Guide To Obtaining Health Insurance For Expats In Spain

Around 5 million expats work in Spain. The social security benefits, work-life balance, weather, and excellent healthcare system are some of the main reasons immigrants love Spain.

Expats often wonder how the Spanish healthcare system works, if they qualify for public insurance, and if they require private insurance. Spain travel insurance solely covers travel-related events, unlike this health insurance.

Spain’s expat healthcare system is explained here before you join the 5 million expats living there.

How Does Spain’s Healthcare System Work?

Every Spanish citizen receives free health insurance under the national public healthcare system. The government fund allows this arrangement since every employed resident contributes a percentage of their wage in taxes to cover healthcare expenditures.

Spain offers private health insurance in addition to public. In this approach, you choose your provider and pay for your insurance plan. Compare plans at Insubuy or get a free price for expats in Spain at Adeslas.

Does Spain Have Free Healthcare?

Spain provides free basic public health care. However, while the majority of the medical treatments, tests, and services are free, you may be forced to pay additional fees in certain situations. For example, you may be obliged to pay an ambulance cost for non-life-threatening calls, in addition to paying additional fees for services covered by the public program.

Expat Health Insurance in Spain

Expats living and working in Spain have the option to choose one of the two following health insurance options:

• Private Insurance Provider.
• National Healthcare System (Sistema Nacional de Salud SNS).

Private Health Insurance for Expats in Spain

Even though it’s not required, many Spanish expats prefer private health insurance to state-funded. Private health insurance covers private hospitals and clinics, reducing wait times and providing English-speaking care.

Your insurance plan includes more services with a private provider than with the state. Expats choose a private healthcare provider that offers a variety of treatments because the SNS does not cover dental care.

You need private health insurance when you enter Spain until you apply for the SNS. No SNS registration means you can keep paying for private health insurance. To help you choose an insurance provider for Spain, Insubuy, Adeslas, or International Citizens Insurance will provide several firms and their products.

Private Health Insurance Companies in Spain

Here is a list of some of the best companies that offer international health insurance for expats in Spain:

• SegurCaixa Adeslas
• Axa
• Bupa (Sanitas)
• Cigna
• Allianz Worldwide

Average Cost of Private Health Insurance in Spain for Expats

The average price of private insurance for expats in Spain ranges from €100 to €200 per month. The price varies depending on your provider, which plans you pay, and your personal situation. The cost of a basic health insurance plan goes as follows:

• For a single person in their 30s: €35 ($39)
• For a family of four: €130 ($142)

If you opt for a more inclusive plan, your average costs can increase to €290 ($318) for a family. To help you choose the best plan for your stay in Spain, head on to Insubuy, Adeslas, or International Citizens Insurance to compare different policies and pick the one that suits you.

Healthcare for Retired Expats in Spain

If you’re a retired expat in Spain, you can still qualify for a public health care scheme known as ‘Convenio Especial.’ This is a national healthcare plan that you have to pay a monthly fee as follows to receive insurance coverage:

• For persons under 65 years of age: €60 ($65).
• For persons over 65 years of age: €157 ($172).

The ‘Convenio Especial’ will also cover any pre-existing conditions.

As a retiree, you can also pay for private insurance, instead of the Convenio Especial, if you wish.

National Healthcare System (Sistema Nacional de Salud SNS)

As an expat living in Spain, you qualify for public insurance during your stay there if you meet the following criteria:

• You are an employed legal resident in Spain (including freelancers and self-employed).
• You are living in Spain and receive state benefits.
• You live in Spain, and you recently divorced or separated from your spouse, who was registered with social security.
• You are a pregnant woman living in Spain.
• You are staying temporarily in Spain and possess a valid EHIC card.
• You are a family member of someone employed in Malta, who is entitled to healthcare.
• You are an international student under 26 studying in Spain (you may be required to use a private provider before entering the country— make sure you contact your university).

The National Healthcare System in Spain, also known as the Sistema Nacional de Salud (SNS), is one of the best healthcare systems in Europe. So, you will be able to get insurance for most of your healthcare needs while you are living in Spain.

What Is Included in the Spain Public Health Scheme?

The public health care system in Spain covers the following primary care services:

• All emergency services.
• Family medicine.
• Pediatric services.
• Nursing and midwives services.

The SNS does not cover the following services:

• Dental care (except for simple extractions)
• Eyeglasses

The SNS partially covers the following services:

• Prescription costs at the pharmacy (your TSI card covers around 40%)
• Surgical prostheses, orthopedic equipment, and wheelchairs.

How Do I Register for the Spanish Healthcare Plan?

After you enter Spain, you have to register with your local health center to qualify for the national healthcare plan (SNS) and receive your TSI (Tarjeta de Identidad de Extranjeros)— your Spanish healthcare card. To get your TSI, you need to follow the instructions below:

• Register your new address.
• Get your social security number.
• Prepare your documents.
• Find your local health center.

Note: During the initial settling-in period after you enter Spain, you must have valid private health insurance until you can qualify for the SNS.

Register Your New Address

As soon as you enter Spain, you have to register your new address with your local town hall (padron) and get your registration certificate (empadronamiento). You will need your registration certificate to apply for your health care card.

Get Your Social Security Number

To register for health insurance, you also have to provide your social security number, which you obtain from your employer. However, if you are self-employed or have not received your number yet, you must apply at your local social security office (Tesoreria General de la Seguridad Social (TGSS)). You can find your local social office here.

Prepare Your Documents

Before you can visit your local health care center and apply for your TSI, you need to prepare the following documents:

• Your residence card
• Your TIE (Tarjeta de Identidad de Extranjeros)
• Passport
• Your certificate of registration (retrieved from your ‘padron’)
• A document proving your right to retrieve health care issued by the social security office.

Find Your Local Health Center

Finally, find your local health facility (which varies by location in Spain). Apply for a health card with all your document. Your TSI card will arrive by mail after the social security office verifies your public health insurance eligibility.

You must show this card to your GP to get health care in Spain. Your family doctor must refer you to a specialist.

The TSI card may be called something else in Spain. Catalans receive CAP (Centre d’Atenció Primaria) cards instead of TSIs.

Facts About Spain’s Healthcare System

Here are some quick facts about Spain’s healthcare system:

• Around 90% of Spaniards use the public health insurance offered by the SNS.
• Around 19% use private health insurance.
• Spain is one of the countries that spend the most on its national healthcare system— around 10% of its GDP.
• WHO ranked the Spanish healthcare system the 7th most efficient in 2000.
• All pregnant women in Spain receive healthcare services no matter their insurance situation.
• In 2018 the Euro Health Consumer Index ranked Spain’s health care system the 19th.
• Spain is the number one country for organ transplants.