Health insurance - pre-existing conditions

Hi finally moved over here to Gran Canaria on 2nd March 2018, and as yet unable to obtain 𝙼𝚎𝚍𝚒𝚌𝚊𝚕 𝙸𝚗𝚜𝚞𝚛𝚊𝚗𝚌𝚎 for both me and my partner, although he is 10 years younger than me at 54 he has under control type 2 diabetes and a stent fitted 4 years ago ( as a precaution,not through any heart attacks/murmurs etc etc ) and is very fit ,! Sensible diet, non smoking (ever) non drinker , gym 5times a week , BMI perfect ,! We applied to AXA and they refused at any cost to insure him and said he had Angina , absolute rubbish ,,,! But would happily insure me ,which obviously I have declined , the big joke about this is that we have been insured with AXA in the UK with no problems whatsoever,do feel after being here only 3weeks we are on a different planet , it is souring our move somewhat !! But we are battling on with other companies and will update as we go along .Any suggestions would be appreciated,

It looks like this thread has been on for a while but I just moved to Spain on a one year VISA and maybe this will be helpful to someone.

The police guy is correct, one needs actual insurance and not just travel insurance. At least that was the specific recommendation from the consulate in the US. I didn't try a travel plan but maybe it snuck past them. I wouldn't try it.

As for insurance, I quickly learned that as soon as you mention an illness, you are rejected immediately. I finally called Aetna International and they allow an option of a plan that does not cover pre-existing coverage. They never ask so their is no fraud or lying as one of you mentioned previously. Your specific illness just will not be covered if you need meds or hospitalized. The plan was roughly $300 a month. If I went forward with a pre-existing condition plan, it would have been much much more.  Fortunately, I have 9 months supply of stock piled meds so my pre-existing issue is not an issue for now.......and I will never be hospitalized for this condition so do not expect any costs.  Its somewhat criminal as you cannot deny insurance coverage in the US based on pre-existing conditions but you can globally.

There seems to be some confusion here

In order to be allowed resident status in spain one must have full medical cover. That can be as worker but if not then the cover must include all circumstances including existing conditions.  If it does not then one cannot obtain residence status.

One might of course take out a policy without declaring pre existing conditions and accepting they will never attempt to make a claim for such.  However i believe that would amount to deceit and if discovered any residence status so obtained would be withdrawn

What the situation regarding medical cover is in any other country is  irrelevant.   We are in Spain and thus subject to the laws of Spain

This is direct from the Spanish Consulate's website;

More than 90 days: Those who will be staying in Spain for more than 90 days (Student Visas, Resident Visas, Work Visas) need Health Insurance. Travel Insurance will not be accepted. The Health Insurance that is required comes from a Spanish company that is authorized to operate in Spain (click here to see examples of acceptable providers). It should be a plan that allows you to go to the doctor for check-ups, minor illnesses and emergencies. It can seem difficult to find and purchase a policy (a lot of the information will be in Spanish), but it is necessary in order to process your visa. Some schools and employers already provide insurance. They should send you proof of insurance from the provider that it satisfies our requirements.

It does not say it has to cover each and every condition known to man.

Ed    I have been present when EU nationals have been refused residence status because they did not have FULL medical cover and theta even excludes policies which have any excess / co-payment.

I am not sure about the Company having to be a Spanish one.    UK retirees  usually have cover paid for by the UK State (DWP)

.

Thanks John- you seem passionate about this. The website nor the consulate in the US said what you are saying. It might be true depending on the person working that day but it is not clear anywhere online (at least for student VISA, maybe its different with resident VISA?). Since you seem to be connected, maybe this is upward feedback you can give to your superiors to clarify and update their staff and/or Embassy's?

As for the previous comment- I was talking about Global plans and not a Spanish plan only. The comment on discrimination based on pre-existing conditions was just that- a political statement. Do not feel defensive about Spain here, its a wonderful country and this had nothing to do with Spain.

Ed it is not that I am passionate but that I have 20 years experience working with the police assisting people making applications

Many Americans have been approved (most likely incorrectly) for the non-lucrative visa with only travel insurance, as opposed to full-blown medical insurance.

This often creates a situation where you can slide through the cracks for the first year, but when you go to renew your residencia after that first year, the extranjeria office will deny your renewal because they will properly apply the rule that excludes travel insurance.

(It should be noted that there *are* a few policies sold as "travel" insurance that actually meet the standards of coverage, and thus might be able to be approved.)

(I know for my family, we applied through the consulate in San Francisco and only used my standard US federal employee/retiree insurance. My coverage was with Blue Cross and they issued me a letter for the purposes of a visa application that was deemed good enough by the consulate.)

Anyway, here is a way to get around the issue. Once in Spain and resident for that first year, after one year you can go onto the Spanish national plan through the convenio especial.  It is in most of the autonomous communities at this point and typically costs around 60 euros a month for people under age 65, and 155-160 euros a month for those over age 65.

The great thing about the convenio especial is that it covers ALL pre-existing conditions.

Wait times to see a doctor at the local clinic, or specialists, can be longer than with private doctors, but it's tolerable, especially considering the bargain price and covering all conditions.

So after 365 days resident in Spain (which you need to be able to document, typically through your empadronamiento) you can get onto the national plan.

After one year you also need to renew your residencia for the first time, but they have a 60-day grace period after the expiration to do so.

You hit 365 days. Apply for the convenio especial. It takes a week or two to get your letter and SIP card. Then, with that, you can apply for your residencia renewal, and since you have the national plan you'll be approved.

Boom, problem solved. This assumes, of course, that you get lucky with the consulate approving you with only travel insurance, as opposed to full coverage- and word is that the consulates are doing a better job of catching that these days.

This was very helpful, Papa Lima!  Thank you.

Can any one help please?
I am in Malaga, Uk citizen, under retirement age,  so cannot get an S1, not working so cannot get convenio especial.  I have been offered medical insurance by DKV excluding a pre existing condition . Does this mean that I cannot get residencia in Spain?

It would seem ok but if you ask for a copy of the policy and take that to the extranjeria ( dept of national police who deal with applications) and ask if sufficient

Thank you John !

oscar599 wrote:

Can any one help please?
I am in Malaga, Uk citizen, under retirement age,  so cannot get an S1, not working so cannot get convenio especial.  I have been offered medical insurance by DKV excluding a pre existing condition . Does this mean that I cannot get residencia in Spain?

My wife is on the convenio especial and she does not work. I am pretty sure that so long as you pay the premiums, they don't care whether you're working or not. Information on the Andalucian web site: https://www.juntadeandalucia.es/servici … pdmdl=3039

With convenio especial you need to have been living in Spain for one year, but many provinces will accept an empadron certificate as the proof- so if you were on the padron for more than a year (even if you didn't have formal residencia) that's often enough.

Do any of you with the convenio especial know how your coverage has been effected by the July 27, 2018 Royal Decree on Universal Healthcare for all?
Real Decreto-ley 7/2018, de 27 de julio, sobre el acceso universal al Sistema Nacional de Salud

https://www.citizensadvice.org.es/for-u … -especial/

Iffy49 wrote:

Here in NY , the consulate wants to see proof of insurance Before it will issue a visa

It is not wise to deal with consulates. Coming here on a tourist visa and having it changes locally is far easier. many here do this and not just from inside teh EU but also from outside. Many even overstay their visas and after some time they request a residnecy permit which rarely gets denied.
U.S. citizens may enter Spain for up to 90 days for tourist or business purposes without a visa.

You can locally get your NIE number from day one (just say it is for investment purposes or opening a bank account). It is done at the Policia Nacional. bets to go to smaller local office of the PN where they are friendlier usually then in cities and more flexible. Remember, this is not the anti-immigrant police state you are leaving behind.

The insurance policy we showed for me was not exactly up to snuff. I was still on the hook for copay but they accepted it as I doubt many there can even read English let alone fully understand it. I was not even aware there were strict requirements. Now that they change dteh law so more foreigners can get health insurance it is unlikely you cannot. Unless you have a serious pre-existing medical condition. Meanwhile I got a better insurance and soon a local state insurance.

As to the main question, the major Spanish insuers will not insure you with serious pre-exuisting conditions but some smaller ones may if you enroll up till age 60 like here in Galicia MUTUALIDAD E PREVISIÓN SOCIAL UNIÓN PROTECTORA C/HORREO,19-1º IZQ-ESC-B, 15702 SANTIAGO (A CORUÑA)  (unionprotectora diot com). Their "cuadro medico" is limited but it will be enough to get you going. Nothing is a precise science  here in Spain. Everything is fluid. It is something most Americans are probably not used to.

There are also an increasing number of very expensive health plans available from US insurers for expats. If you still have some insurance running through a past employer, you may also still qualify for special plans for abroad through them. It is a growing market. More and more they include pre-existing conditions under certain terms. Same with some British insurers who operate internationally. Avoid Cygna though. They promise but do not deliver.

Also bear in mind you have the option of, if you are retiring to have Medicare Part A+B at least so you can always return to the USA for the serious stuff. Then you can take an international insurance that simply excludes your pre-existing condition.

Still, I would love to eventually hear of course when Spanish insurers also change their policies and start covering pre-existing conditions. The market will force them to act eventually. Until then I am keeping my part A+B.

Paperdetective     I have tried to understand your last post but I had problems.   Several of the things you mention are incorrect, however, I do not have the time to clarify all the errors and misinformation.

Briefly:   

To obtain residencia as a non EU National you must have sufficient income, and 100% medical cover, with no co -payment and no exclusions.   

Also the policy, if not written in Spanish,  must be translated into Spanish by an officially sworn translator.  The police are not required to speak english thus suggesting they are ‘inferior' because of that is at the least impolite.

(http://www.exteriores.gob.es/portal/en/ … dosas.aspx)

That you may  not have been required to conform to the rules,  is no justification for suggesting others might try to do the same

Please note:  once the application had been submitted that  a visa (or 90 days if no visa required) expires has no significance and one is not then illegally in spain.  Normally the process takes longer than 90 days,  thus the System is designed to accommodate that.

Johncar wrote:

Paperdetective     I have tried to understand your last post but I had problems.   Several of the things you mention are incorrect, however, I do not have the time to clarify all the errors and misinformation.....

To obtain residencia as a non EU National you must have sufficient income, and 100% medical cover, with no co -payment and no exclusions.   

Also the policy, if not written in Spanish,  must be translated into Spanish by an officially sworn translator.  The police are not required to speak english thus suggesting they are ‘inferior' because of that is at the least impolite.
......

Perhaps we do not speak the same language. I speak English. ;-)

Or perhaps you are criticizing my spelling errors, which are due to my 75% blindness. No idea.

The context here is not the one you started off with in your criticism. It was instead about whether to go to a consulate in the US (and have extra barriers put up or work locally on this initial residency application in Spain where there is often less rigidity. Obviously one still needs to show proof of one's income and get an insurance. It just does not need to be the hassle depicted.

Actually, having one's papers translated by a professional locally official sworn translator (I am a non-sworn one) is a must and much easier when doing it here in Spain. Less costly as well.

Getting an insurance locally is also easier. Insurers require for example direct debits on Spanish bank accounts. Easier to organize here then when being far away.

I also mentioned a way to get around the "pre-existing conditions" issue (till age 60) so then there is no exclusion. As to getting an international health insurance in the US or UK, they can sometimes be had even for cancer patients (I am a cancer patient). You just have to shop around. and depending on the condition the insurer may institute a wait time before you are fully covered even if there will always be a cap. It is frankly a moot point though. If you can show you have Medicare A+B coverage for such extreme cases, and for the rest international coverage, there is no real exclusion. You won't become a burden of the Spanish state then. I showed my translated Tricare (as US military dependent) policy and that was sufficient, even though it only covers me fully in the USA and 75% in Europe..

Also, the application costs are minimal here, 10 Euro for a NIE and  about10 euro for a residency visa application. Unless you use an intermediary here but even then it is a low cost process.

It is also much more comfortable to deal with the responsible people here, especially in smaller offices of the Policia National. They are often kinder, faster and look at you far more like a local asset worthy to be of service to. Americans are certainly very valued here in Galicia due to the strong immigration-related ties they developed through the  many Galicians who went to work in America.

As to your request to be "polite" towards Spaniards and pretend that most Spanish do not speak English, it is a fact and most Spanish know it and wish it were different. They do not feel comfortable with their lack of such an important skills. This is why English language teaching jobs abound here. Pity they cannot afford to pay much for that work, but a great opportunity for foreigners who want to earn something on the side.

Get used to the far more direct Spanish, even if the older generation still has some pretense politeness. It is not the nowadays dominant disingenuous politeness we have in America, or worse the UK.

As to your attempt to make it look like one would do something illegal with working within the local flexible Spanish immigration process, that is a picture rom an anti-immigrant anti-refugee world. Most Spanish here value immigrants including refugees, and especially Americans. One is treated here far more like an individual than one would expect, certainly in Galicia as is my experience.  Humans are seen here more like assets to cherish than in America even in the bureaucracy here. This is also why the country is quite generous towards letting immigrants including refugees in and has quite low barriers for them. Just look for example how littel cincome is required to be here and that amount ha snot chaanged

Remember, Spain, and especially Galicia, is NOT America! Thank god.

This is all I have to say to this. Thanks for providing me with the opportunity to add some extra information about this and please lighten up. People who escape hell should not be given the impression they may continue in hell. ;-) It is such a breeze of fresh air here.


ps
Re your: "
To obtain residencia as a non EU National you must have sufficient income, and 100% medical cover, with no co -payment and no exclusions..."

You are wrong that it is only a rule for non-EU nationals. It is the same for EU-nationals.
As to the coverage, in reality the people reading the application do not really read the  terms of one's insurance when one enrolls locally with a Spanish insurer, but then most insurance here in Spain has little to no copay here. Too insignificant to bother. By the way, all over Europe there is always some degree of copay with insurers. What is great is that there are even nowadays major insurers here in Spain offering special plans for expats from abroad and several have Engl

Paperdetective

Please note :   I have worked with the Policia Nacional for over 20 years.  Amongst my duties is assisting people applying for their legal paperwork

It was in that capacity, and with that experience and knowledge,  I  made my post to assist those who need to know the reality.

We are about to move to Valencia, Spain and are trying to figure out which health insurance plan is best for us as a small family (two adults + baby). Does anyone have any recommendations? We would like to be able to choose the doctors as only a few doctors will be be fluent in English. Thank you!

Hi

It has been several years since your last post and I assume you lived in Spain. I would like to learn from your experience about pre-existing conditions coverage in Spain if you don't mind.

1) Do they cover people with ulcerative colitis? how much would they charge if they raise premiums?

2) I have not seen anyone talking about prescription coverage. Do they cover expensive drugs or humira injections for ulcerative colitis / IBD / Inflamatory Bowel Syndrome? 

3) How about type 2 diabetes? blood pressure?

Please share information pertaining to US citizens trying to live in Spain with non lucrative via. Thanks

adam

We have lived in Spain for 8 years and in that time the rules for the private health insurance has continually changed.  It used to be travel insurance was accepted, then private insurance with copay and so on.  Now they are pretty strict with no copay, no deductible, no waiting periods.  Some companies can work with a pre existing condition or write a policy excluding it. Every company is different, depending on the condition too.  It is really worth it for you to get several quotes and see.  There are many Spain private health insurance companies listed here and one is a broker which can provide you with information from several different companies: ***

Hi, how was DKV insurance in the end? I am looking for an option that accepts pre existing conditions.