1st year of private insurance with preexisting conditions

Sorry to hear of your medical insurance troubles. 1,600 euros per month sounds outrageous! Is this a Spanish policy or a USA policy? USA insurance companies are notorious for sky-high premiums and ruthless exclusions, but I would expect a Spanish company to be a bit more reasonable (but I guess it depends on the pre-existing conditions).

Even if you think your conditions are well-managed, I would absolutely not recommend signing up for any policy which excludes your conditions!

The Spanish comparison sites are Rastreator and Acierto, you should be able to enter your age and info and get a list of the cheapest quotes. Then try a couple of them directly (Asisa, DKV are usually amongst the cheapest) and see what it goes up to based on your specific conditions.

Regardless of cost (and it will be more expensive as immigration specifies a zero copay) you will almost certainly need a private Spanish policy to complete the immigration formalities (I'd suggest also looking at the "no lucrativa" option as it's very popular with Americans). In the 2nd year, it can be cheaper as you can switch to a larger copay.

My understanding is that the Convenio Especial requires that you've been resident in Spain for a year. If so, this wouldn't help you get your visa. But if they let you join because your private insurance would be crazy expensive, then it would be a great option.

As you so rightly say, the best course of action is to register in the Spanish social security system, and then make your monthly contributions. After a certain number of contributions, you are then covered in the Spanish healthcare system (free or nearly free in most cases). For many Americans, this is one of the most wonderful aspects of life in Europe! :-)

I do not think it will take 5 years to be covered (or that you need to be a permanent resident), but I'm no expert on this.

You should also note you can make contributions as an employee, self-employed, or unemployed.

As a bonus, once you're covered in Spain, they will give you an EHIC (European Health Insurance Card) which gives you similar cover when travelling in other EU countries.

I am a Brit (like you, a non-EU citizen, but perhaps I get special Brexit treatment) and I registered as unemployed in Bulgaria (where I also have residence). This is 12 euros per month, and is an absolute bargain! I was covered after 3 months, and they gave me a Bulgarian-issued EHIC which is good for when we're in Spain and Cyprus. Bulgaria is another EU country, so the rules/process for this are pretty similar to Spain and any other EU country.

The continuation of your USA work remotely is a different issue entirely. If you're living in Spain, you become a Spanish tax resident, so you should declare all income, even if earned remotely. You could become an "autonomo" and do the appropriate declarations and contributions as self-employed. Or (I'm not sure on this one, others can perhaps confirm if this is OK) I'd guess it was also OK to do whatever you do in USA, as now, and file your earnings/taxes there (you continue to be a US taxpayer because of your passport)... and register as unemployed in Spain and pay this contribution. As long as you include your USA earnings in your Spanish tax return and pay the appropriate tax (there is a double taxation agreement), I would have thought Spain was happy.

Thanks, it's definitely confusing. At first it was seeming clear to me that as I'm "doing the work" in Spain that I am self-employed in Spain. But then when I started reading about declaring my business as an autonomo as if the *business* existed in Spain, it started to sound weird again. How can my law firm exist in Spain when a) the office is in the US, b) the clients are in the US, c) the money is in the US, d) I have no license to practice in Spain (this is the big one for me)?

But I guess the bottom line may be that it is a "Spanish business" that provides US services to US clients in the US. And I don't solicit or serve Spanish residents, so I'm not engaging in the unauthorized practice of law in Spain. (???)

As for the health insurance quote, I hasten to point out that the outrageous 1,600 euros monthly I mentioned is without having told them about the preexisting conditions yet!! This was just the "generic quote" from filling out the entry-page form, and they said the premium would only go up *more* once they knew my preexistings. So I'm pretty baffled by all these people paying  a tenth of that.

Also, does anyone know if DKV is based in Spain? I called every number on their website and couldn't get through to any. I used the country code 34 for Spain (the site doesn't say anywhere what country code to use or where they are).

First, health insurance... If the 1,600 is based on your age alone, then you might have misread an annual quote for a monthly quote. Or you're 120... or you picked the world's most expensive health insurance company. :-)

Often the highest age you can enter for Spanish health insurance quotes (online, you have to go into an office if you're older) is 69. Last time I looked, there are many quotes under 200 euros per month even at this age. (But this is before you give them the list of pre-existing conditions to get the true cost.)

As mentioned, I recommended you get a quote via Rastreator or Acierto as they list all the companies and their prices (and the level of cover).

Most insurance companies also have direct quotes/purchase on their website. So we have ASISA at asisa.es (good and fairly inexpensive), and DKV is at dkv.es (many recommend it, and it's also one of the cheaper ones). Personally, I would do the online thing, rather than phoning up a Spanish health insurance company. But if you want to show off your Spanish, then you can do that too (Asisa 900 10 10 21 and DKV 900 50 01 01).

Second, remote lawyering... involves two main issues, taxation and legal structure.

A key issue for Americans expats (as this doesn't apply to most non-Americans) is that they are often subject to taxation in two countries: USA by virtue of citizenship, even if living abroad... and Spain by virtue of the presence test, more than 183 days. You can (usually, there are other tests too, sadly) avoid the Spanish tax residence by staying less time. This is up to you to decide/manage. But, perhaps, if you're making a ton of money, it might be worth avoiding. Which you can do by still spending time in USA, or perhaps by getting residence in a 2nd EU country (like Bulgaria or Cyprus), and relaxing on two European beaches, rather than one. :-)

If you're still going to spend significant time in the USA, then avoiding European tax residence should be quite easy, especially if you have legal residence in two EU countries. If you want to gracefully exit the USA, then you'll need to pick a European option as your main tax base. Bulgaria is especially attractive as it has a 10% flat tax, and you can still spend up to 182 days in Spain.

Thus the main issue is that your income from your remote lawyering is part of your taxable worldwide income, and Spain would like its due share. As long as you're declaring it, and paying it, I don't think the exact way you organize yourself is terribly important.

You answered your own question as to how remote lawyering (or remote anything) can be a Spanish business (either autonomo or Spanish corporation). You live in Spain, and you provide remote services... ergo, you're working in Spain. It might seem more logical to therefore have a Spanish bank account and receive the funds there, but there's nothing stopping a Spanish autonomo (or Spanish corporation) also having an overseas bank account and receiving funds there (as long as they get included in the accounting and properly declared).

If you're an individual lawyer just doing the occasional phone consult, then being a Spanish autonomo seems like a decent solution. Or register as unemployed (as you don't, apparently, work in Spain) to pay your social security, and include the USA source income in your Spanish tax return.

If you're Mr. Big, and you have 100 lawyers slaving away in the USA, while you relax on a Spanish beach, then this is most likely already an established USA entity (corporation, LLC, partnership, etc.). In this case, there is an existing American business, and it doesn't become a Spanish business even if you, personally, relocate to Spain. Thus the US entity continues as before and makes whatever returns it usually makes.

But, if you do actual work (as opposed to just owning it) then I'd imagine you get paid for working. In which case taxes need to be paid. Or, possibly, you work unpaid, knowing that there is a monster distribution of profits coming at the end of the year. In which case, this needs to be added to your Spanish tax return.

Or, you tell your firm to incorporate a Spanish subsidiary, which has one employee (you), and pays you a nice little salary (with all tax and social security payments made monthly) for your name/advice/client-pleasing bonhomie. And you don't take anything directly from the USA entity. This is maybe a bit of a faff, but it's quite neat/logical. (For completeness, the remaining option is for you to incorporate a Spanish entity, and transfer ownership of the American entity to it, and make yourself an employee and director of this entity. But this is the biggest possible faff, so I think we can safely ignore it.)

Thirdly, Golden Visa... If you're thinking of a Golden Visa rather than the "no lucrativa", that suggests you're doing pretty well financially. In which case, I'd suggest that, before you make your relocation decision, you pay for a bit of a consult on the best visa options, and the most tax-efficient way to structure your new life (both in terms of days/tax residence status, and the legal structure of your lawyering entity going forward).

Personally, I'm not much of a Golden Visa or Golden Passport kinda guy, but I know some folks like them. My objection is that they're a very expensive way of achieving something that can usually be done (very inexpensively) by regular visas.

Surprisingly, the UK also has "golden visa" type deals via its Tier 1 applications. One of the reasons that London is so beloved by wealthy foreigners, is that it has the famous "non dom" tax status (whereby you are resident, but as your domicile is the USA, you only pay income tax on money made in UK, or remitted to the UK).

The Spanish option is 500k euros (plus big-time lawyer fees), which is a pretty decent chunk of cash. You can invest it in real estate, which is a big plus, compared to some dodgy Spanish carbon-credits scheme. However, I would remind you that Spain has several taxes which apply whether or not you decided to spend more than 183 days and become a tax resident for income tax purposes. They are property tax, wealth tax, and imputed rental income tax.

The regular visa option beloved by many Americans (and other non-EU citizens, such as us Brits after Brexit) is the "no lucrativa" visa, which is for those of "independent means" who "will not work in Spain". As your work is ostensibly in the USA, this is a great option. This requires three principal proofs: funds (minimum wage ish x 12), address (rental contract or ownership deed of any Spanish property), health insurance (as discussed above). It's pretty easy, and many folks handle it themselves... or an attorney/gestor can help you (which costs relatively little).

Wow thanks for all of this, I really appreciate it.

I don't know what to say about the 1,600 quote. I think I'm gathering that international policies (which this is) are distinct from Spanish policies for expats, with international being much more expensive (apparently) and also with some potential to cover medications which Spanish policies never do. However, I also recently heard somewhere that Spanish policies don't cover "pharmacy" drugs but that they might cover "hospital" drugs. Not sure what that means or if it's true. But the 1,600 quote did include a $25,000 max of medication coverage per year, which the <$200/month policies don't seem to. Still, with premiums that high I am almost better with the cheaper premiums and out-of-pocket payments for medicine.

I'm 52 by the way.

I did get a call back from DKV from someone with excellent English (most of the people I've spoken with only had kind of good English). It was cheap, didn't cover medicine, and said it either will cover me with an exclusion for my conditions or not cover me at all -- gotta apply to find out.

So I'm kind of resigned to the fact that I'll be paying for these very expensive meds (about $1,000/month) for at least a year. I'll bite the bullet as part of the cost of moving (since a $200 premium would be a quarter of what I pay in the US) if I can determine that I'll eventually get into the public health system as a permanent resident. 5 years of expensive drugs followed by covered for life is a good deal.

Thanks for this also, especially for helping me see how I am "working in Spain" even though all the results take place in the US. And this is a good thing, right, because it means I will be "required" (I want to anyway) to pay social security taxes in Spain -- good because that's what entitles me to the reward of full health coverage when I become a permanent resident?

To give more background and narrow down the scenarios, I'm a solo attorney. It's just me and my spouse who is an employee of the sole proprietorship. I talk to people on the phone and prepare and e-file papers for them. They're in the US, so they pay into my US bank account. It seems funny to me that I would register as an autonomo in Spain, effectively "setting up a business" in Spain when nobody from Spain will ever interact with my business and when my business is a "law firm" even though I'm not licensed to practice in Spain (nor am I practicing Spanish law or dealing with Spanish people!) But if that's how it works, that's great!

I did wonder what you meant when you wrote this:

If you're an individual lawyer just doing the occasional phone consult, then being a Spanish autonomo seems like a decent solution. Or register as unemployed (as you don't, apparently, work in Spain) to pay your social security, and include the USA source income in your Spanish tax return.

First why would I register as unemployed -- I thought it was established that doing "lawyer work" while in Spain constitutes being self-employed in Spain. Second, why do you say I don't work in Spain (same question, I guess). And third, are you saying that someone registering as unemployed can pay into social security and get health coverage that way just as someone who's employed or self-employed can (that confuses me because I thought people who don't work don't pay into the system and don't get the reward). And finally, if I register as unemployed, wouldn't that contradict the USA source income that you say to include in my Spanish tax return. Sorry! I was following everything you said until that paragraph which quite threw me for a loop.

Hi Gwynj,

Thanks for all your insights and concern to help. I hope you don't feel poorly repaid by all the follow-up questions I spat back at you. Just a few more words about your "thirdly" reply. I'm mostly settled on the golden visa but a little intrigued by your remark about how there were cheaper ways to accomplish the same thing. I'm not doing *that* well financially. The golden visa requires only a 500,000 euro home, and I'm from Southern California where there are no homes worth less than that anymore. But I still need to work, so I couldn't do the non-lucrative visa. Are there others that you had in mind?

I admit the golden visa is a little unappealing to me just because I dislike that I have to buy a house before I even know whether they'll let me in (i.e., whether I'll find suitable health coverage). And I don't understand the timing. I feel like I have to go buy a house and then go back to the US leaving the house vacant for months while I process the visa and then come back *again*. (because I can't grasp how I can buy a house and process immigration status all in the mere 90 days that the tourist visa allows me to stay).

Just the idea of two trans-Atlantic flights back to back is almost too daunting!

Thanks for the interesting replies, I'll try to clarify. It's very helpful to know more about your situation.

And, of course, it's a big decision, so it's natural to want more info. I think that's especially the case if you think that the only option is a Golden Visa for 500k. That's a lot of money to plunk down on an unknown country! In others words, all questions welcomed! :-)

What I can say is that Spain is a very nice, very safe country. Plenty of sunshine and beaches, like California. Excellent public healthcare (unlike USA) which is accessible to all. Relaxed culture, and excellent food. Much, much lower cost of living.

For a time, I lived in a beautiful area next to San Francisco (Mill Valley, Marin County near Mt. Tamalpais)... and it cost me a small fortune to hang out there! By way of contrast, we bought a large apartment near Alicante city (Elche) for less than 60k. And our property tax (IBI) is about 150 euros per year. Is it as fancy-schmancy as hanging out in Mill Valley with its $5 coffees, and being able to hike up Mt. Tam everyday? No, of course not! But we live in a lovely, historic city (UNESCO-listed for its palm groves), close to beautiful Costa Blanca beaches. Here I walk the lovely Rio Vinalopo trail every day... and have my morning coffee in Mayte's for 1 euro. It's pretty great, and I can rarely be motivated to drag my ass back to the USA!

Funnily enough, my Mill Valley buddy (who used to say things like, "it's impossible to retire unless you have at least 10 million dollars!") has a $5 million, 2,000 sq ft house, on the slopes of a 2,500 ft mountain... and his property taxes and utilities are ridiculous. My Bulgarian country house, for under $100k (and $100 annual property tax) is 3,000 sq ft on the slopes of a 5,000 ft peak in the Balkan Mountains. Sure, it's nowhere near as fancy... but it's less than 5% of the cost. And the hiking and biking is pretty much the same. Actually, Mt. Tam is super busy, and my mountain is just for me, usually. :-)

WILL YOU BE WORKING IN SPAIN?

You've described your desired situation as living in Spain, and continuing to work remotely with your US clients (and only your US clients). In my opinion (and I imagine there will be some here who disagree), this type of situation (with remote workers / digital nomads and so on) is a bit of a grey area.

Perhaps it's a little confusing, as you can say that you live in Spain... and you do the same work you did before... just over the phone/computer from your Spanish apartment. Therefore, yes, some would say you are, effectively, working in Spain.

However. I think you can choose to treat yourself as you wish (or is most convenient)... so you can say that you "won't work in Spain" (for the no lucrativa visa), or that you're "unemployed" in Spain (in order to pay social security). Or, if you preferred, you could say that you were an autonomo (self-employed) in Spain, and then register as such, and file self-employed accounts (and pay self-employed contributions).

So, in practice, it's less about the philosophical question of "where can I be said to work?" and the practical question of: "Do you have an employment contract in Spain? Or have you registered as autonomo in Spain?".

NO LUCRATIVA VISA

There are many in your type of situation that apply for the no lucrativa visa, and I think it's the best option, even allowing for your concerns stated above. Obviously, you don't volunteer that you will be a remote worker, or digital nomad, or anything of that sort. The consulate in LA says that this visa is for: "non-working individuals (with a reliable, ongoing source of income and substantial savings) who wish to reside in Spain for more than 3 months." And "working" is typically taken to mean having a job (or being self-employed) in Spain.

I think you'll find that any immigration attorney (apart from ones specializing in Golden Visas) will tell you the same. This is basically for those of "independent means" who don't need to work in Spain. You have to show some savings, but it's in the order of 600 euros (the current IPREM, a proxy for minimum wage) x 12 months = 7,200 euros. if you have this amount in savings, then you don't need to show an income. (But if you have more savings, or some unearned income from real estate rentals or stock dividends, then that supports your case.)

Here's a very helpful lawyer link on the visa:
https://balcellsgroup.com/non-lucrative-residency/

In particular, this is what they say in relation to NOT "working", as defined by Spanish immigration:

"When talking about the non-lucrative visa, the General Immigration Regime in Spain states that:
- You cannot work for a Spanish company
- You cannot work for a Spanish employer
- You cannot open your business in Spain
- You cannot open a branch office in the Spanish territory"

Hence, in my opinion, you would find it very easy to qualify for the no lucrativa visa. And I am sure you would find an immigration lawyer happy to assist you in getting it.

The advantages of applying for this would be:

- quick and easy (in a month or two, no problem)
- inexpensive (in terms of government fees, lawyer fees which are non-refundable and the proof of savings required, which remain in your account, and are usable once you get your visa)
- no need to buy a big expensive house (your proof of address can be the deed for a cheaper property, or a long-term rental contract).
- you can try it first, at minimal cost (you can rent a decent apartment for a few hundred euros per month... and if they say no, you can go get the Golden Visa for 500k)

EMPLOYMENT STATUS vs. TAX STATUS

As I discussed previously, there is an issue about whether you want to live full-time (or more than 183 days) in Spain, which makes you a Spanish tax resident. If you were to become a Spanish tax payer, the key issue is that they tax your worldwide income, so you'd need to declare your USA-source lawyering revenue. So, as long as you file a Spanish tax return which includes this US income, I don't think they'll be very concerned about how you chose to conduct the work, or that you didn't register as self-employed in Spain (or incorporate a company). Again, I encourage you to check, but I'd imagine many immigration/tax lawyers would say exactly the same (and perhaps even further, along the lines of, yes, that's what you should do... but they'll never know if the funds stay in USA).

SOCIAL SECURITY CONTRIBUTIONS

There are three typical options: you can be an employee, self-employed, or unemployed. For obvious reasons, unemployed is the cheapest (and in many cases the government pays it). I do this in Bulgaria, and the cost is 13 euros per month. It's more expensive in Spain, but the principle is the same. Unless there are some special rules excluding Americans, I still think you will be covered fairly quickly, and you won't have to wait 5 years for your permanent residence to get covered.

If you're neither officially an employee, nor officially an autonomo, then that leaves unemployed. And I see no reason why you can't register as unemployed (for social security purposes).

HEALTH INSURANCE

Yes, if you get an international health insurance, it will also cost a small fortune. I had one when I was your age, and it was several thousand per year, and I was in perfect health with no pre-existing to declare. I rapidly got rid of it!

The far better way is to get a private national policy for the country you live in (or mostly live in). If you're moving to Spain, you'd get one from DKV or ASISA (or others). I recommend you get a proper quote based on your age and your pre-existing conditions, so you know what it will cost. These are definitely far, far cheaper than a fully international policy... and probably will have better cover. My policy was less than 1,000 euros, and my partner's is less than 400.

Spanish health insurance is very good, and entitles you to high-quality healthcare throughout Spain. Typically, Spanish policies avoid the huge deductibles and sneaky exclusions that are so popular with American policies (understandably, because treatment there can cost hundreds of thousands of dollars). You will be very pleasantly surprised.

Importantly, you won't need this policy for long. You must have it for the first year, so you can can get your no lucrativa visa (you provide the policy as one of the required proofs). Even if you keep the policy, in the 2nd year and on, you can elect for a larger deductible which lowers the cost significantly. I'd guess most can get themselves covered in the public system in the first year (and public cover is FANTASTIC, it's simply something you MUST DO).

In Bulgaria, I had a private policy too before I was in the Bulgarian social security system. I kept it afterwards because the premium dropped substantially once I was covered by the public health system. (This makes sense, as the public system is paying a big chunk of the treatment, and the private policy is only paying the extra for VIP options. I'd imagine it's the same in Spain.)

If you're in the Spanish public health system, you can also get an EHIC, which is great. It entitles you to the same kind of free healthcare in any EU country.

To supplement your Spanish health insurance, you can get some kind of travel insurance policy which covers your for all emergency treatment, or repatriation to Spain. I have an annual multi-trip policy for under 200 euros, and it covers me for up to 60 days of travel. It's worldwide including USA, so if I go spend a month or so seeing my Mill Valley buddies, I know I'm covered and won't end up with any bankrupcy-inducing American hospital bills.

SUGGESTIONS

Based on what you've said, I would recommend you try for the no lucrativa visa. Even if you pay for an immigration attorney to help you, it's going to be very inexpensive compared to the Golden Visa option. I get that you're a fairly well-off Californian, and you can afford the 500k.., but if you can get something broadly equivalent for a couple of grand, doesn't that sound more appealing? :-)

I would personally prefer to be a Bulgarian resident, and spend less than 182 days in Spain. As Bulgaria is great too, and quite close... and has only 10% tax rate. But if you prefer to be all the time in Spain, and be a Spanish tax resident, that's a very convenient option too (and the default probably, unless you actively try to avoid it).

If you get the no lucrativa, that rules out being self-employed or employed. So I would keep my remote activities in the USA. Maybe as sole proprietor as now. Or maybe change it to a USA entity (LLC most likely) just to differentiate from you personally, vs your professional activities. Filing your USA accounts for your LLC shouldn't be very different from what you do now. And I think having a separate American entity supports the claim that you, personally, are not working in Spain.

Alternatively, you might incorporate a Bulgarian company (again 10% flat tax), with a US LLC as a subsidiary. Now you file in the USA with your LLC. And your Bulgarian files in Bulgaria, including the USA accounts. And now you can have European clients too (invoiced via Bulgarian entity).

As you're probably saving a lot of money by not doing the Golden Visa, I think you can afford to pay for a bit of tax / structure consulting before making your final decision.

Hello. I want to  work and relax in Tenerife. Help me Please. Thank you.                                     Edvardas Lithuania.

Greetings @edvardasmeskauskas9 and welcome to the expat.com board!

You are lucky, you are an EU citizen... so you can "work and relax" in any EU country that you want to.

You don't need me to advise how you to relax on a Tenerife beach... that's too easy. :-) As long as you can afford it!

Working is a different story. And depends on your skills, background, and Spanish level... and exactly what you want to do. You can search for jobs online... or just go spend a month in Tenerife and knock on some doors.

I'm curious: you say your prescriptions cost about $1,000/month; is that the US price or the Spanish price? You may fund that your prescriptions are *far* cheaper in Spain.

Don't worry too much about the cost of medication. It is unbelievably inexpensive here as opposed to the USA.

@goodstafford

Yes DKV is very much in Spain.

- @nkolihomes

@goodstafford Hi,It's possible to obtain a Golden Visa in Spain even with preexisting medical conditions. However, finding private insurance that covers your conditions and medication may be challenging. As you mentioned, if you can find insurance that covers you for one year, you can then enroll in the Convenio Especial for 60 euros per month, which would cover your preexisting conditions.Regarding your follow-up question, if your business is based in the US and you're only physically present in Spain, you may not be considered self-employed in Spain and therefore not be required to pay Spanish social security. However, it's recommended to consult with a lawyer who specializes in immigration and social security to clarify your situation.I would also recommend checking out the website pellicerheredia.com from Spain, which provides comprehensive information on obtaining a non-lucrative visa in Spain, including health insurance requirements and options.I hope this helps. Good luck with your move to Spain!