The short answer is yes.

When applying for private health insurance in Spain, you are required to fill out a health questionnaire. This is a critical step in the application process, and honesty is paramount. But why is it so important, and what are the consequences if you don't? Let's delve into the details.

Why you must declare pre-existing conditions

Insurance companies base their coverage and premiums on risk assessment. A pre-existing or chronic condition represents a higher risk because it's a known health issue that will likely require medical care. By declaring your condition, you allow the insurance company to make an informed decision. Based on your health declaration, the company can:

• The insurance company may agree to cover all risks under the contract.
• The insurance company may limit coverage for the declared illness (for example, by imposing an additional waiting period for future diagnosis and treatment).
• The insurance company may exclude medical services, diagnosis and treatment of the declared illness from coverage.
• The insurance company may be unable to take on the risk coverage.

The dangers of non-disclosure

It might be tempting to omit information about a chronic illness to secure coverage. However, this is considered insurance fraud and can have severe consequences:

Potential consequences of hiding a condition:

The insurance contract includes a clause stating that by signing the contract, you declare that you were honest when completing the health declaration, and in case of providing false information, the insurance company reserves the right to limit coverage or terminate the contract.

What is considered a "pre-existing condition"?

A pre-existing condition is any illness, injury, or medical condition for which you have experienced symptoms, received medical advice, diagnosis, care, or treatment before the start date of your new health insurance policy. This includes chronic conditions like diabetes, heart disease, asthma, and autoimmune disorders, as well as past issues like a resolved cancer diagnosis or a surgery.

What if the insurance company excludes existing illnesses from coverage?

Even if the insurance company excludes something from the coverage, you will have a lot of other possible risks covered. This is still more advantageous than paying for all medical services as a private patient.

Can a health declaration increase the cost of health insurance?

Yes, it can. The insurance company may offer to cover the declared illnesses with superior premium. The amount will be communicated by the risk department before signing the insurance contract, and if the proposed condition is not suitable, you can decline the insurance.

Conclusion

In conclusion, regarding the necessity of making a health declaration when applying for private health insurance, it is important to approach this question with intelligence and understanding of all pros and cons. If you have any doubts or questions, you can get a personalized consultation here: WhatsApp or Telegram

Olena Trubchaninova

Licensed DKV insurance agent
Agent code: 0260003173
Spain

When buying private health insurance in Spain, you'll likely come across the term "carencia" (waiting period). But what exactly does it mean, and how does it affect you?

Simply put: Carencia is a waiting period that applies to certain services in new policies during the first year of coverage. During this time, specific treatments or procedures are not yet covered.

Why do Insurance companies use carencias?

The main reason is to prevent situations where people buy insurance only when they already know they need expensive treatment. Waiting periods help insurance companies manage risk and keep premiums affordable for everyone.

For example, using the popular DKV Integral policies, waiting periods apply to the following services:

DKV Integral

• Hospitalization and surgery (including prothesis): 6-8 months
• High-tech diagnostics (CT, MRI, etc.): 6 months
• Childbirth (natural or C-section), except in cases of premature birth: 8 months
• Biomechanical gait analysis: 6 months
• Proton therapy for pediatric cancer treatment: 8 months
• Transplants: 12 months

How does it work? A real example

A policy was issued on 01.09.2022. On 10.09.2022, the client consulted a traumatologist regarding neck pain. The doctor prescribed an MRI. According to the insurance contract, there is a 6-month waiting period for MRIs. This means the scan cannot be covered by insurance before 01.03.2023. If necessary, the study can be performed privately at the client's own expense.

FAQs

What if...? Will private insurance cover me in an emergency?

Clients often ask, "What happens if something serious happens to me?" When it is a matter of life and death (vital urgency), the insurance company waives the waiting period. In practice, it works like this: in the event of an acute condition, you go to the ER (via ambulance or by arriving yourself). The doctor assesses your condition, performs diagnostics, and provides a report. The clinic administration then sends this report to the insurance company to authorize coverage. Waiting periods only apply to new policies during the first year. When you renew your contract for the second year and beyond, there are no longer any waiting periods.

Can I get a policy without waiting periods?

Yes, it is possible. If you are an expat in Spain, you can sign up for a special type of policy designed specifically for long-term visa or residency applications (such as the NLV or Digital Nomad Visa). In these policies, waiting periods (carencia) are waived for all services, with the sole exception of pregnancy and childbirth.

Do carencias reset if I renew my policy?

No! Once you've completed the initial waiting periods and renew with the same company, you won't face them again. This is one reason why maintaining continuous coverage is beneficial.

Can the company set additional waiting periods?

Yes. After reviewing your health declaration, the insurance company may impose an individual waiting period for specific treatments or pre-existing conditions. You will be notified of this before the contract is signed, allowing you to make a final decision regarding the coverage before committing.

Switching companies and special conditions

If you are already insured with another company in Spain and wish to switch to DKV, you can often transfer your "seniority" to waive waiting periods for all services except childbirth. Important: If you decide not to renew your policy at some point, but change your mind later and sign up for a new one, you will have to go through the waiting periods all over new. Insurance seniority can only be preserved if certain conditions are met. Contact me, and we will review your case together.

Need help choosing the right policy?

Understanding carencias and choosing the right health insurance can be complex. I'm here to help you find the perfect coverage for your needs and budget. Get a personalized consultation here: WhatsApp or Telegram

Olena Trubchaninova
Licensed DKV insurance agent
Agent code: 0260003173
Spain

Many expats who live or are planning to move to Spain start wondering: "When should I buy private health insurance if I want to have a baby here?"

The answer is simple: The best time to arrange private medical insurance is before pregnancy is confirmed.

There are several important reasons why.

1. Waiting period for childbirth coverage — 8 months

All private medical insurance companies in Spain apply an initial waiting period (carencia) for childbirth coverage. This waiting period is typically 8 months from the date the policy comes into effect. This means that to have your childbirth covered by the insurance, you must have been a policyholder for at least 8 months before the birth takes place. If you become pregnant before completing this waiting period, or if your due date falls within the waiting period, the costs associated with childbirth will generally not be covered by the insurance. This measure is in place to prevent individuals from taking out a policy solely for the purpose of covering an immediate, high-cost event.

2. Coverage of congenital conditions for the newborn

A significant benefit of having private health insurance 10 month before giving birth is the automatic coverage for your newborn from day one, often including congenital conditions, without additional waiting periods or health questionnaires for the baby. This is crucial as it ensures that if your baby is born with any health issues, they will receive immediate and comprehensive medical care. This benefit typically applies when the mother or father has been continuously insured with the DKV for a certain period before the birth. It's essential to check the specific terms and conditions of your policy regarding newborn coverage to understand the full scope of benefits.

3. Financial benefit — no need to buy costly extra coverage

Having comprehensive private health insurance means you won't need to purchase additional, often expensive, individual policies or services once pregnancy is confirmed. Many standard health insurance plans, when secured in advance, include extensive maternity benefits that cover everything from prenatal appointments and diagnostic tests to delivery and postpartum care. This foresight saves you considerable out-of-pocket expenses and ensures that financial concerns do not overshadow the joyous anticipation of your new arrival. It streamlines the entire process, allowing you to focus on health and well-being rather than navigating complex payment structures or limited service options.

4. Full coverage for pregnancy risks and complications

Pregnancy can sometimes involve unforeseen complications that require specialized medical attention. By securing private health insurance before conception, you guarantee full coverage for any potential risks, complications, or necessary interventions throughout your pregnancy journey. This includes access to advanced diagnostics, specialist consultations, and emergency care, if needed. This comprehensive coverage provides immense peace of mind, knowing that you and your baby will receive the highest standard of medical care, regardless of any challenges that may arise, without the added stress of unexpected medical bills.

What if I'm already pregnant?

DKV has option to get an additional coverage for pregnancy care and delivery, possible to apply up to 24th week of pregnancy.

What if you're not in Spain yet?

If you're still planning your move to Spain — good news: you can arrange your private health insurance remotely from your home country. The entire process is digital: you can sign the contract online and receive all official documents by email.

Conclusion: don't wait to insure

The key takeaway is to be proactive. Getting private health insurance well before you become pregnant is the most reliable way to ensure you have comprehensive, high-quality care during one of the most important times of your life. It provides security, choice, and comfort, allowing you to focus on the joy of welcoming a new member to your family.

Get a personalized consultation here: WhatsApp or Telegram

Olena Trubchaninova
Licensed DKV insurance agent
Agent code: 0260003173
Spain