Spain Health Insurance for Expats: Guide to Healthcare System



Spain Health Insurance for Expats: Guide to Healthcare System

The World Health Organization ranks Spain's healthcare system seventh in the world. We talk about the pros and cons of the system, who can get free medical care and the benefits of private health insurance in Spain

Order a checklist - step-by-step instructions for obtaining a visa and moving to Spain
Order a checklist - step-by-step instructions for obtaining a visa and moving to Spain

According to the World Health Organization, the Spanish health care system ranks seventh among the most efficient health care systems in the world. Public and private hospitals in Spain are considered to be among the best in the world.

The Spanish National Health System ("Instituto Nacional de la Salud") was founded in 1986 and guarantees free access to health care for all Spanish citizens and foreigners, regardless of economic status.

Health care is mostly paid for by taxpayers through Social Security. However, if you need specialized medical care, such as a dentist or psychologist, it is better to have private health insurance.

Read more about the health care system in Spain, insurance methods and medical tourism in the country.

European Health Insurance Card. Read here how to get preferential medical care in the EU countries.

Find the best jobs in Spain for foreign nationals in 2023 here.

How does the healthcare system work in Spain?

The public healthcare system in Spain is free, apart from some small costs, such as prescription deductibles.

It is financed by social insurance payments from employed and self-employed workers.

Pros and cons of the healthcare system in Spain

Advantages of the Spanish health care system

The Spanish public health system is generally of high quality and has a well-trained medical staff.

Spain has a good network of hospitals and medical centers, some of which are considered among the best in the world.

The public health care system also covers the insured person's immediate family, such as spouses, dependents under the age of 26, brothers and sisters.

Disadvantages of the Spanish health care system

Long waiting time for operations, procedures and treatment at specialist doctors.

State health services do not allow you to choose your own doctor or specialist.

You may have some difficulty finding English-speaking staff in public hospitals or care centers.

Lack of coverage for dental care.

Who can get free healthcare in Spain?

Any person who lives and works in Spain, whether employed or self-employed, can use public health care free of charge. The insured's spouse and children also benefit from coverage.

Children, pregnant women and students under the age of 26.

Persons who have recently separated from a partner registered in the social security system.

Recipients of certain child benefits.


Citizens of the EU/EFTA (European Free Trade Association – Iceland, Liechtenstein, Norway and Switzerland) can receive free medical care based on the European Health Insurance Card (EHIC).

Illegal migrants can also receive medical care, but must pay at least 40% of the cost of the medicine prescribed to them.

How to register in the Spanish health care system?

Expats who have the right to legal residence in the country with an EHIC card or a Spanish health card (tarjeta sanitaria individual – TSI) can access public health care. Both cards come free with health insurance.

You can apply for a Spanish health card at your local primary care center (centr d'atencio primaria – CAP). You will receive your TSI card at your home address within two to three weeks. This allows you to register with an individual doctor or health center in your local health area. However, to see other specialist doctors, you need to get a referral from your family doctor.

What does the Spanish public health system cover?

As part of the state health insurance policy, an expat can apply for: primary medical care, childbirth, physiotherapy, prevention and diagnosis of diseases, rehabilitation and emergency care.

Private health insurance in Spain

Spanish residents and expats usually have private health insurance (seguro de salud privado) that complements public health insurance. Most people prefer private insurance to get better and faster access to treatment. About 25% of the population has some form of private healthcare. Private insurance is also popular among expats.

Private health insurance usually costs between €50 and €200 per month, depending on the coverage plan.

Importantly! To enter Spain and obtain a visa, a foreigner must have travel or health insurance (read about the difference between travel and health insurance here).

Who must take out private health insurance in Spain?

A certain category of expats must have private health insurance:

Foreigners who applied for a residence card as a family member of an EU citizen.

At a family reunion.

If you are not an EU citizen and have a student visa.

When issuing a Golden visa.

When issuing a tourist visa.

Medical tourism in Spain

Thousands of medical tourists come to Spain every year to visit Spanish medical centers, spas and hospitals, this number is increasing and is expected to reach around 200,000 in the near future.

Citizens of which countries most often go to Spain for treatment?

If you need to travel for treatment, you must have a medical visa to Spain. A medical visa for treatment in Spain can be:

- Category C, if the period of stay in the country is less than 3 months;

- Category D, which is called national and allows you to stay in the country for more than 90 days.

Most health tourists come to Spain from European countries. If the duration of treatment will exceed 90 days, a medical visa must be issued for entry.

• Germany

• France

• United Kingdom

• Italy

• Austria

• Sweden

Spain topped the ranking of the healthiest countries in the world according to Bloomberg in 2019. The total life expectancy in the country is 83.5 years, which is the best indicator among all other member states of the European Union (EU). Expats and medical tourists can count on the help of highly qualified specialists in Spain.

An important step in any move or trip is the successful obtainment of a visa or residence permit. You can find out more about the types of visas in Spain, the rules for applying for them, and what documents are required here

Visit World products for a comfortable trip:

Legal advice on businesseducationmedical treatment and immigration in Spain;

Travel and medical insurance for foreigners in Spain;

Insurance for foreign students in Spain.

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