Global Medical Health Insurance for International Citizens Living in Spain
Spain has a comprehensive, cost-efficient universal public healthcare program that is one of the best in the world. According to the WHO report, Spain’s healthcare system is ranked 7th overall. It also has one of the highest life expectancy rates. Health insurance in Spain is known as the Sistema Nacional de Salud (SNS).
In general, standards in Spain’s health practices are very high. Spain’s 454 SNS hospitals are modern and provide state-of-the-art diagnostic equipment. Spanish doctors must pass rigorous exams to obtain their medical licenses. However, island residents or those in more remote areas often need to travel to larger centers for specialized care. That being said, even small villages usually have at least one health clinic, although some operate with limited hours.
Despite operating at a highly sophisticated level, the SNS is relatively new compared to many other European countries. It only came into effect in 1986 through the General Health Law. Previously, Spain had mandatory health insurance through employment taxation.
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Costs of Medical Care for Expats in Spain
Spain spends between 9% and 10% of its GDP on healthcare. The public system is funded through social security contributions.
Each region of the country is responsible for its budget, which the federal government allocates. There are no co-pays for any doctor visit in Spain. Most tests, services, and procedures are also included in the public system.
However, modest fees apply to ambulance use if the service is deemed non-life-threatening. Furthermore, dental care is not included in the SNS system, except for children under 15 years of age.
For those not covered by private insurance or the public health system, the average cost of an emergency room visit is €200, and the average cost of a doctor’s visit is €100.
Private vs Public Healthcare in Spain
Nearly 99% of the Spanish population has some form of health insurance. Approximately 90% of Spaniards utilize the public healthcare system, while about 19% hold private health insurance. This number has grown by 5% in the past five years.
While the standard of public healthcare in Spain is excellent, there are several points of frustration among those who use it.
One issue is wait times for specialist appointments and surgical procedures. The wait times for non-urgent and elective procedures have increased dramatically in the past several years.
It’s a hot topic of debate among locals! If you anticipate seeing multiple specialists during your healthcare, having private health insurance to supplement your public care will save you significant time and aggravation.
Receiving care through the private medical system also generally means greater comfort and privacy, such as having a private hospital room.
Private Spanish insurance also greatly improves your access to multilingual staff members. While most Spanish physicians speak English, it’s certainly not guaranteed in the public system. If this is a concern for you, accessing care through the private medical system will help tremendously.
Finally, one big advantage of private health insurance is that there are Spanish insurance plans that include dental coverage. Without medical insurance, dental visits and special procedures can become very costly, very quickly.
Pros and Cons of Spain’s Healthcare System
Overall, the SNS is an excellent public healthcare system. There are no co-payments for patients, and no claims need to be filed.
There are no financial incentives for doctors to prescribe certain medications or treatments; therefore, patients usually receive the most cost-effective treatment option.
However, on the downside, certain things are not covered. The list includes most pharmacy prescriptions and dental care.
Additionally, while many physicians are multilingual, in rural areas, staff are often limited, making it harder to find a doctor who speaks English or another language.
Eligibility For Healthcare in Spain
If you’re living and working legally in Spain, you’ll have access to state-funded Spanish healthcare. Yes, this even applies to expats, digital nomads, and those not enrolled in traditional employment!
Those who are self-employed, pay social security contributions, and are legal residents can qualify.
As well, if you’re a retired senior citizen living in Spain as a permanent resident, you’ll also have access to the public healthcare program.
Additionally, undocumented immigrants have the right to healthcare if they go through a public emergency room.
It all sounds reasonably straightforward, but of course, there are always exceptions and rules to consider. Any EU resident with a European Health Insurance Card (EHIC) can access the benefits of the Spanish public healthcare system.
However, you must apply for your free EHIC before you travel. Visitors from Andorra, Brazil, Chile, Ecuador, and Peru are also entitled to receive basic healthcare, as these countries have reciprocal healthcare arrangements with Spain.
Coverage is granted to registered students under 26. However, university students over 26 are generally not automatically covered (though their university may offer additional options). Children are automatically covered through their parents’ coverage.
Considering Spanish Health Insurance as an Expatriate
Local councils play a crucial role in administering health-related services within each region. However, their resources can vary by region and different priorities.
Some of these regions, for instance, have excellent resources for seniors, while others have more limited resources. In general, resources in rural areas are more limited.
Patients may need to travel to cities for more advanced tests and specialist appointments.
Global Medical Plan Options for Expats in Spain
In Spain, waiting times are a hot topic of conversation. In fairness, the wait times are generally not that bad. Spain actually has one of the lowest rates of patient deaths resulting from delayed treatment in the world.
However, at any given time, approximately half a million people are waiting for non-urgent procedures.
Perhaps not surprisingly, the number of people with private health insurance has increased by about 5% since 2012.
Having private health insurance reduces wait times and ensures comfortable, more private treatment facilities.
In Spain, dental care isn’t covered by the public healthcare system. The exception is for children under 15, who are entitled to free dental care; however, this is the only exception.
When selecting a global medical insurance plan, ensure you choose a package that includes dental coverage.
Best International Health Insurance Plans for Expats in Spain
A private international health insurance plan offers several benefits over local Spanish plans. Most importantly, they offer worldwide coverage, so you are wherever you are.
Additionally, they are designed to be more comprehensive, giving you access to a wider range of healthcare facilities and doctors.
For other options, view our list of the best global medical health insurance companies.
Health Insurance for Foreigners Living in Spain
Cigna Global Insurance Plan
- Flexible plans tailored to your needs and budget
- 1.5M+ providers in 200+ countries
- 24/7 multilingual customer support
IMG Global Prima Medical Insurance
- Five flexible plan levels with optional add-ons
- Choose your coverage area based on where you live or travel
- Freedom to select your healthcare provider anywhere in the world
Best Insurance for US Citizens Living in Spain
BCBS Global Solutions Worldwide Premier
- Unlimited annual and lifetime coverage
- Pre-existing conditions covered with prior insurance
- For U.S. citizens abroad or foreign nationals in the U.S.
Short-Term Insurance in Spain for Visitors
Short-term visitors and travelers to Spain are responsible for covering their own healthcare costs. They are not eligible for the benefits of the public health system.
If this applies to you, you must have your own travel insurance to cover any health or personal emergencies that might come up while you are on the road.
If you’re in Spain to pursue adventure sports, such as cave exploration, mountaineering, or skiing, ensure your insurance covers these activities. They are rarely included in standard travel insurance.
Find the Best International Medical Insurance
- Compare multiple quotes from top insurers
- Get expert advice at no additional cost
- Find the right plan for your needs and budget
Joe Cronin, President of ICI, is a leading expert in international health, life, and travel insurance. An MBA and founder of multiple global businesses, he helps expatriates and travelers access trusted, comprehensive insurance solutions worldwide.
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