €55/month across all eligible ages including 70+.

Certificate wording the consulate is looking for

The visa certificate issued by your insurer must confirm the no-copay status explicitly. The certificate is always issued in Spanish. Consulate officers check the wording.

The certificate should state all three of the following (exactly or in equivalent terms):

"La póliza no tiene franquicia, ni copago, ni coseguro."
(The policy has no deductible, no copayment, and no co-insurance.)

If your certificate does not include explicit wording confirming all three, contact your insurer and request a corrected version before submitting your visa application. All six major insurers will issue corrected certificates on request.

Common mistakes to avoid

• Buying the with-copayment version by accident — the most common mistake. With-copay plans look almost identical in many comparison tools. Always confirm the plan includes "sin copago" or "visado" in its description.
• Not checking the certificate wording — even if you bought the right plan, verify that the certificate explicitly states no deductible, no copayment, and no co-insurance before your appointment.
• Assuming an existing domestic plan is copay-free — if you are already living in Spain with a domestic health plan, check its terms carefully. Most popular domestic plans include copayments. You may need to upgrade or switch.
• Using a plan without repatriation — repatriation must be included. Most no-copay visa plans include it as standard; confirm before purchasing.

Frequently asked questions