Health Insurance in Spain for Expats (2026 Guide)
Health insurance in Spain is not just another policy for expats — it is a legal requirement, a gateway to healthcare access, and a key factor in visa approval and long-term stability.
Whether you are moving to Spain, renewing a residence permit, retiring, studying, or settling long term, understanding how health insurance works gives you clarity and control.
This guide focuses specifically on health insurance and healthcare access.
For a complete overview of all insurance types expats need in Spain — including home, car, life, travel and visa-related coverage — see our central reference: Expat Insurance Guide Spain.
Table of Contents
- Health Insurance in Spain — The Essentials
- Public vs Private Healthcare (Overview)
- When Private Health Insurance Is Required
- Spain Visa Health Insurance Requirements
- What Proper Coverage Looks Like
- Seniors & Pre-Existing Conditions
- Cost Ranges in 2026
- How to Compare Plans Correctly
- Step-by-Step: How Expats Get Insured
- Common Mistakes
- Related Guides
- Faqs
- Get Visa-Ready Health Insurance
Health Insurance in Spain — The Essentials
Spain has one of Europe’s strongest healthcare systems, but access depends on your legal and employment status.
- Public healthcare (SNS) is available through Social Security eligibility
- Private healthcare is required for most non-EU expats at the beginning
If you want to understand how healthcare works in practice, including doctors, hospitals, waiting times and prescriptions, see:
Public vs Private Healthcare (Overview)
Spain’s public system is managed by the Spanish National Health System (SNS) under the Ministry of Health.
Official reference:
Public Healthcare (SNS)
- Funded through Social Security
- High quality, nationwide
- Often requires eligibility and referrals
- Long waiting times in many regions
Private Healthcare
- Faster specialist access
- Direct appointments
- English-friendly clinics
- Nationwide hospital networks
Most expats rely on private healthcare initially, even if they later gain public access.
When Private Health Insurance Is Required
Private health insurance is typically required if you are:
- Applying for a long-stay visa
- Renewing residency without Social Security
- Retired or not employed in Spain
- A student
- A digital nomad before Social Security registration
Travel insurance and basic international plans do not qualify.
Health insurance is only one step in the relocation process. For the correct order of visas, documents, registration and setup, follow our complete Moving to Spain Checklist.
For most non-EU expats, health insurance in Spain is not a personal preference — it is defined by immigration law.
Each residence visa establishes specific insurance requirements. Choosing a policy that does not fully comply is one of the most common reasons for visa delays or rejections.
Before choosing any plan, it’s essential to understand how health insurance fits into your specific visa pathway and legal status in Spain.
Spain Visa Health Insurance Requirements
Spanish consulates apply strict rules from the Ministry of Foreign Affairs (MAEC).
Official authority:
A compliant policy must:
- Cover medical care equivalent to the public system
- Include hospitalization and emergencies
- Have no copayments
- Have no waiting periods
- Be valid nationwide
- Be issued by a Spanish-authorized insurer
Health insurance is only one part of the residency process. To understand how insurance fits into each visa pathway, see our complete overview of Spanish Residence Visa and Permits.
Full legal checklist:
Private health insurance is mandatory for most long-stay residence permits, especially for applicants under the Non-Lucrative / Retirement Visa Spain and the Digital Nomad Visa Spain, where consulates require full private coverage with no copayments or waiting periods.
What Proper Coverage Looks Like Required
A valid expat policy typically includes:
- GP & specialist visits
- Diagnostics & imaging
- Hospitalization & surgery
- Emergency & ICU
- Oncology
- Ambulance services
Repatriation is strongly recommended, especially for non-EU expats.
Seniors & Pre-Existing Conditions
Insurers assess:
- Age
- Medical history
- Pre-existing conditions
Coverage for expats aged 70–75+ is limited but possible.
Repatriation is strongly recommended.
Coverage for expats aged 70–75+ is limited but possible.
All insurers operating legally must be authorised by Spain’s insurance regulator:
Cost Ranges in 2026
Typical monthly costs:
- 18–35 → €40–€70
- 35–50 → €70–€120
- 50–65 → €120–€180
- 65–70 → €150–€250
- 70–75+ → €180–€310+
How to Compare Plans Correctly
Always check:
- Visa compliance
- Copayments (must be zero for most visas)
- Waiting periods
- Hospital network quality
- Language accessibility
For a practical breakdown of policy options, see Private Health Insurance Options for Expats in Spain:
Step-by-Step: How Expats Get Insured
- Share your situation
- Compare compliant plans
- Choose confidently
- Receive certificate (often same day)
Common Mistakes
- Buying travel insurance for visas
- Choosing the cheapest plan without checking coverage
- Assuming public healthcare is automatic
If you still have practical questions about visas, residency or healthcare after reading this guide, see our Spain Expat FAQ for clear answers to the most common expat doubts.
Related Guides
Related Insurance Products
FAQs
Do expats need private health insurance?
Yes, in most visa and early residency situations.
Does travel insurance work for Spanish visas?
No.
Get Visa-Ready Health Insurance
- Visa-approved coverage
- No copays
- No waiting periods
- Full hospitalization
- Certificates accepted by all consulates