US Citizens Choosing Spain: What You Need to Know About the NLV
Spain's Non-Lucrative Visa (NLV) is the most common route for US citizens who want to live in Spain without working for a Spanish employer. It is a passive residency visa designed for people who can demonstrate sufficient income or savings to support themselves — retirees, those with investment income, people with remote income from the US, and others.
To obtain the NLV, you must apply at a Spanish consulate in the United States — the consulate in your state of residence. The requirements are specific, and health insurance is one of them. US domestic health insurance, Medicare, Medicaid, and travel insurance are not accepted. You need a policy from a Spanish insurer registered with the DGSFP that provides comprehensive cover within Spain with no copayments.
247 Expat Insurance arranges NLV-compliant health insurance for US applicants and provides the documentation your consulate appointment requires.
Important for US applicants: Requirements vary between Spanish consulates in the US — Los Angeles, Miami, New York, Houston, Chicago, and others. We are familiar with the requirements across all US consulates and will ensure your policy meets the specific standards of the consulate handling your application.
What the NLV Health Insurance Policy Must Include
- Comprehensive medical cover valid throughout Spain
- No copayments at any point of use (sin copago)
- No waiting periods — cover active from policy start date
- Issued by a DGSFP-registered Spanish insurer
- Coverage for the duration of the initial visa period (typically one year)
- Emergency, hospitalisation, GP, and specialist cover included
- An insurance certificate that can be submitted with your consulate application
Why US Health Insurance Does Not Work for the NLV
This is one of the most common misunderstandings among US applicants. US health insurance — whether through an employer, the ACA marketplace, or Medicare — is not accepted for the NLV because it does not provide cover within Spain. Spanish consulates require a policy that will actually function in Spain, from a Spanish-regulated insurer.
Travel insurance is also not accepted, as it is designed for short-term trips rather than long-term residency.
The policy you need is a Spanish private health insurance policy — the same product that millions of Spanish residents use for their day-to-day healthcare needs, adjusted to include no copayments and immediate cover as required by the visa rules.
US Insurance
Does not provide cover in Spain. Not accepted by Spanish consulates for NLV purposes.
Travel Insurance
Designed for short trips. Not compliant for residency visa applications. Typically excludes ongoing conditions.
Spanish DGSFP Policy
The only accepted option. Comprehensive cover within Spain, no copayments, from a regulated Spanish insurer.
The Cost of NLV Health Insurance for Americans
Premiums vary depending on your age, health history, and the level of cover selected. For a healthy adult in their 30s–40s, annual premiums are generally very affordable — comparable to or less than a US health insurance co-pay for a month. For those over 50 or with pre-existing conditions, premiums will be higher but are usually still competitive.
We will provide you with a specific quote based on your personal situation. There is no obligation, and we are happy to explain the options in plain English before you commit to anything.
Age 25–44
Generally the most affordable age bracket. Good choice of insurers and products.
Age 45–64
Premiums increase with age. Pre-existing conditions become more relevant. Comparison is important.
Age 65+
Specialist options available. Higher premiums but genuine cover available. Contact us to discuss.
Why Choose 247 Expat Insurance for Your NLV Application?
Experienced with US Applications
We have helped US citizens apply through multiple consulates across the United States and understand the specific requirements of each.
English-Speaking Team
No language barriers. We explain everything clearly and handle the process in plain English, 7 days a week.
DGSFP-Registered Insurers Only
We only work with insurers officially registered with Spain's insurance regulator. Your policy will be accepted.
Fast Turnaround
Certificates typically issued within 24–48 hours. Urgent cases handled where possible.
Correct Documentation
We ensure you receive the right certificate in the right format for your consulate appointment.
Ongoing Support
Your NLV insurance relationship does not end at the visa stage. We support renewals and any cover changes you need.
Common Mistakes US Applicants Make
- 1Using US health insurance or Medicare — these are not accepted by Spanish consulates for NLV purposes. You need a Spanish DGSFP-registered policy.
- 2Buying travel insurance thinking it qualifies — travel insurance is specifically excluded as a valid form of health insurance for Spanish residency visa applications.
- 3Not checking the specific consulate requirements — requirements differ slightly between Los Angeles, Miami, New York, and other US consulates. Always verify what your specific consulate requires.
- 4Choosing a policy with copayments — even small copayments can result in a visa application being rejected. Always ensure the policy is sin copago.
- 5Leaving it to the last minute — allow at least a week before your consulate appointment to arrange insurance and receive your documentation.
Frequently Asked Questions
Do US citizens need health insurance for the Spanish NLV?
Yes. Health insurance is a mandatory NLV requirement. US domestic insurance and Medicare are not accepted. You need a Spanish DGSFP-registered policy with no copayments.
Can I use my US health insurance for the NLV application?
No. US health insurance does not provide cover in Spain and is not accepted by Spanish consulates. You need a separate Spanish private health insurance policy.
Which Spanish consulate in the US do I apply through?
You apply through the Spanish consulate in your state of legal residence. Major consulates include Los Angeles, Miami, New York, Houston, Chicago, and Washington DC. Requirements are similar but not identical across consulates.
How long does it take to get the insurance certificate?
Typically 24–48 hours. If you have an urgent consulate appointment, contact us and we will do our best to meet your timeline.
Is the NLV health insurance renewable?
Yes. NLV holders typically need to renew their visa after the first year (and then after two years), and health insurance must be maintained and renewed throughout. We handle renewals and keep your cover continuous.
Can I have a pre-existing condition and still get NLV insurance?
In most cases, yes. The outcome depends on the condition. Some conditions are covered in full, others excluded, and some attract a premium loading. We will advise you honestly on what to expect for your situation.
Does my family need separate insurance policies?
Family members included in the NLV application also need compliant health insurance. This can sometimes be arranged as a combined policy or as individual policies — we will advise on what works best for your family.
What happens to my health insurance after I get the NLV?
Your policy continues to provide healthcare cover while you live in Spain. At NLV renewal, you need to show that your health insurance is still in force. We will notify you ahead of renewal to ensure continuity.