Health Insurance for Foreigners in Spain

How Does Health Insurance Work in Spain?

Foreigners in Spain have three main coverage options: the tax-funded public healthcare system, Spanish private health insurance, and international health insurance. Eligible residents can access public healthcare, while others may need a private plan.

The right choice depends on your residency status, eligibility for public healthcare, medical needs, and whether you need coverage outside Spain. Some foreigners also need a qualifying private policy to meet visa or residency requirements.

• Spain’s public healthcare system: Employees and the self-employed generally access it through Social Security registration. Other eligible residents may qualify through different arrangements, including the convenio especial (special healthcare agreement). This is a paid public healthcare scheme for residents who do not otherwise qualify for publicly funded care.
• Spanish private health insurance: Local insurers offer plans that provide access to networks of private doctors, specialists, and hospitals. These often work alongside the public system.
• International health insurance: Global plans provide private medical coverage for expats living in Spain. They can be useful for people who often travel, move between countries, or need coverage across multiple countries.

The main difference between local and international plans is where you can receive treatment. Spanish private plans generally focus on treatment within Spain, while global plans can cover medical care across multiple countries.

The 17 autonomous communities (comunidades autónomas) manage Spain’s public healthcare system. As a result, registration procedures, local services, and waiting times vary by region.

For more information about eligibility, registration, and accessing public healthcare, see our Healthcare in Spain guide.

What Health Insurance Do You Need?

Use the table below to identify the type of coverage that may suit your situation.

Travel Health Insurance for Spain

If you are visiting Spain for a vacation, business trip, or other short stay, travel medical insurance is generally more suitable than a long-term health plan.

Travel policies focus on unexpected medical needs during a trip rather than ongoing healthcare. Learn more about the differences between travel and international health insurance.

Travelers who need a Schengen visa must have medical coverage of at least €30,000 for emergency treatment, hospitalization, and medical repatriation. This must be valid throughout the Schengen Area for their intended stay. See our Schengen visa insurance requirements for details.

Eligible EU, EEA, and Swiss visitors may use a European Health Insurance Card (EHIC), while eligible UK visitors may use a Global Health Insurance Card (GHIC). These cards provide access to medically necessary public healthcare under applicable rules. However, they do not cover private treatment or medical repatriation.

For more information, see our Travel Insurance for Spain guide.

Best Health Insurance for Foreigners in Spain

We recommend the following global medical plans for foreigners who want comprehensive private coverage in Spain and other countries. These recommendations focus on medical benefits, geographic area, and access to healthcare providers.

Important for visa applicants: These plans offer global medical coverage, but we do not specifically recommend them for Spanish visa compliance. Some visas require policies from insurers authorized to operate in Spain, without deductibles, copayments, or waiting periods. Confirm that the insurer and policy meet your consulate’s rules before applying.

Cigna Global: Choose Optional Benefits Around Core Medical Coverage

Cigna Global lets you build on core medical coverage with optional benefits for outpatient care, medical evacuation, health and wellbeing, and dental and vision care.

To cover routine doctor visits and outpatient prescriptions, you generally need to add the Outpatient module.

IMG Global Prima: A Europe-Only Coverage Option

IMG Global Prima Medical Insurance is worth considering if you want coverage in Spain and other European countries without selecting a worldwide policy. Its Europe-only coverage area is defined by the policy’s country list, so check that it includes every destination where you expect to receive care.

Choose from five benefit levels and compare outpatient benefits, excesses and optional dental or routine maternity coverage. Treatment outside your selected area is restricted, and optional benefits have waiting periods.

BCBS Global Solutions Worldwide Premier: Coverage in Spain and the U.S.

BCBS Global Solutions Worldwide Premier is worth considering for U.S. citizens living in Spain who also want medical coverage during return visits to the United States.

The plan also includes access to the Blue Cross Blue Shield network in the U.S. and unlimited annual and lifetime medical maximums.

Individual benefit limits and out-of-pocket costs still apply. Before applying, confirm your eligibility and whether your prior health insurance qualifies you for immediate coverage of pre-existing conditions.

What Do Global Medical Plans Cover?

Global medical plans typically cover hospital stays, doctor visits, specialist care, diagnostic tests, and prescription medications. Depending on the policy, extra benefits may include mental health services, maternity care, and dental or vision treatment.

Before choosing a plan, review its coverage limits, deductibles, coinsurance, waiting periods, exclusions, and pre-existing condition terms. Check whether the geographic area meets your needs in Spain, across Europe, or worldwide.

For a detailed breakdown of benefits and available options, see our International Health Insurance guide.

Is International Health Insurance Worth It in Spain?

An international plan may be worthwhile if you want private healthcare in Spain and coverage in other countries. It can be useful if you travel often, split your time between countries, or want to keep your private health cover when you move abroad.

However, a global plan isn’t necessary for everyone. If you qualify for Spanish public healthcare and primarily need treatment within Spain, a local private policy alongside public coverage may be sufficient and often costs less.

The key consideration is whether you need private medical coverage mainly in Spain or across multiple countries. Compare the costs, benefits, and geographic area of local and global policies before deciding.

Health Insurance for a Non-Lucrative Visa

Spain’s Non-Lucrative Residence Visa (NLV) allows non-EU citizens to live in Spain without working there. Applicants must provide evidence of qualifying healthcare coverage.

The requirements below apply to applications submitted through Manchester. Its published non-lucrative visa checklist requires a public or private health insurance certificate from an insurer authorized to operate in Spain. The policy must provide:

• Coverage for all risks covered by Spain’s public healthcare system
• Unlimited medical coverage
• No excess or deductibles
• No copayments
• No waiting periods

Manchester also accepts a receipt confirming online registration of a Social Security S1 form as an alternative.

Coverage duration must meet the requirements of the consulate handling the application. For example, the Spanish Consulate in Los Angeles explicitly requires insurance valid for one year.

International health insurance plans do not automatically qualify. Before purchasing a policy, confirm its benefits, coverage dates, insurer eligibility, and supporting documents against your consulate’s current requirements.

How Much Is Health Insurance in Spain?

Health insurance costs in Spain depend on the type of coverage you choose. Spanish public healthcare is usually free at the point of use for eligible services, while the convenio especial has fixed monthly contributions.

Private and international plan premiums vary by age, benefits, deductibles and cost-sharing arrangements, as well as geographic coverage. Optional benefits, such as dental, vision, or maternity insurance, may increase premiums.

* Source: Spanish Ministry of Health – Convenio Especial. Published statutory monthly rates, applicable in 2026. Check the official source for updates and any applicable regional charges.

** Source: Rastreator, Health Insurance Price Index (2025). Figures reflect average premiums recorded through its comparison service, not guaranteed prices or premiums specifically for visa-compliant policies.

*** Source: International Citizens Insurance (2026). Average monthly equivalents are calculated from annual premiums and converted to euros using the ECB reference rate on 7 October 2026 (€1 = US$1.1177). Individual premiums and payment schedules vary; these are illustrative costs, not guaranteed or visa-specific quotes.

For a more accurate estimate of global medical premiums, request a personalized quote based on your age, healthcare needs, and preferred benefits.

Using Private Healthcare in Spain

A private policy generally gives you access to doctors, specialists, clinics, and hospitals in its network. How you receive treatment and pay for it depends on your insurer and policy.

Spain has a well-developed private healthcare sector, especially in major cities and popular expatriate areas. Some private healthcare providers offer services in English and other languages.

Private plans may use different payment arrangements:

• Direct billing: The insurer pays an approved healthcare provider directly, reducing the amount you need to pay upfront.
• Reimbursement: You pay for treatment and submit a claim to your insurer.
• Pre-authorization: Certain treatments, such as surgery or hospital stays, may require approval before you receive care.

Spanish insurers generally provide a cuadro médico, or directory of doctors and clinics in the network. Global insurers may use provider networks or offer different arrangements for accessing treatment.

Before buying a policy, check whether your insurer covers your preferred doctors and hospitals and offers direct billing.

In an emergency, call 112, the Europe-wide emergency number. Emergency treatment is available through Spain’s public healthcare system, although eligibility for publicly funded treatment and any resulting charges depend on your situation.

For more information about medical facilities, see our guide to hospitals in Spain. To learn more about reimbursement, see our guide on how to file an international health insurance claim.

How to Get Health Insurance in Spain

To get health insurance in Spain, start by checking whether you qualify for public healthcare or need a private plan.

If you need a private plan, compare suitable policies, check provider access and exclusions, and submit an application. For a visa or residency permit, confirm the coverage requirements before buying.

Public Healthcare in Spain

If you work in Spain, your employer will generally register you with Social Security, or you can register as a self-employed worker (autónomo). This registration can establish your entitlement to public healthcare.

Some non-working residents may qualify for the convenio especial after one year of continuous registered residence in Spain. Other rules also apply. The relevant autonomous community’s health service handles applications, not Spain’s Social Security office (INSS).

Once you qualify for public healthcare, you can register at your local health center (centro de salud) and obtain your health card (tarjeta sanitaria). Documents may include your NIE or TIE and proof of local registration (padrón).

For detailed eligibility and registration instructions, see our guide to Healthcare in Spain.

Private Health Insurance in Spain

Spanish insurers such as Sanitas, Adeslas, DKV, and ASISA offer private health plans.

To apply for a Spanish private policy:

1. Choose an insurer and check that its provider network includes suitable doctors and hospitals near you.
2. Request a quote and confirm any waiting periods, copayments, deductibles, and medical underwriting requirements.
3. If applying for a visa or residency permit, verify that the policy meets your consulate’s rules, including the required coverage start date.
4. Submit the identification and application documents requested by the insurer.

You may be able to purchase a private plan before arriving in Spain. Check its start date and whether it meets your visa or residency requirements.

International Health Insurance in Spain

When choosing global coverage, consider:

• Geographic coverage (such as Europe or worldwide)
• Medical benefits and optional extras
• Deductibles and coinsurance
• Provider networks and direct billing
• Exclusions and pre-existing condition rules
• Your budget

Once you’ve identified your needs, compare global medical plans and request quotes from suitable insurers. Review each policy’s coverage, exclusions, and terms before you decide.

If you need coverage for a visa or residency application, confirm the required start date, insurer eligibility, and supporting documents before buying.

Why Work With an International Insurance Broker?

A specialist broker can help you compare plans from multiple insurers, understand policy differences, and find coverage that fits your needs.

International Citizens Insurance offers guidance from licensed advisors and personalized global medical quotes at no extra cost to you.

Learn more about the benefits of working with an international insurance broker, or get a custom quote.

Health Insurance in Spain FAQs