Health Insurance in Spain: A Complete Guide for Expats

Looking for health insurance in Spain? This guide covers public and private health insurance options, costs, coverage, and how to access medical care as an expat.

Understanding Health Insurance in Spain

Spain offers universal healthcare through its Sistema Nacional de Salud (SNS), but many residents choose to supplement it with private health insurance (seguro de salud privado) for faster access and broader coverage. Expats, retirees, and temporary residents must understand how to register for public healthcare or whether they need private medical insurance.

This guide covers:

• Who needs health insurance in Spain?

• What is covered by Spanish health insurance?

• How to apply for public health insurance

• Private health insurance options

• Costs and contributions

• Medical insurance for unemployed or low-earners

Who Needs Health Insurance in Spain?

Anyone living and working in Spain is entitled to public healthcare through social security contributions. This includes:

• Employees and self-employed workers

• Children under 15

• Students under 26

• Retirees receiving a Spanish state pension

• Dependents of registered social security contributors

EU/EFTA Nationals

EU/EFTA nationals can use their European Health Insurance Card (EHIC) for temporary stays. Long-term residents must register for public healthcare and obtain a Tarjeta Sanitaria Individual (TSI).

If staying for less than two years or retiring in Spain, apply for an S1 form to receive healthcare benefits.

Non-EU/EFTA Nationals

Non-EU expats must have private health insurance when applying for a Spanish visa. Once settled, they can register for public healthcare or continue using private insurance.

For more details, visit Travel Doctor.

What Is Covered by Spanish Health Insurance?

Medical Service Covered by Public Insurance? Notes Doctor visits (médico de cabecera) Yes General practitioners are available through SNS Emergency care (urgencias) Yes Available at hospitals and clinics Prescription medication (medicamentos recetados) Partially SNS covers 40-60% of costs; retirees pay 10% Mental healthcare (salud mental) Yes Public system has long waiting times Maternity care (atención materna) Yes Fully covered under public healthcare Dentistry (dentista) No Private insurance required for dental care Sexual and reproductive health (salud reproductiva) Partially Includes contraception, STI testing, and abortion Fertility treatments (tratamientos de fertilidad) Varies Coverage depends on region Vaccinations (vacunación) Yes Mandatory vaccines covered, optional vaccines not

Expats often supplement public healthcare with private insurance for faster access to specialists and broader coverage.

Prescription Medication Costs in Spain

Spain’s public healthcare system subsidizes prescription drugs based on income level:

• General patients pay 40-60% of medication costs.

• Retirees pay only 10%.

• Undocumented migrants must pay at least 40% of prescription costs.

How to Apply for Public Health Insurance

To access public healthcare, you need a Spanish social security number (Número de Seguridad Social) and a Spanish health card (Tarjeta Sanitaria Individual - TSI).

Steps to Register:

1. Obtain a social security number from the Instituto Nacional de Seguridad Social (INSS).

2. Download a healthcare certificate from the Spanish Social Security e-Office.

3. Apply for a health card (TSI) at your local Centro de Salud.

4. Receive your TSI by mail within 2-3 weeks.

Once registered, you can choose a general practitioner (médico de cabecera) for primary care.

For guidance, visit Travel Doctor.

Private Health Insurance in Spain

Should You Get Private Health Insurance?

Many expats and locals choose private health insurance to:

• Reduce waiting times for specialist care.

• Gain access to English-speaking doctors.

• Cover dental and mental healthcare.

• Access private hospitals and clinics.

Choosing a Private Health Insurance Provider

When selecting an insurer, check for:

• Accreditation by Consejo General de Colegios Oficiales de Médicos (CGCOM).

• Coverage for specialists, diagnostics, and hospital stays.

• Plans with no copayments and full coverage from day one.

For telehealth consultations, Travel Doctor offers online medical services, with in-person visits in:

• Paris: American Medical Center

• Budapest: Expat Medical

• Berlin: Arztbesuche

• Bucharest: Expat Medical

• Argentina & Mexico: Travel Doctor ES

• Greece (Athens & Crete): Doctor Athens

• Krakow, Poland: Doctor Krakow

Cost of Private Health Insurance in Spain

Private health insurance costs between €50–€200 per month, depending on:

• Age

• Medical history

• Coverage level

• Add-ons (e.g., dental, alternative medicine)

Some providers allow pay-per-treatment options instead of monthly fees.

Health Insurance Contributions & Reimbursements

Social Security Contributions for Public Healthcare

• Employees contribute 4.7% of salary to social security.

• Employers pay 23.6% on behalf of workers.

• Freelancers pay 18.75–26.5% based on income.

• Retirees do not contribute further.

Medical Insurance for Unemployed & Low-Earners

Spain offers low-cost health insurance through the Convenio Especial, which allows unemployed residents to pay a reduced monthly fee for public healthcare.

The convenio especial pauses during employment periods when social security contributions resume.

Summary: Key Takeaways

• Public healthcare is available to residents through social security contributions.

• EU/EFTA nationals can use EHIC for temporary stays.

• Non-EU expats need private health insurance for visa applications.

• Public healthcare covers most treatments but excludes dental and some mental healthcare.

• Private health insurance provides faster access to specialists.

FAQ

1. Do I need private health insurance in Spain?

If you want shorter waiting times, access to English-speaking doctors, or extra services like dental care, private insurance is recommended.

2. How much does private health insurance cost in Spain?

Between €50–€200 per month, depending on coverage and age.

3. What does public health insurance cover?

Doctor visits, emergency care, maternity services, mental health (limited), and prescriptions (partially covered).

4. Can I use my EHIC card in Spain?

Yes, but only for temporary stays. Long-term residents must register for SNS healthcare.

5. Where can I get telehealth services in Spain?

Travel Doctor offers online consultations and in-person visits in select cities.

For additional medical guidance, visit Mayo Clinic.