Healthcare in Spain

For many people, quality healthcare is a key factor when buying a home or moving to Spain. Fortunately, Spain has one of the best healthcare systems in Europe, with modern hospitals, well-trained doctors, and excellent medical facilities throughout the country. For non-residents, healthcare can be either private or public, but expats do not have immediate access to the public system. Therefore, it is advisable to take out temporary travel insurance. In some cases, it is also possible to obtain a temporary health card at a local medical center upon presentation of a European Health Insurance Card, padrón (proof of registration with the municipality), and an NIE number.

However, access to healthcare varies depending on your personal situation. Do you work in Spain, are you retired, do you spend only part of the year in Spain, or are you planning to emigrate permanently? In all of these situations, different rules may apply to your health insurance and access to public healthcare.

In this guide, we explain how the healthcare system works in Spain, when you are eligible for public healthcare, when private insurance is necessary, and what steps you need to take after moving to Spain. We also discuss the cost of medications, how to apply for a Tarjeta Sanitaria, and the options for medical care on the Costa Blanca and throughout the rest of Spain.

Are you planning to move to Spain or buy a home on the Costa Blanca? If so, it’s a good idea to research your health insurance and medical services in advance so you can enjoy your new life in Spain without any worries.

In this guide, we provide a comprehensive overview of the Spanish healthcare system and health insurance. You’ll learn who is eligible for public healthcare, how to find a doctor, what costs to expect, and get an overview of childbirth in Spain.

Public healthcare in Spain is funded through social security and is among the best in Europe. Apart from a small copayment for certain medications, healthcare is largely free for those enrolled in the system.

If you work in Spain as an employee or self-employed person and pay social security contributions, you are generally eligible for public health care. In many cases, family members such as spouses and children may also be covered under your insurance.

However, the situation may vary depending on your personal circumstances. Are you retired, working remotely for a foreign employer, or have you just moved to Spain? If so, different rules may apply.

For example, many retirees who move to Spain from an EU country use what is known as an S1 form. This allows them to access the Spanish healthcare system while their healthcare costs are covered by their home country.

People who emigrate to Spain but do not yet have access to public healthcare often opt for private health insurance on a temporary basis. In many cases, this is also a requirement for certain residence permits.

Public health care covers, among other things:

• primary care
• specialized care
• hospitalizations
• emergency room
• pregnancy care
• preventive healthcare

For many residents, the Spanish healthcare system is one of the reasons they choose to move to Spain permanently. The combination of high-quality medical care, modern hospitals, and relatively low costs is often seen as a major advantage.

Spain’s public healthcare system is internationally renowned for its high quality and comprehensive coverage. Many people who move to Spain are pleasantly surprised by the quality of the hospitals, health centers, and medical professionals. However, as in other countries, there are both advantages and considerations you should keep in mind.

Advantages of the Spanish healthcare system

High-quality healthcare
Spain has modern hospitals, well-trained doctors, and specialized medical centers. Several Spanish hospitals are even among the highest-rated in Europe.

Extensive network of healthcare facilities
Virtually every city has health centers, urgent care clinics, and hospitals. As a result, medical care is easily accessible to most residents.

Coverage for family members
In many cases, spouses and children can be covered under the primary insured’s policy, giving families access to the same healthcare services.

Low costs for residents
For people enrolled in the Spanish social security system, most medical treatments are available at little or no cost.

Disadvantages of the Spanish healthcare system

Waiting times for specialists
As in many other European countries, waiting times for non-urgent treatments or specialist care can be long. That is why some residents opt for private health insurance as a supplement.

Limited freedom of choice regarding doctors
Within the public system, you are usually assigned a primary care physician, and specialist care is provided through referrals. As a result, you have less freedom than with private healthcare.

Limited dental coverage
Most dental treatments are not covered by public health insurance. As a result, many residents use private dental practices or supplemental insurance.

Why do many residents choose to purchase supplemental private insurance?

Although Spain’s public healthcare system is of a high standard, many residents opt for supplemental private insurance. This often gives them faster access to specialists, greater freedom of choice, and shorter wait times for certain treatments.

For people who are moving to Spain permanently, a combination of public and private healthcare can therefore be an attractive solution.

The Spanish public healthcare system, known as the Sistema Nacional de Salud (SNS), provides comprehensive coverage for residents enrolled in the system. The quality of care is highly regarded internationally and covers virtually all essential medical services.

Within the public system, you have access to, among other things:

• primary care
• pediatricians
• nursing
• Prenatal and postpartum care
• physical therapy (if medically necessary)
• specialized care
• hospitalizations
• emergency room
• preventive screenings and vaccinations
• rehabilitation programs

As in many other European countries, you are usually assigned a primary care physician first. This physician is your first point of contact for medical issues and can refer you to a specialist or hospital if necessary.

Specialized care in Spain

When specialized care is needed—such as from a cardiologist, dermatologist, or orthopedic specialist—this is usually arranged through a referral from your primary care physician. In most cases, the costs of these treatments are covered by the public health insurance system.

Waiting times can vary by region. That is why some residents choose to take out private health insurance as a supplement, so they can see certain specialists more quickly.

What is typically not covered by public health care?

Although the Spanish healthcare system is very comprehensive, not all medical expenses are fully covered.

For example, most dental treatments, orthodontics, and certain specialized treatments are not covered under standard coverage. A copayment often applies to prescription drugs as well, depending on your age, income, and personal circumstances.

For many residents, the combination of public health care and supplemental private insurance is therefore a practical solution.

The cost of medications and medical treatments in Spain depends on your personal situation and the type of care you receive.

Over-the-counter medications, such as pain relievers, vitamins, and certain self-care products, can be purchased directly at the pharmacy. For medications covered by the public health insurance system, you need a prescription from a doctor.

Copayment for medications

Unlike many medical treatments covered by public health insurance, prescription drugs are usually not completely free. The amount of the copayment depends on factors such as your income, age, and employment status.

In general, the following apply:

• a lower copayment for retirees;
• employees a percentage of the costs;
• children and certain groups in specific situations pay no or only a limited amount.

As a result, the cost of many prescription drugs remains relatively low compared to various other European countries.

Medical treatments

If you are enrolled in the Spanish public health care system, visits to your primary care physician, specialist care, hospital admissions, emergency care, and many necessary medical treatments are generally fully covered.

However, additional conditions or copayments may apply to certain treatments, medical devices, or specialized care.

Public or private healthcare?

People with private health insurance often receive treatment at private clinics and hospitals. In such cases, the costs and reimbursements depend on the insurer’s policy terms and conditions.

Many residents of Spain therefore opt for a combination of public healthcare and supplemental private insurance. This allows them to benefit from the comprehensive coverage of the public system as well as shorter wait times and greater freedom of choice within the private healthcare sector.

You can apply for the Tarjeta Sanitaria at your local health center. You must bring identification documents and proof of your social security status. If you are not eligible for social security, you can apply for the Convenio Especial for a monthly fee.

The Tarjeta Sanitaria Individual (SIP card in the Valencian Community) provides access to public healthcare in Spain. However, not everyone who moves to Spain automatically receives this card.

If you work in Spain or receive a Spanish pension, you are generally enrolled in the Spanish social security system and can apply for a Tarjeta Sanitaria through your local health center.

However, many people who emigrate to Spain initially opt for private health insurance. This is often the case, for example, when applying for a non-lucrative residence permit (Non-Lucrative Visa) or during the initial period after emigration. In this situation, you will usually not receive a Tarjeta Sanitaria, because you are not enrolled in the Spanish social security system.

With private insurance, you do have access to medical care through your insurer’s network of private clinics and hospitals.

Depending on your personal circumstances, you may still be eligible for public health care at a later date, for example, if you start working in Spain, receive a Spanish pension, or are able to use an S1 form from your home country.

Are you unsure which healthcare plan applies to your situation? If so, it’s a good idea to get all the necessary information in advance so you don’t face any surprises after moving to Spain.

Many people who move to Spain initially opt for private health insurance. This applies, for example, to people who do not yet have access to the Spanish social security system or to holders of certain residence permits for which private health insurance is mandatory.

Private insurance provides access to an extensive network of private clinics, hospitals, and specialists. As a result, patients can often receive examinations, treatments, and specialized care more quickly than they would within the public healthcare system.

Many residents ultimately opt for a combination of public and private healthcare. This allows them to benefit from the comprehensive coverage of the public system and the shorter wait times in the private system.

Benefits of private health insurance

• Faster access to specialists
• Shorter wait times for tests and treatments
• More freedom of choice in doctors and hospitals
• Access to private clinics
• Option to receive medical care in multiple languages

Popular health insurance providers in Spain

Some well-known providers of private health insurance are:

• Health
• Adeslas
• Asisa
• DKV
• Mapfre

The premium depends on factors such as age, health, coverage, and any pre-existing medical conditions. On average, the cost is often between €50 and €200 per month per person, depending on the plan selected.

Which insurance plan is right for your situation?

The right choice depends on your personal circumstances. Are you retired, do you work in Spain, or are you planning to move there? If so, your options can vary significantly.

It is therefore a good idea to carefully research in advance which type of healthcare and insurance best suits your situation and future plans in Spain.

Please be aware of any existing medical conditions

When you purchase private health insurance in Spain, it is important to take existing medical conditions into account. Most insurers will ask for your medical history in advance through a health declaration.

Depending on the insurer and the medical condition, different terms and conditions may apply. In some cases, pre-existing conditions may be excluded from coverage, a higher premium may be charged, or the insurer may impose a waiting period before certain treatments are reimbursed.

That is why it is wise to carefully review the coverage offered in advance and always disclose any pre-existing medical conditions honestly when applying for insurance.

If you are enrolled in the public health care system in Spain, you will typically be registered with a local health center (Centro de Salud) and assigned a primary care physician. This physician is your first point of contact for medical questions and can refer you to a specialist or hospital if necessary.

Many residents find the Spanish primary care system to be accessible and well-organized. Depending on where you live, you may be able to switch doctors or indicate a preference.

Find a general practitioner or specialist

In the public healthcare system, specialist care is usually provided through a referral from your primary care physician. Do you have private health insurance? If so, you can often make an appointment directly with a specialist within your insurer’s network.

In the larger cities and popular areas along the Costa Blanca, you’ll also find many international medical practices where multiple languages are spoken, including English and sometimes even Dutch.

Dental Care in Spain

In most cases, dental care is not covered by public health insurance. That is why many residents use private dental practices.

Spain has a wide range of modern dental practices, and costs are often lower than in many Northern European countries. As a result, some people even choose to have more extensive dental work done in Spain.

Medical care on the Costa Blanca

If you live on the Costa Blanca—for example, in Ciudad Quesada, Torrevieja, or Orihuela Costa—you have access to a variety of health centers, private clinics, and modern hospitals in the region.

For many people who emigrate to Spain, the availability of good medical facilities is an important factor in choosing where to live.

The quality of healthcare in Spain is high, but as in many other European countries, there may be waiting times for non-urgent treatments and specialist care.

The exact wait time depends on various factors, such as:

• the region where you live;
• the type of specialist;
• the urgency of the treatment;
• the busy atmosphere inside the hospital in question.

Of course, immediate care is provided for emergencies and urgent medical situations. However, for less urgent treatments, you may have to wait several weeks or months for an appointment with a specialist or a scheduled surgery.

Public versus private healthcare

One of the main reasons why many people in Spain choose to take out private supplemental health insurance is to reduce waiting times.

Within the private healthcare system, patients can often receive faster access to:

• specialist consultations;
• medical examinations;
• scans and diagnostics;
• scheduled surgeries.

As a result, many people opt for a combination of public and private healthcare so they can take advantage of the benefits of both systems.

Regional differences

Waiting times can vary across Spain’s regions. In popular areas such as the Costa Blanca, modern hospitals and medical centers are available, but even here, waiting times within the public healthcare system can vary.

For people who are moving to Spain permanently, it is therefore a good idea to find out in advance what healthcare services are available in the region where they plan to live.

Spain has an excellent healthcare system for pregnancy and childbirth. Both the public and private healthcare sectors offer modern medical facilities, and pregnant women receive close monitoring throughout their pregnancy.

If you are enrolled in the Spanish public healthcare system or have private insurance that covers pregnancy, the costs of prenatal checkups, childbirth, and postnatal care are often reimbursed in full or in part. It is important to check the terms of your insurance policy in advance, as some private insurance plans have a waiting period for maternity care.

Prenatal care in Spain

During pregnancy, regular checkups are conducted by a midwife, gynecologist, or specialist. In addition, ultrasounds, blood tests, and other medical examinations are performed to monitor the health of the mother and child.

Spanish hospitals are known for their modern facilities and high-quality care. In many regions, you can choose between public hospitals and private clinics.

Giving birth as an expat in Spain

For people who are emigrating to Spain or living there temporarily, it is important to thoroughly research the health insurance system in advance. Access to prenatal care and coverage for childbirth may vary depending on your residency status and insurance plan.

That is why it is a good idea to find out well in advance of your pregnancy or move to Spain which healthcare provisions apply to your situation.

Healthcare for families

For many families considering a move to Spain, the quality of healthcare is a key factor. Thanks to the excellent medical facilities, modern hospitals, and comprehensive prenatal care, many families choose to settle permanently in Spain.