Concept
DKV Seguros y Reaseguros, Sociedad Anónima Española is a Spanish health insurer authorized by the Dirección General de Seguros y Fondos de Pensiones (DGSFP) and part of the ERGO group within Munich Re. In a Spanish residence file a DKV policy does the same job as one from Adeslas, Sanitas or Asisa: it supplies the private medical cover that the Startups Law (Ley 28/2022) makes mandatory for the international teleworker, better known as the Digital Nomad Visa.
🍓 A DKV policy in an immigration file has a narrow function: it confirms medical coverage equivalent to the Spanish national healthcare system. It is not proof of income, tax residency, or entitlement to a residence permit—it is specifically the medical component of the document package.
The requirement follows a simple logic. Ley 28/2022 opened a fast residence track for remote workers but left them outside the public health system until they start paying into Spanish Social Security. Private cover equivalent to that system fills the gap, which is why UGE reads the policy line by line and turns away generic travel or expat plans.
What UGE Requires from an Insurance Policy
The Unidad de Grandes Empresas y Colectivos Estratégicos (UGE-CE) sits inside the Ministry of Inclusión, Seguridad Social y Migraciones and decides the in-country residence authorization. It resolves within 20 working days, applies positive administrative silence and runs fully online; an in-country grant lasts up to three years, against one year for the consular visa. The policy it will accept has to meet four conditions:
- Medical coverage in Spain for the entire duration of the permit;
- Coverage comparable to the Spanish national healthcare system;
- Without significant co-payments, waiting periods, or coverage limitations;
- The policy must be issued in the name of the specific applicant and family members in the immigration file.
UGE explicitly states that the following are not accepted:
- tourist insurance;
- reimbursement-only policies;
- policies with significant co-payments;
- policies with waiting periods.
Reimbursement versus direct-access cover
This is where files come apart. A reimbursement (reembolso) policy pays you back after you have settled the bill yourself; a cuadro médico policy lets you walk into a contracted clinic and show a card. UGE has refused reimbursement-only contracts, so even a generous worldwide plan can fail if it carries no direct-access component. The dependable choice is a cuadro médico product, or a hybrid that includes direct access, with copago set to zero.
DKV as a Provider
DKV is supervised by the DGSFP and backed by the ERGO group within Munich Re; solvency is not in doubt. The file turns instead on which product you buy. UGE accepts a cuadro médico (direct-access) plan with zero co-payments and no waiting periods; a worldwide reimbursement-only contract, even one marketed for visas, sits close to the category UGE rejects. DKV's visa-oriented health plans qualify once the no-copago, no-carencia option is selected, though exact product names shift by sales channel and year.
Among the authorized insurers the differences are practical rather than legal. DKV leans on a wide cuadro médico, English-speaking support lines and bilingual clinics in the larger cities, which counts when a renewal depends on a clean certificate issued on time. Asisa and Sanitas compete on price and network, so it pays to compare DKV against the Asisa option before committing.
What to Check in Your Policy
- List of insured persons — must match the family composition in the immigration file;
- Validity period — it must cover the whole authorization: one year for the consular visa, up to three years for an in-country UGE grant;
- Coverage — sin copagos, sin carencia (without co-payments, without waiting periods);
- Territory — Spain and preferably EU/Schengen;
- Availability of insurance certificate — for attachment to the immigration file.
Where DKV Is Suitable
- primary applicants for Digital Nomad Visa and their family members;
- Spanish residence permit programs requiring medical coverage;
- families with children and parents (DKV covers different age categories).
Where It Is Not Suitable / What to Watch Out For
- if the applicant already has medical coverage through an employer under an applicable legislation certificate — DKV may not be required;
- if the applicant will register with Spanish Social Security — as an autónomo under RETA, or as an employee covered by an applicable international social-security agreement — UGE treats public cover as enough and a private policy is not required;
- if the policy contains copago or carencia — UGE may refuse it.
Insurance, residence and tax are separate
Keep three things apart. The medical policy is an immigration requirement and says nothing about how you are taxed. Many Digital Nomad Visa holders separately elect the Beckham regime to be taxed at a flat 24% as if non-resident, an election with its own forms and deadlines, while the wider Spanish tax and wealth-tax picture follows its own rules again. Holding DKV cover neither grants nor blocks any of this.
Activating and using the policy
Once the contract is signed DKV issues the póliza and the certificado you attach to the file, and opens the customer account. The app and member area then carry the day-to-day load: finding a contracted doctor, booking, authorizations for tests or surgery, and pulling a fresh coverage certificate when a renewal comes round. Keep every annual certificate, since at each renewal UGE checks that cover has run without a break.
The residence renews in steps, up to five years in total, after which long-term residence becomes available and the private-policy condition falls away once you are inside the public system. Until that point a lapse in cover is the avoidable reason a renewal stalls.