This southwestern European country is highly attractive to many expatriates. It offers several migration pathways via retirement or investment programs. Still, moving to a new country comes with many ups and downs, and one particular difficulty expats have is navigating through a new healthcare system, and Spain is no exception.
What Kind of Healthcare System Does Spain Have?
Spain has a public healthcare system funded by taxes and government funds. Residents and citizens contribute to the social security scheme (Seguridad Social), which also covers healthcare and health insurance.
However, not all residents are eligible to sign up for the national healthcare plan, so they purchase private health insurance. So, while the healthcare system in Spain is mainly public, private healthcare also plays an important role in the country’s health system.
Is Healthcare Free in Spain?
Healthcare is generally free in Spain. This means you won’t be required to pay for the services when visiting a public doctor or a healthcare centre. This results from universal healthcare, which taxpayers and the government fund. As a result, you pay for your healthcare indirectly via your social contributions. You will notice a portion of your wages go towards taxes and social security, which fund public healthcare.
However, if you visit a private facility or doctor, you must pay for the services unless you carry private insurance.
Spain Health Insurance for Expats
Expats who move to Spain have two choices regarding health insurance:
- Sign up with the national healthcare plan, or
- Opt for private health insurance coverage (Choose SegurCaixa Adeslas, the premier health insurance provider that fulfills prerequisites for Student Visa, Investment Visa (Golden Visa), Non-lucrative Visa, NIE card (the residence permit), Renewal of NIE card, and more).
Legal Basis
Spanish health insurance requirements are outlined in Organic Law 4/2000 (as amended by Royal Decree 557/2011) and Law 14/2013. According to these laws, health insurance is mandatory when applying for:
- A student visa (short-term or long-term).
- Investment and Non-lucrative Visa.
- A NIE/TIE (Foreigner’s Identification Number/Residence Permit).
- Renewals of existing visas or residency permits.
These regulations ensure that foreigners have adequate medical protection during their stay in Spain.
Public Health Insurance in Spain for Expats
Spain’s public healthcare system (Sistema Nacional de Salud-SNS) is one of the best healthcare systems in Europe, and expats who live there can benefit from the SNS. Usually, if you are employed in Spain, you are eligible for the SNS. Additionally, your family members qualify for the SNS if you are a legal resident.
With the public healthcare system, you can receive medical attention for free, with a small fee for prescriptions and additional services. The system is funded by taxes meaning that you as an individual must pay social security contributions for the healthcare system to function.
You will be able to see a general practitioner for medical attention, and they will refer you to a specialist if required. For emergencies, you can visit one of the nearest emergency centres (Servicios de Emergencias Médicas-SEM).
If you are travelling to Spain for a holiday, a business trip, or another type of short-term visit which lasts less than 181 days, then you should get travel insurance for Spain.
What Is Covered by the Spanish National Healthcare System?
The SNS covers all of your medical needs, but some of the services are not free, as displayed here:
| Full coverage | Partial coverage | No coverage |
| Emergency visits | Medicine prescriptions (around 40%) | Dental care (except for emergency cases) |
| Doctor consultations | Prosthetics, wheelchairs, and orthopaedic equipment. | Eyeglasses and eye care |
| Pediatric visits | ||
| Emergency visits | ||
| Nursing and midwife services | ||
| Inpatient and out-patient care |
Private Health Insurance in Spain
Private health insurance is another option for expats living in Spain. Because of the SNS, it’s not usual for citizens to rely only on private health insurance. So, it usually plays a complementary role to the SNS by providing coverage for the areas it does not cover, such as dental and eye care. However, it takes several months after you move to Spain to become eligible for the SNS, during which you need to obtain proper health insurance.
Some of the best private insurance companies in Spain include:
- Adeslas
- Sanitas
- Asisa
- Cigna Global
- William Rusell
- DKV
The Cost of Private Insurance in Spain
The cost of private health insurance in Spain goes between €50 to €200 per month. This price depends on several factors such as:
- Age. With private insurance, the older you are, the higher your premium price may go, mainly because as people get older, they tend to have more medical problems.
- The longer you plan on purchasing your policy, the higher your insurance price will go. So, if you need short-term private insurance, the cost won’t be too much.
- Insurance company. Prices will change based on which company you choose to purchase your insurance from.
- If you opt for more extensive coverage, you will be required to pay more for your premium; if you opt out of unnecessary coverage such as maternity care, the cheaper your insurance price is.
| Did you know that Spain is the number one country in the world for organ transplants? |
Health Insurance for Foreign Workers
If you’re employed in Spain, you are automatically included in the SNS that is because your employer will register you for social security contributions. You need to contact your nearest SNS office and retrieve your medical insurance card (Tarjeta Sanitaria Individual- TSI).
If you are self-employed, then the registration process is slightly different. You need to receive your social security number, which employed workers retrieve from their employer, but you, as a self-employed person, need to apply for your social security number at the (Tesoreria General de la Seguridad Social-TGSS).
You also need to make sure that you pay your social security contributions correctly to become eligible for SNS medical care. If you ever need medical assistance, take your TSI card and visit your GP. Please note that your TSI may be called differently depending on which region in Spain you are located.
Health Insurance for International Students
Students don’t generally qualify for public health insurance as they don’t contribute to the social security system which funds public insurance. As a result, if you are a non-EU student in Spain, you must purchase private health insurance, covering you during your study period in Spain, unless you are from a country that Spain
However, Spain has bilateral agreements with certain countries, enabling students from these nations to access public healthcare services. These countries include:
- Andorra
- Brazil
- Chile
- Ecuador
- Morocco
- Peru
- Tunisia
Students from these countries should review the specific terms of these agreements, including the extent of coverage and required documentation.
Recommended Private Insurers for Students
Several reputable insurance companies in Spain offer plans tailored to the needs of international students:
- Choose SegurCaixa Adeslas: As one of Spain’s leading health insurance providers, Adeslas offers plans specifically for international students. Their extensive network includes over 43,000 professionals and more than 1,200 medical centers. They specialize in meeting the unique needs of foreign students, offering tailored plans that perfectly fit Student Visa and NIE/TIE (residence permit) requirements.
- Sanitas: The “Sanitas International Students” plan is designed for students aged 14 to 35, offering comprehensive coverage with no copayments or waiting periods. It also provides access to a broad network of professionals and facilities.
- DKV Seguros: DKV offers a variety of health plans for international students, emphasizing preventive care and specialized services. Their extensive network ensures easy access to healthcare across Spain.
- ASISA: ASISA provides health plans for expats and international students, ensuring comprehensive coverage and access to a wide network of healthcare professionals.
Additional Considerations
- University-Provided Insurance: Some Spanish universities offer their own health insurance plans for international students. It’s worth checking with your institution to see if this option is available.
- European Health Insurance Card (EHIC): EU, EEA, or Swiss students should secure an EHIC before arriving in Spain. While the card grants access to public healthcare, it may not cover all expenses, making additional private insurance a wise choice.
Securing the right medical insurance is crucial for international students in Spain. Not only does it ensure access to necessary medical services, but it also fulfills visa requirements. Researching and selecting the most appropriate plan for your needs and budget will help make your stay in Spain smoother and worry-free.
What Documents Are Needed to Purchase Private Health Insurance as a Student?
To purchase private medical insurance as a Student, you will typically need the following documents:
- A copy of your passport or ID.
- Your student visa (if applicable).
- Proof of enrollment in a Spanish institution.
- Contact details, including your Spanish address (if already available).
Contact your chosen insurer for a detailed list of required documents.
Can I Use My Home Country’s Health Insurance While Studying in Spain?
Some home country insurance plans may provide international coverage, but they often do not meet the specific requirements for Spanish visas. Verify that your existing plan includes comprehensive medical protection in Spain and repatriation services. If not, consider purchasing a local private insurance plan.
Do I Need Health Insurance for Study Programs in Spain Lasting Less Than 90 Days?
Yes, health insurance is mandatory even for short-term stays. If your study program in Spain is under 90 days, a Schengen travel insurance plan with sufficient medical coverage is usually acceptable. Be sure your policy meets the minimum coverage requirements set by Spanish authorities.
>> Explore Affordable Spanish Visa Insurance Plans for Short-Term Students
Health Insurance for Retired Expats in Spain
Retired expats in Spain have one of the following options to choose from when it comes to health insurance in Spain:
- Voluntarily register with the SNS. Spain provides a national healthcare scheme in which individuals can buy in and be included in public healthcare. This is also known as ‘Convenio Especial’. Retired expats under the age of 65 must pay a monthly fee of €60 ($65) to qualify, while those over the age of 65 must pay a fee of €157 ($172).
- Buy private insurance. They can opt for private insurance, especially insurance tailored to seniors who need coverage for pre-existing conditions.
- A combination of both. Some retirees prefer to have the option of both public and private health insurance. This way, they can use the services the SNS offers but still receive coverage for areas not included in the national healthcare plan.
Health Insurance for US Expats in Spain
US citizens who move to Spain can choose between private insurance or benefit from the SNS— if they’re eligible. Medicare and insurance from the US will most likely not cover you while you are abroad. But, if your insurance company has an international plan, you can check with them and ask in advance.
For expatriates in Spain, SegurCaixa Adeslas stands as a trusted beacon for health insurance. With a deep understanding of the expat lifestyle, they provide specialized insurance options that cater to your unique needs. Whether you’re pursuing a Golden Visa, a Non-lucrative Visa, or seeking NIE card renewal, SegurCaixa Adeslas offers comprehensive coverage without compromise. With a solid reputation and unwavering commitment to excellence, SegurCaixa Adeslas ensures your well-being is protected, allowing you to fully embrace your new life in Spain.
Spain Health Insurance for EU Citizens
If you’re an EU citizen in Spain, you can access the SNS services freely by using your EHIC (European Health Insurance Card). Make sure your card is valid before leaving for Spain. If you plan to stay in Spain for over three months, you must sign up for the National Health Care plan.
Spain Private Insurance VS Public
Here are a few notable differences between public and private health insurance in Spain:
| Public health insurance | Private insurance |
| Coverage for most of the medical services. | Coverage as you customise your plan. |
| Free medical services are funded by taxes. | Monthly payment to keep your insurance. |
| Healthcare is universal, i.e., all patients are treated regardless of their income or social status. | Access to private facilities and English- speaking doctors. |
FAQ
Are Dental Services Covered by Health Insurance in Spain?
Most basic health insurance plans, including public healthcare through EHIC, do not cover dental services. However, private health insurance providers often offer optional add-ons or specific plans that include dental care. If dental coverage is important, review plan options carefully before purchasing.
Can I Change My Health Insurance Provider After Arriving in Spain?
Yes, you can switch insurance providers while in Spain, but it’s important to ensure continuous coverage to avoid gaps that might affect your visa compliance. Before changing plans, verify that the new policy meets all legal requirements.
What Happens If I Need Emergency Medical Care Without Insurance?
If you require emergency medical care and do not have insurance, you will typically need to pay for the services out of pocket. This can be very expensive. It’s always advisable to have adequate insurance in place to avoid financial stress during emergencies.