US Citizens: Check Your 2026 DNV Eligibility
It is the phone call every applicant dreads.
You have the salary. You have the clean criminal record. You have the remote job.
But then the insurance broker calls you back: “I’m sorry, but due to your medical history, Sanitas has declined your application.”
If you have a pre-existing condition—diabetes, a history of heart issues, or even a recent surgery—Spanish private insurers will either reject you outright or exclude your specific condition.
For the Digital Nomad Visa (DNV), the law requires “full coverage without exclusions.” This creates a dead end. You can’t get the insurance, so you can’t get the visa.
Or so most lawyers will tell you.
At JuroSpain, we use a specific legal mechanism to bypass the private market entirely.
The “Private Insurance” Myth
Most blogs tell you that you must buy private health insurance (Adeslas, Sanitas, DKV) to apply.
This is only true if you are not contributing to the Spanish system.
If you are a freelancer (Autónomo), you are required by law to pay into Social Security (RETA). This payment (~€350/month in 2026) grants you full access to the Spanish Public Healthcare System (Sanidad Pública).
The Spanish Public System cannot reject you. It covers everything. Cancer, insulin, surgery, transplants. No exclusions. No waiting periods.
The “Commitment” Strategy
The Catch-22 is obvious: “How can I register for Social Security if I don’t have the visa yet?”
The UGE-CE (Large Business Unit) knows this.
Instead of uploading a private insurance policy, we submit a Compromiso de Alta (Commitment to Register). This is a formal legal declaration stating that, upon approval of your visa, you will immediately register in RETA.
The Workflow:
- We draft the Compromiso: We cite the specific Social Security regulations protecting your right to public care.
- We submit the DNV application: We leave the “Private Health Insurance” field blank and attach the “Social Security Commitment” instead.
- Approval: The UGE grants your 3-year residency.
- Activation: You arrive in Spain, register in RETA, and get your public health card (Tarjeta Sanitaria).
Why this saves families
This strategy is not just for you.
If you buy private insurance, a family of four can cost €4,000+ per year. And if your spouse has a medical condition, they might be uninsurable.
Under the Social Security route, one payment covers everyone.
As the main contributor, you simply add your spouse and children as beneficiarios. They get the same unlimited public coverage for €0 extra cost.
The “Contractor Flip”
If you are currently an employee, this is yet another reason to switch to a Contractor (Independent) contract with your company.
- As an Employee: You are stuck trying to find private insurance (or fighting for a Certificate of Coverage).
- As a Contractor: You pay your RETA, you get public healthcare, and your medical history becomes irrelevant.
Do not let a diagnosis stop your relocation. The Spanish system is one of the best in the world—you just need the right key to open the door.
Frequently Asked Questions
Can I use the 'Convenio Especial' for my initial visa application?
No. The Convenio Especial (buying into public health) is only available after you have been a resident for 12 months. It does not solve the initial application requirement.
If I register as an Autónomo, do I still need private health insurance?
No. If you commit to registering as an Autónomo (RETA), you are entering the Spanish Public Health system. The UGE-CE accepts this commitment in place of a private policy. This is the key loophole for uninsurable applicants.
Does this work for family members too?
Yes. Once the main applicant is registered in Social Security, their spouse and children can be added as beneficiaries (beneficiarios) to the public system completely free of charge.
What if I am an employee (not a freelancer)?
It is harder. Unless your employer registers in Spain (creating a Permanent Establishment), you cannot easily access the public system. We often recommend converting to a 'Contractor' role specifically to unlock this health coverage.
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