Question about Spanish health insurance
The wife and I are considering moving to either Portugal or Spain. However, she has a pre-existing condition—a heart condition that includes having a pacemaker installed. We’ve scoured the internet trying to figure out which country would be best for us because of her condition.
Finally, I decided to ask ChatGPT about the problem. Here’s what it told me:
It’s worth noting that under Portuguese law, insurance companies are required to offer coverage to individuals with pre-existing conditions. However, they may charge higher premiums or apply waiting periods before covering the pre-existing condition.
In Spain, insurance companies are required by law to offer coverage to individuals with pre-existing conditions, although they may apply waiting periods before covering the pre-existing condition. However, unlike Portugal, in Spain, insurance companies are not allowed to charge higher premiums for individuals with pre-existing conditions.
Anyone know if this is true? Are insurance companies not allowed to charge higher premiums for pre-existing conditions in Spain? If so, that would be the obvious place for us to move to.
Answers
These are the answers of some Facebook group members:
“They can and they can drop you too if they feel your a liability. Its worse than the USA in that respect. They can do it because the state offers public insurance, private is for those who choose and qualify. Be careful because anything which can be tied to the pre existing condition may not be covered too. As for costs, if you need surgery or other intensive procedures it won’t be small change. Contact a company, inform them of your pre existing conditions and see what they offer.”
“I don’t know if those are new laws but when I tried to get a Spanish health insurance in 2018, no Spanish insurance company would cover me because of my numerous but stable pre existing conditions. I had to get what is called a global policy which also would not cover the pre existing conditions but at least gave me enough coverage so I could get my visa. I then used private doctors for any check ups I needed. And that global policy cost thousands of dollars.
A friend of mine who needs active treatments did not report to the private Spanish insurance companies what her pre existing conditions are, so sh was able to get the necessary insurance. This is illegal. She kept her American insurance and flies back to the USA for any checkups or treatments.
Now that I have public Spanish health insurance, I’d say they are excellent for any emergencies or things like regular mammograms, etc. but I will need to get private Spanish insurance for more regular checkups of the type I was used to getting in the USA.”
“Waiting for an appointment in Spain can run unbelievably long in the Public system, like six months. Private is much quicker.”
“With all of this, know that if your wife has an emergency heart event, you can take her to any hospital and she will be treated without question. Undocumented immigrants aren’t turned away from the spanish health system when presenting with an emergency. Your health will be far more protected here than in the U.S.”
“In Spain, after a year of residency, you may purchase coverage through the public health system for a modest monthly fee (Convenio Especial). There are no exclusions for preexisting conditions in the public health system. However, prescriptions are not a covered benefit.”
“Sanitas denied me coverage entirely. I’m interested to hear that it may have been illegal for them to do so.”
“Spanish health insurance companies can completely exclude pre-existing conditions and many have up to a 10 month waiting period for expensive tests and hospitalizations for everything else. Insurance companies can also drop you at each annual renewal unless you belong to a group plan. Read any policy you’re considering carefully. On the plus side after one year of residency you can buy into the public healthcare system for around €65 a month or €156 a month if you’re over 65 and they don’t exclude pre-existing conditions or have waiting periods.”
“I can’t answer your question about coverage, but if you do find that it’s not covered, you may want to check further to see what direct pay costs are, to manage the condition. My husband has one pre-existing condition that was not covered; however, we found that direct pay costs here in Spain for periodic management of the condition are approximately equal to the co-pays we would have incurred in the US. (And our annual health insurance costs here are otherwise about 1/8 what they were in the US, if you include deductibles and co-pays.)”
“The irony is that even if Spanish health insurance companies did charge more for a pre-existing condition, their rates are so dramatically lower overall that you’d never notice! Our coverage in Spain is appx 2.5 X less than in the US. It’s worth noting that while companies are required to offer coverage to those with pre-existing conditions, the policy probably won’t cover that condition.”
Conclusion
In conclusion, according to Spainguru Facebook group members, the issue of Spanish health insurance coverage for pre-existing conditions can be somewhat complex. While it is true that insurance companies in Spain are required by law to offer coverage to individuals with pre-existing conditions, there are nuances to consider.
Some members have reported that Spanish insurance companies may apply waiting periods for certain treatments or procedures related to pre-existing conditions. Additionally, there have been cases where individuals were denied coverage altogether or resorted to global policies that did not cover pre-existing conditions.
However, it’s important to note that the Spanish public health system can provide excellent care for emergencies and routine check-ups, and after a year of residency, individuals can purchase coverage through the public health system for a modest fee, which does not exclude pre-existing conditions.
Ultimately, it’s advisable to thoroughly research and consult with insurance providers to understand the specific terms and conditions of coverage to make an informed decision regarding your move to Spain, especially considering your wife’s heart condition.
Read more about What exactly is needed for health insurance for NLV besides no copay? and Can I cancel my health insurance if my Spanish Non Lucrative Visa application is rejected?
