Private Health Insurance in Spain: Comparison Guide

Private health insurance in Spain offers faster access, English-speaking doctors, and more convenience than the public system. For many expats—especially those requiring private insurance for visa purposes—understanding your options is essential.

Quick comparison: Need to compare insurers side-by-side? See our Health Insurance Comparison Tool with provider recommendations by visa type and situation.

Why expats choose private insurance

Even with access to excellent public healthcare, many expats maintain private coverage:

Required for visas:

• Non-lucrative visa
• Digital nomad visa
• Student visa
• Golden visa (initially)

Convenience benefits:

• Shorter wait times for specialists
• English-speaking doctors and staff
• Choose your own doctor
• Direct specialist access (no referral needed)
• More comfortable hospital rooms
• Flexible appointment scheduling

Practical reasons:

• Bridge coverage before public healthcare eligibility
• Backup for complex procedures
• Dental and optical coverage
• Mental health services with more options

Types of private insurance

Full private health insurance (Seguro de salud)

Comprehensive coverage similar to the public system but through private providers:

• Hospital care
• Specialist consultations
• Diagnostic tests
• Surgeries
• Maternity (often with waiting period)
• Emergency care

Cost: €50-200+/month depending on age and coverage

Copayment plans (Copago)

Lower monthly premiums with copayments for each service:

• Pay less monthly
• Pay €10-30 per doctor visit
• Pay percentage of procedures
• Good for healthy people who rarely need care

Cost: €30-80/month plus copays

Reimbursement plans

Use any doctor or hospital, pay upfront, get reimbursed:

• Maximum flexibility
• Access to any provider
• Must pay out of pocket first
• Reimbursement can take weeks

Cost: Varies widely

Visa-compliant insurance

Specific policies designed to meet Spanish visa requirements:

• No copayments (required for some visas)
• Minimum coverage levels
• Repatriation coverage
• Must be from Spanish or EU-authorized insurer

Cost: €60-150/month typically

Major insurance providers

Sanitas

Overview: Spain’s largest private health insurer, part of Bupa global network.

Strengths:

• Extensive network of doctors and hospitals
• English-speaking customer service
• Good digital platform and app
• International reputation
• Wide range of plans

Considerations:

• Premium pricing
• Some plans have significant copays
• Popular = sometimes busy clinics

Typical costs: €70-150/month for comprehensive coverage

Adeslas

Overview: Major Spanish insurer with broad coverage network.

Strengths:

• Large provider network across Spain
• Competitive pricing
• Good hospital coverage
• Flexible plan options

Considerations:

• Less English support than Sanitas
• Variable service quality by region
• Some bureaucracy for claims

Typical costs: €50-120/month

Mapfre

Overview: Large Spanish insurer offering health among other insurance products.

Strengths:

• Competitive pricing
• Bundle with other insurance (home, car)
• Solid network
• Good for families

Considerations:

• Less specialized in health than Sanitas/Adeslas
• Network varies by region
• Less English support

Typical costs: €45-100/month

Asisa

Overview: Medical cooperative with strong presence, especially in certain regions.

Strengths:

• Often more affordable
• Good coverage in their regions
• Own hospital network
• Strong in Madrid, Valencia, Andalusia

Considerations:

• Smaller national network
• Less international focus
• Regional strength varies

Typical costs: €40-90/month

DKV

Overview: Part of Munich Re, offers comprehensive health insurance.

Strengths:

• Strong international backing
• Good preventive care focus
• Wellness programs included
• Solid dental options

Considerations:

• Smaller network than big Spanish insurers
• Higher premiums for comprehensive plans
• Less known among expats

Typical costs: €60-130/month

Cigna (for expats)

Overview: International health insurance, good for globally mobile expats.

Strengths:

• International coverage
• English-speaking support
• Good for frequent travelers
• Established expat expertise

Considerations:

• More expensive than local options
• May be overkill if staying in Spain
• Claims process can be slower

Typical costs: €150-400/month

What to look for in a policy

Essential coverage

Ensure your policy includes:

• Hospitalization: Inpatient care, surgeries, room and board
• Outpatient care: Doctor visits, specialists, diagnostic tests
• Emergency care: ER visits, ambulance, urgent treatment
• Prescription coverage: Medications (check limits and copays)
• Maternity: If relevant (check waiting periods—often 8-12 months)
• Mental health: Increasingly important, check session limits
• Chronic conditions: Pre-existing condition policies vary

Visa requirements

For visa-compliant insurance, verify:

• No copayments: Many visas require copay-free policies
• Full coverage: Must cover all medical needs
• Spanish authorization: Insurer must be authorized in Spain
• Repatriation: Coverage for medical evacuation
• Minimum coverage period: Usually 1 year
• No waiting periods: Some visas require immediate coverage

Get written confirmation that your policy meets visa requirements before applying.

Network considerations

• Doctors near you: Check provider directory for your area
• Hospital quality: Research hospitals in the network
• Specialists available: Ensure your needed specialties are covered
• English speakers: Verify English-speaking providers if needed

Policy details to check

• Waiting periods: Time before certain treatments are covered
• Pre-existing conditions: What’s excluded or has waiting periods
• Age limits: Some policies won’t cover older applicants
• Annual limits: Maximum coverage per year
• Lifetime limits: Maximum total coverage
• Exclusions: What’s specifically not covered
• Cancellation terms: Notice periods and refund policies

Costs by age and situation

Rough monthly premium ranges

Age	Basic Plan	Comprehensive
20-30	€35-60	€60-100
30-40	€45-80	€80-130
40-50	€60-100	€100-170
50-60	€80-140	€140-220
60-70	€120-200	€200-350
70+	€180-300+	€300-500+

Factors affecting price:

• Age (biggest factor)
• Coverage level
• Copayment vs. no copayment
• Deductibles
• Pre-existing conditions
• Geographic area
• Family vs. individual

Family coverage

Most insurers offer family plans with discounts:

• Spouse addition: 80-100% of individual premium
• Children: €30-60/month each (often cheaper)
• Family packages may offer 10-20% savings

How to buy insurance

Direct from insurer

Contact insurers directly through:

• Their websites
• Phone (Spanish often required)
• In-person offices

Pros: No middleman, direct relationship Cons: Must navigate Spanish, compare yourself

Through a broker

Insurance brokers (corredores de seguros) can:

• Compare multiple insurers
• Explain options in English
• Handle paperwork
• Advocate if you have claims issues

Pros: Expert guidance, saves time, often free (commission-based) Cons: May push certain insurers, less direct relationship

Expat-focused services

Several companies specialize in expat insurance:

• Understand visa requirements
• English-speaking throughout
• Experience with foreign applicants
• May cost slightly more

Making claims

Direct billing (most common)

For in-network providers:

1. Show your insurance card
2. Provider bills insurer directly
3. You pay any copay at time of service
4. No paperwork needed

Reimbursement claims

For out-of-network or reimbursement plans:

1. Pay provider at time of service
2. Get itemized invoice (factura)
3. Submit claim to insurer (online or paper)
4. Receive reimbursement (typically 2-4 weeks)

Keep all receipts and documentation for any medical expenses.

Common issues and solutions

Pre-existing conditions

Insurers handle pre-existing conditions differently:

• Exclusion: Condition not covered at all
• Waiting period: Covered after 6-24 months
• Surcharge: Higher premium to cover condition
• Acceptance: Full coverage (rare for serious conditions)

Tips:

• Disclose everything on application (non-disclosure can void policy)
• Get quotes from multiple insurers
• Consider policies specializing in pre-existing conditions
• Public healthcare may be better for serious pre-existing conditions

Denied claims

If a claim is denied:

1. Request written explanation
2. Review your policy for coverage details
3. Appeal with supporting documentation
4. Contact insurance ombudsman if needed
5. Consider legal advice for significant denials

Changing insurers

You can switch insurers, but:

• Pre-existing conditions restart (including conditions developed with previous insurer)
• Waiting periods restart
• Time your switch to avoid coverage gaps
• Some insurers offer “portability” reducing waiting periods

Private insurance + public healthcare

Many expats use both systems strategically:

Use private for:

• Quick specialist access
• English-speaking doctors
• Routine care and checkups
• Convenience and comfort

Use public for:

• Major surgeries (excellent quality, no cost)
• Cancer treatment
• Chronic disease management
• Emergency care
• Expensive procedures

This dual approach maximizes convenience while minimizing costs for expensive care.

Recommendations by situation

Not sure which option fits your needs? Use our interactive insurance comparison tool to find the best match for your visa type and budget.

Digital nomad/visa applicant

• Prioritize visa compliance
• Sanitas or Adeslas visa-specific plans
• Verify no-copay requirement
• Budget €80-120/month

Young, healthy expat

• Copayment plan for lower premiums
• Basic coverage sufficient
• Consider higher deductible
• Budget €40-70/month

Family with children

• Comprehensive family plan
• Good pediatric network
• Maternity coverage if planning more children
• Budget €150-300/month

Retiree

• Comprehensive coverage important
• Check pre-existing condition policies
• Consider convenio especial (public) + private supplement
• Budget €150-350/month

Frequent traveler

• International coverage (Cigna, Bupa Global)
• Worldwide emergency coverage
• Evacuation and repatriation
• Budget €200-400/month

Questions to ask insurers

Before signing up, ask:

1. Does this policy meet visa requirements? (get in writing)
2. What are the waiting periods for each service?
3. How are pre-existing conditions handled?
4. What’s the claims process?
5. Which hospitals and doctors are in network near me?
6. Are there English-speaking providers?
7. What’s excluded from coverage?
8. What happens if I need to cancel?
9. How do premiums change with age?
10. Is there a maximum age for coverage?

Get answers in writing, especially for visa-critical questions.