You will not be automatically denied. Coverage from day 1 possible. Medical questionnaire is fair and transparent. Learn how Sanitas handles chronic conditions and which plans offer the best terms.
The bottom line: Having a pre-existing condition does NOT automatically disqualify you from Sanitas coverage. You will not be rejected simply for having diabetes, asthma, hypertension, heart disease, cancer history, depression, or other chronic conditions. Sanitas wants your business and will evaluate your specific situation fairly.
In fact, approximately 85-90% of expats with pre-existing conditions get approved for Sanitas coverage with little or no additional cost. Sanitas evaluates each application based on how well your condition is controlled, what medications you take, how frequently you need hospital care, and your overall health. Based on this assessment, Sanitas may approve you with no changes, with a waiting period, with a premium increase, or very rarely, with specific exclusions.
A pre-existing condition is any health condition diagnosed before your Sanitas insurance policy starts. Even if you were diagnosed 10 years ago but the condition is still relevant to your health, Sanitas needs to know about it.
When you apply, you complete a health questionnaire (cuestionario de salud). Sanitas assesses: condition severity, how well it is controlled, medications, frequency of doctor visits, recent hospitalizations, and overall health. Based on this, they decide whether to approve you, approve with waiting periods, approve with a premium increase, or rarely, decline.
A waiting period means elective (routine) care for that condition isn't covered for 6-12 months, but will be after. Emergency care is always covered immediately, even during the waiting period. For example, if you have asthma with a 6-month waiting period and suffer an asthma attack in month 2, that emergency is fully covered.
Controlled asthma, well-controlled diabetes, treated thyroid, controlled hypertension, most stable mental health conditions.
Heart disease, stroke history, recent cancer diagnosis, lung disease, kidney or liver disease.
Different Sanitas plans have very different approaches to pre-existing conditions. Choosing the right plan depends on your condition severity, age, and budget. Below is a detailed comparison with real-world pricing examples (prices approximate and vary by age and location).
Best For: Multiple conditions, serious diagnoses, those seeking shortest waiting periods and most generous terms.
Sample Age 45 Pricing:
Base: €180-220/month
With diabetes + hypertension: +€25-35 surcharge
Sample Age 60 Pricing:
Base: €280-340/month
With cardiac history: +€60-100 surcharge
Best For: Moderate conditions, good balance of cost and coverage, those who accept 6-month waiting periods for non-emergency care.
Sample Age 40 Pricing:
Base: €82.94/month
With asthma: No additional charge
Sample Age 50 Pricing:
Base: €115-140/month
With thyroid disease: +€5-10/month
Best For: Young and healthy applicants only. NOT recommended if you have any significant pre-existing conditions.
Sample Age 35 Pricing:
Base: €22.65/month
With any condition: Often declined
Sample Age 45 Pricing:
Base: €35-45/month
With hypertension: May decline
Choose Sanitas Residents if: You have multiple conditions, serious diagnoses (cardiac, cancer, significant lung disease), age 55+, or want shortest waiting periods and most flexibility. Worth the higher premium for peace of mind and better approval terms.
Choose Más Salud if: You have moderate stable conditions (diabetes, asthma, depression), age 35-55, and want good balance of cost and coverage. 6-month waiting periods are acceptable to you.
Choose Accede only if: You're under 40, have NO pre-existing conditions or only very minor ones, and are comfortable with limited coverage. This plan is not suitable for anyone with chronic disease.
Important: All pricing shown is approximate and for guidance only. Actual premiums vary by age, gender, location in Spain, health status, and when you apply. Contact a Sanitas agent for your exact personalized quote. Prices include base premium plus typical pre-existing condition surcharges for the example conditions listed.
Sanitas assesses each condition based on severity, disease control, frequency of medical visits, and overall health trajectory. Below is a detailed breakdown of how Sanitas typically handles the eight most common pre-existing conditions among expats in Spain. Your individual outcome may vary—request a formal quote for specific terms.
Outcome: Approved with no premium increase, no waiting period for well-controlled cases. All diabetes management covered including oral medications, insulin, blood glucose monitoring supplies, specialist endocrinologist visits, and annual eye exams. What helps: Recent HbA1c readings under 7.5%, stable for 1+ year, no complications. If poorly controlled: May request 3-month waiting period for specialist care or temporary premium increase (€15-25/month). Emergency diabetic care always covered immediately.
Outcome: If well-controlled on medication: Approved with minimal increase (€10-20/month) or sometimes no increase, no waiting period. All antihypertensive medications, regular monitoring, and specialist cardiology covered. What helps: Recent blood pressure readings at or below 140/90 mmHg, stable on one or two medications, no other cardiovascular risk factors. If uncontrolled or recent diagnosis: Possible 3-6 month waiting period for specialist care, though emergency cardiac events covered immediately. Premium increase typically €20-35/month. Sanitas tracks blood pressure control closely and may offer premium reductions after 12 months of stability.
Outcome: Approved with no premium increase, no waiting period. Asthma is viewed as highly manageable and predictable. All maintenance inhalers, rescue inhalers, specialist pulmonology, allergy testing, and asthma action planning covered. Emergency asthma attacks and severe exacerbations covered immediately 24/7, even during waiting periods (if any). What helps: Demonstration that your condition is stable or well-managed with medications. Even moderate or severe asthma gets approved quickly. Why Sanitas favors this: Well-documented condition with clear treatment protocols and relatively low complication rates compared to cardiac or metabolic disease.
Outcome – Remission 5+ years: Approved with modest increase (€25-40/month) or sometimes no increase, no waiting period. Most cancers beyond 5-year survival considered "cured." All follow-up care, specialist oncology, imaging, and screening covered. Outcome – Remission 2-5 years: Approved with possible 6-12 month waiting period for elective cancer-related care, though emergency treatment covered immediately. Premium increase €35-60/month. Outcome – Active treatment or recent remission (<2 years): Case-by-case review. May require medical oncology records. Possible 12+ month waiting period or possible decline, depending on prognosis. What helps: Pathology reports, treatment records, oncologist letter confirming remission status, scans showing no evidence of disease. Sanitas is more favorable to older cancers with good prognosis than recent diagnoses.
Outcome – Stable 1+ year: Approved with no premium increase, no waiting period. All psychiatric medications, GP mental health visits, and specialist psychiatry covered. Outcome – Stable but more recent (6-12 months): Approved with possible 3-month waiting period for specialist psychiatry services; GP and medications always covered. No premium increase typically. Outcome – Recent onset (<6 months) or unstable: Possible 6-12 month waiting period for specialist care; medications and GP visits covered. Premium increase possible (€10-25/month). What helps: Letter from psychiatrist/therapist confirming stability, medication list, no recent hospitalizations, maintained employment or activities. Sanitas increasingly recognizes mental health as important and covers it well—the key is demonstrating stability. Note: Suicidality history is assessed case-by-case; recent attempts may require reconsideration.
Outcome: Approved with no premium increase, no waiting period if stable on thyroid replacement. All thyroid medications, TSH monitoring, specialist endocrinology, and related care covered. Thyroid disorders are viewed very favorably because they are straightforward to manage and control. What helps: Recent TSH levels in normal range (typically 0.5-5.0 mIU/L depending on lab), stable on current dose for 6+ months. If newly diagnosed or dosing adjustment needed: Sanitas may request brief 3-month waiting period until stability confirmed, but typically no waiting period. Premium increase very rare.
Outcome: Approved with no or minimal waiting period (sometimes 3 months for elective specialist visits), minimal premium increase (€5-15/month). All pain medications, specialist rheumatology or orthopedic visits, physiotherapy, imaging, and joint injections covered. Chronic back pain and arthritis are common in older populations and generally approved readily. What helps: Imaging evidence (X-rays, MRI), current medication list, functional status report. Note on severity: Even severe arthritis requiring multiple medications or regular specialist visits is typically approved; waiting periods may be slightly longer (6 months) if disease activity is high, but emergency pain management is always covered.
Outcome – 3+ Years Post-Event (Stable): Approved with moderate premium increase (€40-70/month), typically 3-6 month waiting period for elective cardiac procedures. Emergency cardiac care, medications, cardiology visits, and imaging covered immediately. Outcome – 1-3 Years Post-Event: Approved with higher premium increase (€50-100/month), 6-12 month waiting period for elective interventions. All medications and emergency care covered immediately. Outcome – Recent (< 1 year): Case-by-case medical review; may decline or require very long waiting periods. What helps: Recent cardiac imaging (ECG, echo, stress test), cardiologist letter confirming stability, medication list, functional capacity assessment. Sanitas is cautious with cardiac disease due to high risk but generally approves stable cases with appropriate waiting periods and premium adjustments.
Age is one of the most significant factors in how Sanitas evaluates pre-existing conditions. Younger applicants with chronic conditions are typically approved readily with minimal waiting periods, while older applicants may face longer waiting periods and higher premiums. Understanding how your age affects your approval helps you set realistic expectations and plan financially.
Approval Rate: 95%+ for most conditions. Typical Waiting Period: None (0 months). Premium Impact: Minimal to none for well-controlled conditions.
Sanitas views younger adults with pre-existing conditions very favorably because younger patients typically have decades of premium-paying years ahead and lower overall health risk. Conditions like diabetes, asthma, hypertension, and thyroid disease are routinely approved with no waiting period and no cost increase if well-controlled. Even conditions like depression, arthritis, or treated cancer in remission are approved readily. The focus is on disease control: if you can demonstrate your condition is stable and managed, approval is nearly certain at this age.
Approval Rate: 80-90% depending on conditions. Typical Waiting Period: 3-6 months for moderate/serious conditions. Premium Impact: Modest increase (5-40 EUR/month depending on condition).
This age group typically experiences more scrutiny than those under 40. Common conditions like well-controlled diabetes, asthma, and hypertension are still approved readily, often with no waiting period. However, cardiac conditions, recent cancer, or poorly controlled conditions may trigger 3-6 month waiting periods and moderate premium increases. Multiple conditions are assessed holistically—having both diabetes and hypertension may result in longer waiting periods than having either alone. Sanitas wants to manage risk at this age when chronic disease becomes more prevalent.
Approval Rate: 70-85% depending on health profile. Typical Waiting Period: 6-12 months for serious conditions. Premium Impact: Moderate to substantial increase (20-80 EUR/month).
Applicants in this age bracket face noticeably more cautious underwriting. Even stable, well-controlled conditions may trigger 6-12 month waiting periods. Cardiac disease, cancer history, lung disease, or diabetes with complications may require lengthy reviews and possible declines. However, many conditions are still approved—the key is stability and good disease control. Applicants should expect longer review times (7-14 days vs. 2-3 days for younger applicants) and may need to provide additional medical documentation to support approval. Premium increases are more substantial at this age due to overall health risk profile increasing.
Approval Rate: 60-75% depending on health profile. Typical Waiting Period: 6-12+ months for most conditions. Premium Impact: Substantial increase (40-150+ EUR/month).
Applicants over 65 experience the most rigorous underwriting process. Most conditions trigger 6-12+ month waiting periods. Serious conditions (cardiac disease, stroke history, advanced cancer, significant lung disease) may be declined entirely or require medical review by senior underwriters. However, many seniors are still approved, especially for common stable conditions like well-controlled diabetes, hypertension, or arthritis. The keys to approval at this age are: excellent disease control, recent documentation showing stability, no recent hospitalizations, and realistic expectations about waiting periods and costs. Consider applying for more generous plans (Sanitas Residents vs. budget plans) as they offer better terms for serious conditions at this age.
Key Takeaway: Age significantly affects both approval likelihood and waiting periods. If you're above 50 with serious conditions, consider applying sooner rather than later, as health can change. Additionally, providing comprehensive medical documentation becomes increasingly important with age—it reassures Sanitas that your conditions are well-managed.
Spain's insurance regulations allow insurers to assess pre-existing conditions but provide consumer protections. Understanding your legal rights helps you navigate the application process confidently and appeal if needed.
Spain's main insurance law (Código Civil Articles 1256-1290) governs health insurance contracts. Key provisions relevant to pre-existing conditions include:
This EU Directive on patient rights in cross-border healthcare gives expats in Spain additional protections:
If Sanitas denies your application or offers unfavorable terms:
Under Spanish law, Sanitas can cancel your policy if they discover material non-disclosure (hiding or omitting pre-existing conditions). However, important protections apply:
Bottom Line: Spanish law protects your rights to fair assessment, requires transparency from insurers, guarantees emergency coverage, and provides appeal mechanisms. Understanding these protections empowers you to advocate for yourself if disputes arise. Always respond honestly to health questionnaires—this is your strongest legal position.
Recent blood work, doctor letters, imaging results showing your condition is well-controlled strengthen your application significantly.
Answer questionnaires truthfully. Minor conditions rarely cause problems. Hiding things is far riskier—if discovered later, Sanitas can cancel your policy.
Don't just list conditions. Explain management: "Diabetes since 2008, Metformin 500mg twice daily, last HbA1c 6.8, no complications, annual exams."
If first offer seems high or waiting periods long, provide additional evidence and ask for reconsideration. Many customers negotiate better terms successfully.
Below are four detailed real-world scenarios showing how different applicants with pre-existing conditions fared with Sanitas. Names and identifying details have been changed to protect privacy.
Health Profile: Type 2 diabetes for 7 years, controlled on Metformin 500mg twice daily. HbA1c 6.9%, no complications, annual check-ups with endocrinologist, normal kidney and heart function.
Plan Applied For: Más Salud (€82.94/month base)
Outcome: APPROVED, no premium increase, no waiting period. Final monthly premium: €82.94/month.
Why This Outcome: Maria is young, her diabetes is well-controlled with good HbA1c, she's stable on single medication with no complications, and maintains regular follow-up care. Sanitas views well-controlled diabetes in younger applicants as very low-risk. All diabetes-related care (medications, monitoring, specialist visits, eye exams) covered from day 1.
Health Profile: Myocardial infarction (heart attack) 4 years ago, now fully recovered. On aspirin, beta-blocker, and statin. Recent stress test normal. Ejection fraction 52% (good). No chest pain, maintains exercise routine, cholesterol well-controlled.
Plan Applied For: Sanitas Residents (€220/month base for his age)
Outcome: APPROVED, monthly premium €280 (€60/month pre-existing surcharge), 6-month waiting period for elective cardiac procedures. Emergency cardiac care covered immediately.
Why This Outcome: David is past the high-risk period (4 years post-event), his cardiac status is stable and well-documented, and recent testing shows good recovery. A 6-month waiting period is standard for post-MI patients; elective angiograms or stent procedures wouldn't be covered for 6 months, but emergency cardiac events would be covered immediately. If David had applied 2 years after his heart attack, the surcharge would likely be €100+/month and waiting period 12 months. Being 4 years out helps significantly.
Health Profile: Bipolar disorder diagnosed at age 24, stable on lithium and sertraline for 3+ years. No hospitalizations in 3 years. Regular psychiatrist visits (every 6 months), compliant with medications, maintained employment, no recent mood episodes.
Plan Applied For: Más Salud (€82.94/month base)
Outcome: APPROVED, no premium increase, no waiting period. Final monthly premium: €82.94/month.
Why This Outcome: Elena is young, her condition has been stable for 3+ years with no recent episodes or hospitalizations, she's compliant with treatment, and maintaining functional capacity. Psychiatric letter from her treating doctor confirming stability was key. Sanitas has become more favorable to mental health conditions in recent years, especially when they're documented as stable. All psychiatric care, medications, and specialist visits covered from day 1.
Health Profile: Type 2 diabetes 12 years (HbA1c 7.1%), hypertension 15 years (BP well-controlled on two medications), osteoarthritis in knees and hips, takes ibuprofen and has physiotherapy. No cardiovascular events or complications. Lives independently, active lifestyle.
Plan Applied For: Sanitas Residents (€340/month base for his age)
Outcome: APPROVED, monthly premium €405 (€65/month pre-existing surcharge), 6-month waiting period for elective orthopedic procedures (joint injections, physical therapy), no waiting period for diabetes or hypertension management. Emergency care covered immediately.
Why This Outcome: At 67, Robert qualifies for cautious underwriting, and having three chronic conditions simultaneously means careful assessment. However, all three are well-controlled and stable—diabetes, hypertension, and arthritis are common in his age group. Sanitas approved him on the more generous Residents plan because this offers better terms than budget plans would. The 6-month wait for arthritis procedures is standard; the diabetes and hypertension management have no waiting period. If Robert had poor control on any condition or recent complications, approval would be doubtful or require longer waiting periods.
Key Takeaway from These Cases: Approval outcomes depend most on (1) age, (2) how well conditions are controlled, (3) time since diagnosis or event, (4) presence of complications, and (5) quality of medical documentation. Young applicants with well-controlled single conditions are almost always approved with good terms. Older applicants or those with multiple serious conditions need more careful planning and documentation.
Free consultation from Sanitas exclusive agents who specialize in pre-existing conditions.
At Spanish Health Insurance, we specialize in helping people with pre-existing conditions navigate Sanitas coverage. As authorized Sanitas agents with 2,000+ satisfied expat clients, we understand the challenges and know how to present your case for the best outcome. Here's exactly how we help.
We conduct a thorough review of your complete medical history before submitting any formal application to Sanitas. We identify which conditions are material, which may need explanation, and how to present them in the most favorable light. We help you gather and organize medical documentation (lab results, doctor letters, imaging) that strengthens your application.
Why this matters: A well-organized, properly presented application gets approved faster and with better terms than a poorly prepared one.
Not all Sanitas plans treat pre-existing conditions equally. We analyze your specific conditions, age, and budget to recommend the plan most likely to accept you with the best terms. We explain the trade-offs: lower premiums vs. longer waiting periods, for example. We sometimes recommend applying to multiple plans simultaneously to compare offers.
Why this matters: Choosing the right plan can mean the difference between approval with no waiting period vs. approval with 12-month wait, or acceptance vs. denial.
We prepare your formal Sanitas application with your complete medical history clearly documented and professionally presented. We submit your application directly to our Sanitas contacts, providing context about your conditions and why you believe you should be approved. We follow up with Sanitas during underwriting to ensure your application is reviewed promptly and answer any clarifying questions they may have.
Why this matters: Direct agent submission gets faster processing (2-3 days vs. 7+ days for direct applications) and our contacts can advocate on your behalf.
If Sanitas offers unfavorable terms (high premium surcharge or long waiting period), we review the offer and determine whether to negotiate. We prepare additional medical evidence and submit a formal request for reconsideration with an explanation of why the original terms are unreasonable. We succeed in improving terms for many clients through this process. If declined, we strategize next steps: appeal, try other plans, or consider alternative insurers.
Why this matters: Sanitas is sometimes willing to improve initial offers if compelling medical evidence is presented. You don't have to accept the first offer.
We don't lock you into Sanitas if it's not the right fit. We can also explore alternative insurers with favorable terms for pre-existing conditions (Axa, Mapfre, Segurcaixa, etc.). We help you understand which conditions are more favorably treated by different insurers and which plan gives you the best overall value. We obtain competitive quotes so you can make an informed decision.
Why this matters: Sometimes a different insurer offers significantly better terms for your specific condition than Sanitas does. We help you find the best option.
We handle all communication with Sanitas in Spanish and English. You don't need to navigate complex Spanish insurance terminology or worry about mistranslation. We explain each step, answer all your questions, and ensure you understand what you're being offered. Our team is available by phone, email, or WhatsApp for quick answers.
Why this matters: Insurance language is complex in any language. Having expert English-language support removes a major barrier to getting proper coverage.
Our services are FREE to you. We are paid commission by Sanitas for placing your policy—you pay the same insurance premium whether you work with us directly or apply yourself. We have no incentive to push you toward expensive plans; our reputation depends on getting you fairly approved for the right coverage. There are zero hidden fees or upselling.