Moving to Spain comes with many responsibilities, and one of the most important is setting yourself up with health insurance. This is why in this guide we’ve detailed everything you need to know about health insurance in Spain, what kind of options are available to you, and how to go about it.
How Can Expats Get Health Insurance in Spain?
As an expat in Spain, you have the following options when it comes to getting health insurance:
- Private health insurance. Most expats prefer to obtain private health insurance since it provides coverage to private hospitals and some additional benefits. It’s also more familiar to expats, and easier to navigate.
- Public health insurance (SNS). The Spanish National Healthcare System (Sistema Nacional de Salud– SNS) is one of the best healthcare systems in Europe and if you’re moving to Spain you’ll also be able to benefit from this system. Usually, registration is automatically tied to your employment, but even as a self-employed expat, you can still sign up for the SNS.
- A combination of both. You can register for public health insurance and still carry private insurance for additional coverage. Some expats prefer to have both, just for peace of mind.
For expatriates living in Spain, SegurCaixa Adeslas is a trusted choice for private health insurance. They understand the unique challenges of the expat lifestyle and offer specialized insurance options designed to meet your needs. Whether you’re applying for a Spanish Golden Visa, a Non-Lucrative Visa, or renewing your NIE card, SegurCaixa Adeslas provides comprehensive coverage. Backed by a solid reputation and a steadfast commitment to excellence, they ensure your well-being is protected, so you can fully embrace your new life in Spain.
What Is the Main Difference Between Private and Public Insurance in Spain
This table breaks down the key differences between private and public healthcare options in Spain:
| Private Insurance | Public Healthcare (SNS) |
|---|---|
| Sold by private health insurance companies. | Funded by social security contributions. |
| You have to actively buy your insurance policy. | You’re automatically registered with the system when you’re employed in the country. |
| Offers access to English-speaking doctors. | Most basic services are free but prescription costs, dental, and vision may require extra payment. |
Private Health Insurance Options for Expats in Spain
Private health insurance is a great choice for you while you’re living in Spain for the following reasons:
- You need private health insurance for your initial stay until you can register with the public health insurance system (SNS).
- It offers coverage for private hospitals and access to English-speaking doctors, which is a great benefit if you still don’t speak the language.
- It provides additional “top-up” insurance to cover the gaps that public health insurance does not cover if you choose to register with the SNS.
Where Do I Get Private Health Insurance?
Some of the best companies offering health insurance for expats in Spain include the following:
- SegurCaixa Adeslas
- AXA
- Bupa
- Cigna
- DKW
- ASISA
- Sanitas
- MAPFRE
Here’s where we recommend you get your insurance:
- A local insurance provider. To buy a policy from providers like Adeslas, DKW, or ASISA, we recommend visiting a Spanish comparison platform. These platforms make it easy to compare plans based on your needs and budget, and you will receive a personalized recommendation for the provider is suited to your profile. Look for options offering English-speaking doctors or coverage for private clinics if that’s a priority for you.
- An international insurance provider. You also have the option to buy your insurance from an international insurance provider. For example, comparison marketplaces such as Insubuy, and International Citizens Insurance, will provide you with a number of companies and their policies that will cover you in Spain.
How Much Does Private Health Insurance Cost for Expats in Spain?
The average price of private health insurance in Spain ranges from as low as €68 (approx. $70) and as high as €212 (approx. $218) per month. Moreover, if you opt for a more inclusive plan, your average costs can increase to €290 (approx. $318) for a family.
Additionally, costs also depend on the provider as shown here:
| Provider | Monthly Premium (EUR) |
|---|---|
| Cigna (coverage in Spain only) | €67.85 per month |
| AXA (worldwide coverage) | €166.81 per month |
| Bupa | €110.75 per month |
| SegurCaixa Adeslas | €50.00 per month |
| Allianz (Spain) | €60.00 per month |
| ASISA | €185.00 per month |
| Sanitas | €50–€60 per month |
| MAPFRE | €70.00 per month |
Public Healthcare Insurance for Expats in Spain
The Spanish public healthcare system is funded through monthly contributions to the social security system made by Spanish residents, who then become eligible for (almost) free healthcare.
As an expat, you are also eligible to register with the SNS if you belong to one of the following categories:
- Employed and residing legally in Spain (including freelancers and self-employed).
- Living in Spain and receive state benefits.
- Living in Spain, and you recently divorced or separated from your spouse, who was registered with social security.
- A pregnant woman living in Spain.
- Staying temporarily in Spain and possess a valid EHIC card.
- A family member of someone employed in Malta, who is entitled to healthcare.
- An international student under 26 studying in Spain (you may be required to use a private provider before entering the country— make sure you contact your university).
What Does the Public Health Insurance System Cover in Spain
The public health care system in Spain covers the following primary care services:
- All emergency services.
- Family medicine.
- Pediatric services.
- Nursing and midwives services.
The SNS partially covers the following services:
- Prescription costs at the pharmacy (your TSI card covers around 40%)
- Surgical prostheses, orthopedic equipment, and wheelchairs.
The SNS does not cover the following services:
- Dental care (except for simple extractions)
- Eyeglasses
How to Enroll in the Spanish Public Healthcare System?
After you enter Spain, you have to register with your local health center to qualify for the national healthcare plan (SNS) and receive your TSI (Tarjeta de Identidad de Extranjeros)— your Spanish healthcare card.
Here’s how you can go about it:
- Register Your Address. Visit your local town hall to register your address (padron) and get your registration certificate (empadronamiento), which is required for healthcare registration.
- Get a Social Security Number. If you’re employed, then your employer will provide you with your social security number, but if you’re self-employed you must apply for it at your local Social Security office (TGSS). You can find your local social office here.
- Prepare Your Documents. Collect your residence card, passport, proof of residence (padron certificate), and proof of healthcare eligibility from the TGSS office.
- Apply at Your Local Health Center. Locate your nearest health center, bring your documents, and apply for your healthcare card (Tarjeta de Identidad de Extranjeros). You’ll receive it by post and use it to access healthcare services.
Keep in mind: Depending on where in Spain you live, the TSI card may be referred to differently. For example, if you live in Catalonia, instead of the TSI, you will receive a CAP card (Centre d’Atenció Primària).
Frequently Asked Questions
Is Healthcare Free in Spain?
No, healthcare is not free in Spain. However, with its public health insurance system in place, it’s heavily subsidized which means you have to pay very little out of pocket and only for specific services, for example, an ambulance fee. Of course, if you also carry private health insurance, then your insurance will cover the bulk of your expenses.
Does Spain Have Universal Healthcare?
Yes, Spain does have universal healthcare, which means every citizen and resident is covered by the social security system.
Are Pre-Existing Conditions Covered?
Under public health insurance, all medical conditions are treated and covered (with the expectation of dental and eyecare which may require additional costs). With private health insurance, pre-existing conditions are also covered, but it may increase the cost of your overall insurance policy.
Can I Get Health Insurance in Spain if I Want to Retire There?
If you’re a retired expat in Spain, you can still qualify for a public health care scheme known as ‘Convenio Especial.’ This is a national healthcare plan that you have to pay a monthly fee as follows to receive insurance coverage:
- For persons under 65 years of age: €60 ($65).
- For persons over 65 years of age: €157 ($172).
The ‘Convenio Especial’ will also cover any pre-existing conditions.
As a retiree, you can also pay for private insurance, instead of the Convenio Especial, if you wish.
Can I Use My European Health Insurance Card (EHIC) in Spain?
Yes, you can use it to get access to the Spanish public health insurance system. But, you have to keep in mind that your EHIC is not a replacement for health insurance if you’re planning on staying long-term in the country.
Can I Just Use Travel Insurance?
No, travel health insurance is meant to cover you for short-term stays and only for medical emergencies. Any regular check-up or care service is not covered by travel health insurance.
Facts and Statistics About Spain’s Healthcare System
Here are some quick facts about Spain’s healthcare system:
- Around 90% of Spaniards use the public health insurance offered by the SNS.
- Around 19% use private health insurance.
- Spain is one of the countries that spend the most on its national healthcare system— around 10% of its GDP.
- WHO ranked the Spanish healthcare system the 7th most efficient in 2000.
- All pregnant women in Spain receive healthcare services no matter their insurance situation.
- In 2018 the Euro Health Consumer Index ranked Spain’s health care system the 19th.
- Spain is the number one country for organ transplants.
Emergency Contact Numbers in Spain
112 is the number of emergency services. The operator will transfer you to the relevant emergency services and there is no need for national area codes, even if you are calling from a foreign mobile phone.
091 is the number of the national police.
092 is the number of the local police
080 is the number of the fire department
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