Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, where he focuses on helping people compare health plans for life abroad. He emphasizes clear information, neutral analysis, and practical decision support.
Non-Lucrative Visa Insurance Requirements
Spain's non-lucrative visa has some of the strictest insurance requirements in Europe. Spanish consulates explicitly require private health insurance with no copays for essential services—a requirement that eliminates many budget options and even some international policies.
Spain's Strict Insurance Requirements
- No copays: Many consulates reject policies with copayments for hospitalization or essential care
- Full coverage: Must cover all medical contingencies without exclusions
- Spanish provider or equivalent: Some consulates prefer Spanish insurers (Sanitas, Adeslas, Mapfre)
- Valid for visa duration: Usually 1 year minimum with renewal guarantee
- No coverage caps: Unlimited or very high coverage limits required
This creates a unique decision: choose a Spanish insurer like Sanitas (lower cost, consulate-preferred, but Spain-only coverage) or an international provider like Cigna or Allianz (higher cost, more flexibility, worldwide coverage). Both approaches work, but they serve different needs.
Unlike Portugal's D7 visa where international insurance is standard, Spain's consulates often have strong preferences. Check with your specific consulate before purchasing—requirements can vary between countries and even between consulates in the same country.
Quick Comparison
Here's how Cigna Global, Sanitas, and Allianz Care compare for non-lucrative visa applicants. The key decision: international flexibility vs. Spanish insurer advantages.
| Feature | Cigna Global | Sanitas | Allianz Care |
|---|---|---|---|
| Visa Accepted | ✓ Yes | ✓ Yes (preferred) | ✓ Yes |
| Spain Network | Excellent | Extensive (own network) | Very Good |
| Coverage Type | International | Spain only | International |
| Max Entry Age | 74 | 69-74 (varies) | 74 |
| Monthly Cost (65yo) | €350-450 | €180-280 | €320-400 |
| Copays | None/Low | Yes (€5-20) | None/Low |
| Travel Coverage | Worldwide | Limited | Worldwide |
| Best For | International flexibility | Spain-focused, budget | Value + travel |
Best International
Cigna Global
Best Spanish/Budget
Sanitas
Best Balance
Allianz Care
Get Non-Lucrative Visa Insurance Quotes
Compare personalized quotes from international and Spanish providers. Takes 5 minutes, no commitment.
Compare Quotes NowWe may earn a commission when you apply through our links. This does not affect our recommendations.
Cigna Global for Non-Lucrative Visa
Strengths
- ✓ Worldwide coverage including home country visits
- ✓ No copays on comprehensive plans (visa-compliant)
- ✓ Excellent Spain network (Quirónsalud, HM, Vithas)
- ✓ 24/7 English support
- ✓ Seamless if you move countries later
Considerations
- • Higher cost than Spanish insurers
- • Some consulates prefer Spanish providers
- • May need to provide additional documentation
Cigna Global makes sense for non-lucrative visa applicants who want international flexibility. If you plan to travel frequently, maintain ties to your home country, or might relocate within Europe, Cigna's worldwide coverage eliminates the need for separate travel insurance.
Their Spain network is excellent—Quirónsalud (Spain's largest private hospital group), HM Hospitales, Vithas, and major facilities in Madrid, Barcelona, Valencia, and the Costa del Sol. Direct billing is available at most major hospitals, minimizing out-of-pocket hassle.
Best for: Applicants who value international coverage, plan significant travel, are American or maintain US ties, or anticipate potentially moving within Europe.
Sanitas for Non-Lucrative Visa
Strengths
- ✓ Preferred by many Spanish consulates
- ✓ 40-50% cheaper than international options
- ✓ Huge Spain network (own hospitals + partners)
- ✓ Dental often included
- ✓ Spanish-speaking support (English available)
Considerations
- • Spain-only coverage (travel insurance needed separately)
- • Copays on most plans (may not satisfy all consulates)
- • Age limits for new enrollment (typically 69-74)
- • Pre-existing condition waiting periods
- • Less flexibility if you move countries
Sanitas (owned by Bupa) is Spain's largest private health insurer with over 2 million customers. Their "Más Salud" and "Integral" plans are commonly used for non-lucrative visa applications. As a Spanish company, consulates are familiar with their policies and acceptance is straightforward.
The cost savings are substantial—often €150-200/month less than international alternatives. For retirees planning to settle permanently in Spain with minimal international travel, Sanitas delivers excellent value. Their network includes their own hospitals plus partnerships with most major Spanish private facilities.
Important: Sanitas plans include copays (€5-20 for various services). Some consulates accept this; others explicitly require no-copay policies. Verify with your consulate before purchasing. Sanitas offers "sin copago" (no copay) options at higher premiums.
Best for: Applicants committed to Spain long-term, budget-conscious retirees, those who won't travel extensively, and applicants whose consulate accepts copay policies or Sanitas specifically.
Allianz Care for Non-Lucrative Visa
Strengths
- ✓ International coverage at competitive pricing
- ✓ Strong European presence (German company)
- ✓ Enhanced mental health coverage
- ✓ Flexible pre-existing condition handling
- ✓ Good Spain network
Considerations
- • More expensive than Sanitas (but cheaper than Cigna)
- • Smaller direct billing network than Cigna in Spain
- • Digital tools less polished
Allianz Care offers a middle ground: international coverage and flexibility like Cigna, but at prices 10-15% lower. For non-lucrative applicants who want worldwide coverage without paying top-tier premiums, Allianz hits a sweet spot.
Their European heritage means strong understanding of Spanish healthcare and EU regulations. Plans are designed for European living with global flexibility. Mental health coverage is notably better than competitors—valuable for retirees adjusting to life abroad.
Best for: Applicants wanting international flexibility at better value than Cigna, Europeans familiar with reimbursement models, those prioritizing mental health coverage, and budget-conscious applicants who still need travel coverage.
Coverage Comparison
Understanding how coverage differs is crucial—especially the gap between Spanish-only and international policies.
| Benefit | Cigna Global | Sanitas | Allianz Care |
|---|---|---|---|
| Hospitalization | Unlimited | Full coverage | €3M |
| Outpatient Care | Full coverage | Full (with copays) | Full coverage |
| Emergency | Worldwide | Spain + EU emergency | Worldwide |
| Repatriation | Included | Limited | Included |
| Pre-existing | Underwriting | Waiting periods | Flexible underwriting |
| Mental Health | Standard limits | Basic | Enhanced |
| Dental | Optional add-on | Often included | Optional add-on |
| Home Country | Add-on available | Not covered | Add-on available |
Key Coverage Considerations
Travel Coverage: The biggest difference. Sanitas covers you in Spain plus EU emergency care. Cigna and Allianz cover you worldwide. If you plan to visit family, travel Europe, or maintain ties elsewhere, international coverage eliminates the need for separate travel insurance.
Copays: Standard Sanitas plans include copays (€5-20 per visit/service). International plans typically don't. Some consulates reject copay policies for non-lucrative visas—verify before purchasing.
Repatriation: Sanitas has limited repatriation coverage. International plans include comprehensive medical evacuation and repatriation—important if a serious illness requires returning home.
Pricing for Non-Lucrative Visa Applicants
The price gap between Spanish and international insurers is significant. Here's what to expect for comprehensive plans meeting visa requirements.
| Profile | Cigna Global | Sanitas | Allianz Care |
|---|---|---|---|
| Individual, Age 55 | €260-330/mo | €140-180/mo | €230-290/mo |
| Individual, Age 65 | €350-450/mo | €180-280/mo | €320-400/mo |
| Individual, Age 70 | €450-570/mo | €250-380/mo | €400-500/mo |
| Couple, Age 60 | €580-740/mo | €300-420/mo | €520-660/mo |
| Couple, Age 65 | €700-900/mo | €360-560/mo | €640-800/mo |
*Sanitas prices are for "sin copago" (no copay) plans where required. Standard copay plans are 20-30% cheaper. International prices for Europe-excluding-US coverage with moderate deductibles.
Spain Network Access
Madrid
Cigna/Allianz: HM Hospitales, Quirónsalud, Vithas, Hospital La Luz
Sanitas: Hospital La Moraleja, Hospital La Zarzuela, plus extensive clinic network
Barcelona
Cigna/Allianz: Quirónsalud, Hospital de Barcelona, Teknon
Sanitas: Hospital CIMA, Centro Médico Teknon (partner), extensive outpatient
Costa del Sol (Málaga, Marbella)
Cigna/Allianz: Quirónsalud Marbella, Hospital Vithas Xanit, HC Marbella
Sanitas: Good coverage in main towns, may need to travel to Málaga for complex care
Valencia & Alicante
Cigna/Allianz: Quirónsalud, Hospital Vithas, IMED Hospitales
Sanitas: Hospital 9 de Octubre (partner), Clínica Sanitas coverage
Real-World Scenarios
Scenario 1: Emergency While Visiting UK Family
You're visiting grandchildren in London when you develop severe chest pain. Need emergency cardiac care.
Cigna:
Full coverage at UK hospital. Same policy covers Spain and UK seamlessly.
Sanitas:
EU emergency-only coverage. Basic stabilization covered, but full treatment may require return to Spain or separate travel insurance claim.
Allianz:
Full coverage throughout Europe. UK care fully covered under same policy.
Scenario 2: Hip Replacement in Marbella
You need an elective hip replacement. Want it done at a quality facility near your Costa del Sol home.
Cigna:
Quirónsalud Marbella or HC Marbella—direct billing, no upfront cost. €15,000-20,000 procedure fully covered.
Sanitas:
May require traveling to Málaga or using partner facility. Copay applies. Still excellent value given lower premiums.
Allianz:
Good coverage at Costa del Sol hospitals. May require reimbursement at some facilities.
Scenario 3: Managing Pre-Existing Diabetes
You have well-controlled Type 2 diabetes needing ongoing management—quarterly visits, medications, annual screenings.
Cigna:
Underwriting determines coverage—may have waiting period or loading. Once covered, full management included.
Sanitas:
6-12 month waiting period typical for pre-existing conditions. After waiting period, covered with standard copays.
Allianz:
Often most flexible—may offer coverage with premium loading rather than exclusion.
Our Recommendation
Choose Cigna Global If:
- • You'll travel frequently outside Spain
- • You're American or need US coverage
- • International flexibility matters
- • Budget is secondary to coverage
Choose Sanitas If:
- • Spain is your permanent home
- • Budget is a priority
- • Your consulate prefers Spanish insurers
- • You won't travel much
Choose Allianz Care If:
- • You want international coverage at better value
- • Mental health is a priority
- • You're European/comfortable with reimbursement
- • You want balance of price and flexibility
The Bottom Line
For most non-lucrative visa applicants planning to live primarily in Spain, Sanitas offers the best value—40-50% savings add up over retirement. But check your consulate's requirements first; some specifically require no-copay policies.
If you need international coverage or your consulate is flexible, Allianz Care offers the best balance of worldwide coverage and reasonable pricing. Cigna Global is worth the premium for Americans, frequent travelers, or those wanting the best network experience.
Ready to Apply?
Get personalized quotes from all providers. Compare real pricing for your non-lucrative visa insurance.
Compare All OptionsWe may earn a commission when you apply through our links. This does not affect our recommendations.
FAQs: Non-Lucrative Visa Insurance
Do I need a Spanish insurer for the non-lucrative visa?
Not necessarily, but some consulates prefer them. International insurers like Cigna and Allianz are accepted by most consulates when their policies meet Spain's requirements (no copays for essential care, comprehensive coverage). Check with your specific consulate—requirements vary. If they prefer Spanish providers, Sanitas and Adeslas are the most commonly accepted.
Why does Spain require no-copay insurance?
Spain wants to ensure non-lucrative visa holders won't become a burden on the public healthcare system. By requiring comprehensive, no-copay private insurance, they ensure you can access care without financial barriers and without relying on the Spanish public system. This protects both you and Spain's healthcare resources.
Can I switch from Sanitas to international insurance later?
Yes, but new medical underwriting applies. Any conditions that developed while on Sanitas may be treated as pre-existing by the new insurer. If you've remained healthy, switching is straightforward. If you've developed health issues, staying with your current insurer is often wiser—they must continue covering you.
What about Spain's public healthcare after residency?
After becoming a permanent resident or citizen (typically 5-10 years), you can access Spain's public healthcare system. However, many expats maintain private insurance for faster access and English-speaking care. You can also use a combination—public for routine care, private for specialists and convenience.
Disclaimer: Non-lucrative visa requirements vary by consulate and change frequently. Always verify current requirements with your specific consulate before purchasing insurance. This comparison is for informational purposes only.
