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Requirements — health insurance

Health insurance for Spain's DNV — what qualifies, and what doesn't

The health insurance requirement is where most applicants make a mistake. Standard travel insurance, employer plans, and international policies with co-payments all fail. This guide explains exactly what you need — and who is exempt.

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€0
co-payment — the insurer pays 100% of covered costs, no excess or deductible
€30,000
minimum coverage amount required by Spanish immigration
Spain-wide
coverage must be Spain-specific, not just Schengen travel cover
Exempt
self-employed autónomos — covered via RETA Social Security contributions

The fundamental distinction

Employed or self-employed? — the rule is different for each

This is the most important distinction in the health insurance requirement. Whether you need private health insurance — and what type — depends entirely on whether you are applying as an employed worker or as a self-employed person.

Employed applicants

Private health insurance required — no exceptions

If you are applying as an employed worker — receiving a salary from an employer outside Spain — you must have a qualifying private health insurance policy. The policy must be Spain-specific, have no co-payment, cover a minimum of €30,000, and be issued by an insurer recognised in Spain. Your employer's health plan almost certainly does not qualify. You need a separate Spanish policy.

Self-employed (autónomo) applicants

No private insurance needed — RETA covers you

If you are applying as a self-employed person and will register as autónomo in Spain, you do not need a private health insurance policy. Autónomos contribute to Spain's Social Security via RETA (Régimen Especial de Trabajadores Autónomos). These contributions give you access to Spain's public health system (Sistema Nacional de Salud) — equivalent to NHS-level public healthcare. You are covered by the state system, not a private policy.

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Not sure which category you fall into?

Your case manager will confirm your employment status at the start of your application. The distinction matters for multiple aspects of the DNV — not just health insurance. If you are a company director who is also a salaried employee of your own company, the rules depend on how your income is structured and your company type. Discuss with your case manager before sourcing insurance.

What qualifies — employed applicants

The five requirements for a qualifying health insurance policy

For employed DNV applicants, your private health insurance policy must meet all five of the following criteria simultaneously. Failing any one of them means the policy does not qualify.

  • ✓ Covers Spain specifically — not just as part of a Schengen travel policy. The coverage must be for Spain as a country of residence, not for temporary visits.
  • ✓ No co-payment whatsoever — no excess, no deductible, no co-pay. The insurer pays 100% of covered costs. This rules out most standard health plans.
  • ✓ Minimum €30,000 coverage — the policy must provide at least €30,000 of total medical coverage. Most qualifying plans significantly exceed this.
  • ✓ Issued by an insurer recognised in Spain — Spanish-authorised insurers such as Sanitas, AXA Salud, Asisa, Mapfre Salud, CIGNA Global, Allianz Care, or DKV Seguros.
  • ✓ Valid for the full permit period — coverage must run for at least the duration of the permit you are applying for.

What does NOT qualify

  • ✗ Standard travel insurance — typically has excess payments and is designed for temporary visits, not residency
  • ✗ International health insurance plans with any co-payment or excess — regardless of the insurer's reputation
  • ✗ Your UAE, UK, or US employer's health plan — not designed for Spanish residency purposes
  • ✗ NHS entitlement — the NHS operates only in the UK and provides no coverage in Spain
  • ✗ European Health Insurance Card (EHIC / GHIC) — only valid for temporary visits, not for residency applications
  • ✗ Schengen travel policies — designed for visa applications and short stays, not Spanish residency

Qualifying insurers

Major insurers with DNV-compliant policies in Spain

The following insurers are well-established in Spain and offer policies that can qualify for the DNV — provided you select the correct plan (no co-payment, Spain coverage, €30,000 minimum). Always confirm DNV compliance explicitly with the insurer before purchasing.

Recommended partner

247 Expat Insurance

Our recommended partner for DNV-compliant health insurance. 247 Expat Insurance specialises in expat health cover and can confirm in writing that a policy meets Spanish DNV requirements. Speak to your case manager for a referral. Policies tailored for the DNV market.

Spanish market leader

Sanitas (Bupa Spain)

Sanitas is a Bupa subsidiary and one of the largest private health insurers in Spain. Sanitas offers DNV-compliant plans — the Sanitas Más Salud range includes no-copago options. Widely accepted, extensive network of clinics and hospitals across Spain.

Major Spanish insurer

AXA Salud

AXA Salud is AXA's Spanish health insurance arm. Offers plans with no co-payment for the private health market in Spain. Good nationwide network. Confirm explicitly that the chosen plan is sin copago (no co-payment) and covers Spain for residency.

Spanish mutual

Asisa

Asisa is a major Spanish mutual health insurer with a strong nationwide network. Frequently used for DNV applications. Offers various plan types — select the no-copago plan explicitly. Strong particularly in Madrid and larger urban centres.

International provider

Allianz Care / CIGNA Global

Allianz Care and CIGNA Global offer international health insurance products that can qualify for the DNV, provided the Spain-specific coverage is activated and the plan has no co-payment. Good options for applicants who want broader international coverage alongside Spanish residency cover.

Spanish provider

Mapfre Salud / DKV Seguros

Both Mapfre Salud and DKV Seguros are well-established Spanish health insurers with DNV-suitable plans. DKV Seguros in particular is active in the expat and international resident market. Both offer no-copago plan options.

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Cost: typically €50–150/month for a single adult

For a single adult in good health, a qualifying DNV health insurance policy typically costs €50–150 per month depending on age, insurer, and coverage level. Family policies (or individual policies for each family member) add to this cost. Premium plans with broader coverage — dental, vision, mental health — cost more. Basic qualifying plans providing no-copago coverage at the €30,000+ level start at around €50/month. Get quotes early and factor this into your Spain budget planning.

Evidence and family cover

How to evidence your policy — and covering your family

For the DNV application, you must provide the full policy document — not just a summary card, app screenshot, or welcome letter. The policy document must clearly state: the insurer's full legal name, your policy number, the coverage start and end dates, the coverage amount (minimum €30,000), the territory covered (Spain), and an explicit statement confirming no co-payment applies.

If your policy document does not explicitly state "no co-payment" or "sin copago", ask the insurer to provide a supplementary letter confirming this. Some insurers include this automatically for DNV applicants when requested.

Family members — each person needs coverage

Each family member included in your DNV application must have their own qualifying health insurance coverage. This can be done via a family policy that names each individual explicitly, provided the same no-copago and €30,000 minimum standards apply to each named person. If a family policy does not adequately cover each person individually, separate policies are required.

Children's health insurance is generally significantly less expensive than adult cover — often €20–50/month per child depending on age and insurer. If you have dependants included in your DNV application, factor their insurance costs into your planning from the outset.

Starting the policy and switching later

You need the policy in place before you submit your application — a draft or conditional policy does not suffice. Some insurers offer a conditional start date tied to your visa application date, which can be helpful if you are not yet in Spain. Once you have your DNV and are living in Spain, you can switch to a different insurer or upgrade your plan at renewal time — the strict requirement applies primarily at the application and renewal stages.

Questions & answers

DNV health insurance — FAQ

A co-payment (also called a co-pay, excess, or deductible) is an amount you pay out of pocket each time you use your health insurance — for example, a €20 charge per GP visit, or a £100 excess before the insurer pays anything. Spain's DNV requires that the health insurance policy has no co-payment whatsoever — the insurer must pay 100% of covered costs. This rules out most standard health insurance plans from the UK, USA, and internationally, which typically include some form of excess or co-pay. You need a policy explicitly described as having zero co-payment (sin copago).
No. Standard travel insurance does not qualify for the DNV health insurance requirement. Travel insurance is designed for temporary visits, typically has excess payments, and is not issued as a residency-level health policy. The DNV requires a private health insurance policy covering Spain on an ongoing basis, with no co-payment, from an insurer recognised in Spain. Some specialist international health insurers offer products that can bridge travel and residency needs, but standard travel cover is not suitable.
Self-employed applicants who will register as autónomo in Spain do not need a private health insurance policy for the DNV. Autónomos pay into Spain's Social Security system (RETA), which gives them access to Spain's public health system. Your Social Security contributions replace the private health insurance requirement. If you are applying as a self-employed person and plan to register as autónomo, advise your case manager — you will need to demonstrate your self-employed status and intent to register as autónomo, but you do not need to source a private policy.
Employer-provided health insurance from a UK, US, or other non-Spanish employer almost certainly does not qualify for the DNV. These policies are typically designed for use in the employer's home country, do not specifically cover Spain as a country of residence, often have co-payments or excesses, and are not issued by an insurer recognised by Spanish immigration authorities. You will need to take out a separate Spanish private health insurance policy.
Yes. Sanitas (a Bupa subsidiary operating in Spain) and AXA Salud are both major qualifying insurers for the DNV. Other qualifying insurers include Asisa, Mapfre Salud, CIGNA Global, Allianz Care, and DKV Seguros. When taking out a policy with any of these insurers, ensure the specific plan you choose has no co-payment (no co-pago) and covers Spain with a minimum of €30,000. Some insurers offer DNV-specific plans — ask explicitly about DNV compliance when taking out the policy.
For a single adult in good health, a qualifying DNV health insurance policy typically costs between €50 and €150 per month. Costs vary based on age, any pre-existing conditions, the insurer, and the level of coverage chosen. Basic qualifying plans start at around €50/month. More comprehensive plans with broader coverage, dental, and additional benefits cost more. Our partner 247 Expat Insurance specialises in expat health cover and can confirm DNV compliance — speak to your case manager for an introduction.
Yes. All major Spanish health insurers provide quotes before purchase. You do not need to commit to a policy before you know its cost. When requesting quotes, specifically ask whether the policy has co-payments — ask for a 'plan sin copago'. Our partner 247 Expat Insurance can provide a DNV-compliant quote and confirm in writing that the policy meets Spanish immigration requirements.
Each family member included in your DNV application must have their own qualifying health insurance coverage. For children, this can sometimes be done via a family policy that clearly covers each named individual. Check that the family policy explicitly provides DNV-compliant coverage (no co-payment, minimum €30,000 coverage) for each person, not just the primary policyholder. If the family policy does not adequately cover children individually, separate children's policies are required. Children's health insurance is generally less expensive than adult cover.
Home country private health insurance — UK Bupa, US UnitedHealth, Australian Medibank, etc. — generally does not qualify for the Spanish DNV. These policies cover you in your home country, not as a resident of Spain. Even international health insurance plans need to specifically cover Spain as a country of residency, and must have no co-payment. If you have an existing international plan, share the policy documents with your case manager for review — occasionally such plans can be amended or extended to qualify.
The policy must be valid for the full duration of the permit period you are applying for — typically 1 year (for consulate route) or 3 years (for UGE route). In practice, most health insurance policies are annual with automatic renewal. For the UGE route, you may be asked to show ongoing coverage or provide a statement of intent to renew. Your case manager will advise on the exact documentary requirement for your route.
This depends entirely on the terms and conditions of your specific insurer. Some insurers offer a short cooling-off period or will refund premiums if an application is rejected, particularly if you advise them promptly. Others do not. It is worth asking your insurer about their policy on refunds in the event of a rejected visa application before taking out the policy. DNV rejections are relatively rare when applications are properly prepared.
The NHS is the UK's National Health Service — a state-funded system that provides healthcare to UK residents at no direct cost at point of use. It does not operate outside the UK and cannot be used for the Spanish DNV requirement. Once you become a Spanish tax resident (183+ days in Spain), you are no longer entitled to NHS treatment as a UK resident. In Spain, if you are self-employed (autónomo), you access public healthcare via RETA contributions. If you are employed, you need private health insurance as described. There is no equivalent of the NHS that transfers to Spain.

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