Healthcare in Spain

Perhaps, Spain is the first European country that comes to mind when discussing healthcare today. Of course the climate, clean air, and Mediterranean dietary habits contribute to overall well-being in the country, yet an efficient healthcare system plays a central role as well. It is also one of the reasons why many expats prefer to buy a home in Spain.

Recognized as one of the best healthcare systems in the world, healthcare for expats in Spain​ consistently ranks high in global health indexes, and life expectancy remains among the highest in Europe, with an average of over 83 years. This success is mainly supported by Spain’s public health system, modern private hospitals, well-trained doctors, and widespread access across the country.

As free healthcare in Spain for expats​ has always been an important topic, the country gives both locals and foreigners excellent opportunities in this regard. For instance, EU citizens can benefit from healthcare services on the same terms as Spanish citizens. On the other hand, non-EU citizens can register in the social security system with a valid work permit and gain the same rights. However, a few details can become complex about Spain’s healthcare for expats at some point.

That is why, as Spain Homes ® professionals, we have prepared this blog about healthcare for expats living in Spain. Our aim is to inform you about everything you need to know while you are integrating into Spanish society as a foreigner.

Public vs. Private Healthcare in Spain for Expats: How the System Works?

Spain operates under a universal healthcare model known as the National Health System (Sistema Nacional de Salud / SNS). Following a social state approach, it is mainly funded through taxation and social security contributions. At the same time, private healthcare is widely used and complements the public system, too. Now, let’s see how these two systems function together!

Public Healthcare in Spain

Public healthcare in Spain offers comprehensive coverage throughout the country. There is a wide network of modern hospitals and healthcare centers providing efficient services with generally reasonable waiting times for primary care.

Further, in public hospitals most services are free at the point of use once you are registered. Meanwhile, prescription medicines usually require a small co-payment based on income level (for instance, pensioners often pay reduced rates).

Before diving into details, below you can find some terms that might be useful to know about the public health system in Spain:

• The SIP Card (Tarjeta Sanitaria Individual) is the physical health card you receive in Spain after you register in the public healthcare system. It allows you to visit your GP, access hospitals, and receive prescriptions within the country.
• The S1 Form is a document used within the EU. It allows someone who is insured in one EU country to access public healthcare in another EU country.
• The Convenio Especial (Public Health Pay-in Scheme) is a system that allows legal residents in the country to access the public healthcare system by paying a monthly fee. The fee is generally around €60-€157 depending on age. It is suitable mainly for people who are not working, not retired, and not covered through social security or an S1 form.

Do expats get free healthcare in Spain?

Yes, expats can get free public healthcare in Spain, but only if they are properly registered in the National Health System. In order to apply for a SIP Card and register in the system, you must be either:

• Working and paying into Spanish Social Security (Seguridad Social)
• Be covered through an S1 form
• Join the public system via the Public Pay-In Scheme (Convenio Especial)
• Qualify as a resident under specific conditions.

How to get public health insurance in Spain?

As can be understood from the information above, the eligibility of expat health insurance in Spain depends on your residency status, employment situation, and visa category. So the way to obtain it also may change depending on your condition. We can analyze the procedure of obtaining Spain’s health insurance for foreigners in three categories:

For Employees in Spain

If you are legally employed and paying taxes in Spain, your healthcare rights will be equal to those of Spanish citizens. Social Security contributions are deducted directly from your salary, and your employer arranges these payments on your behalf.

On the other hand, if you are self-employed, you are responsible for paying your own monthly Social Security contributions. Therefore, you should complete your legal registration as soon as possible.

In order to register, you must obtain a Social Security number, work and pay into the system, register at your local health center (centro de salud), and apply for your SIP card.

For Retirees in Spain

Healthcare for retired expats in Spain is also accessible under certain conditions. All EU and EEA retirees living in Spain can benefit from the same rights as Spanish retirees, as long as they hold the S1 form. This form is designed to transfer your healthcare rights from your home country to Spain.

So, if you are retired, you should request an S1 form from your home country. Once you arrive in Spain, register it with Social Security (Seguridad Social) and apply for your Spanish health card. After registration, you will receive a temporary card.

And when your registration is completed, you can register at your local health center (centro de salud) in Spain, where you will be assigned a family doctor. With this approach, Spain will provide your healthcare, but your home country will reimburse the cost.

As a side note, since it may take a while to receive the permanent card, it would be better to keep the application documents with you during this transition period.

For Unemployed Residents

If you are not retired, don’t have an S1 form or if you are not currently working in Spain, you cannot get into the Spanish Public Healthcare System. In this case, it would be better to get private health insurance in Spain for expats​ unless you are eligible for Convenio Especial, the public health pay-in scheme that allows residents to join the system by paying a monthly fee.

What public healthcare typically covers in Spain?

• General practitioner (GP) visits
• Specialist consultations (with referral)
• Hospital treatments and surgeries
• Emergency services
• Maternity and pediatric care
• Chronic disease management
• Subsidized prescription medications

Overall, we can say that public healthcare in Spain is organized regionally, but standards remain high nationwide.

Private Healthcare in Spain

Private hospitals and clinics within the country are modern and well-equipped, especially in cities like Madrid, Barcelona, Málaga, Valencia, and Alicante. Therefore it is widely used, even among Spanish citizens. Nowadays, around 20-30% of residents prefer to hold private health insurance in Spain alongside public coverage.

How much is private health insurance in Spain​?

As of February 2026, private health insurance usually costs between €50 and €150 per month per person in Spain, depending on age and coverage level.

With private health insurance for expats in Spain​, you can:

• Reduce waiting times
• Access specialists directly without GP referrals
• Choose doctors and hospitals freely
• Receive more personalized attention
• Find English-speaking professionals more easily

Also you should note that some foreigners rely fully on private expat health insurance in Spain​, particularly during their first years while others combine both systems, using public healthcare for major treatments and private services for routine or faster access.

Visa-Specific Healthcare Rules in Spain

Health insurance for expats in Spain​ also depends on the type of visa you hold:

Healthcare for Digital Nomad Visa (DNV) Holders in Spain

With Spain’s Digital Nomad Visa, healthcare access becomes possible for remote workers who choose to live in the country while continuing to work for foreign employers or clients. However, in Spain Digital Nomad Visa health insurance requirements vary according to your employment and social security status. For instance:

• If you are employed by a foreign company but register and contribute to the Spanish social security system, you will gain access to Spain’s public healthcare system once your contributions start.
• If you register as an autónomo (self-employed) in Spain, you must pay monthly social security contributions. After registration, you will be included in the public system.
• If you remain affiliated with a foreign social security system and do not contribute to the Spanish system, you will typically need to obtain comprehensive private health insurance.

Healthcare for Non-Lucrative Visa (NLV) Holders in Spain

Meanwhile, Spain’s health insurance for Non-Lucrative Visa requires strict policies to meet such as:

• Zero deductible and no co-payment
• Coverage equivalent to the Spanish public healthcare system
• Valid throughout Spain
• Minimum one-year validity
• Full hospitalization and specialist coverage

Applicants must present proof of compliant insurance during the visa application. The policy must remain active during residency renewals. It also should be noted that travel insurance is not accepted because it does not provide comprehensive or long-term protection.

Additionally, the requirement of zero deductible and no co-payment (“sin copagos”) ensures that Spanish Non-Lucrative Visa holders have truly comprehensive private health coverage that functions similarly to Spain’s public healthcare system. This means policyholders can access general practitioners, specialists, diagnostic tests, emergency services, and hospitalization without making any additional payments at the time of treatment.

Healthcare Rights for Dependents

Family members who relocate under family reunification can access healthcare through the main applicant.

• If the primary applicant contributes to Spanish social security, spouses and dependent children are usually covered under the public healthcare system.
• If the main applicant holds private insurance (such as Non-Lucrative Visa holders), dependents must also be included in the same compliant private policy. In other words, the policy must meet the official requirements for health insurance for Spain visa applications, including full coverage, no co-payments, and minimum one-year validity.
• Meanwhile, in some cases, separate private insurance may be required if dependents do not qualify automatically.

Emergency Services, Mental Health Support and Dental Care in Spain

As we have stated above, Centro de Salud is your assigned primary healthcare center. You visit it for routine matters such as check-ups, prescription renewals, and referrals to specialists. Appointments are made through the “Cita Previa” (appointment) system, which operates online, by phone, or via regional mobile applications.

On the other hand, Urgencias refers to emergency services. These are available 24/7 in hospitals and certain health centers. Urgencias is intended for serious or urgent medical situations. For life-threatening emergencies, you can call 112.

On the other hand, mental health services are available in Spain’s public system, but access typically requires a GP referral and waiting times may apply. So, we can say that private insurance often provides faster access to psychologists and psychiatrists.

Dental care in the public system is limited and generally covers only emergency treatments. Therefore, most residents rely on private dental clinics for routine and specialist care. As a result, expat dental insurance in Spain has become a popular and affordable option, offering coverage for check-ups, cleanings, fillings, and other common procedures.

To sum up, we can say that Spain offers one of the most structured and accessible healthcare systems in Europe. While public healthcare provides extensive coverage through social security contributions, private insurance adds flexibility and speed.

Frequently Asked Questions