Can I use NHS coverage in Spain?

The UK Global Health Insurance Card (GHIC) only covers temporary stays, not residency. Once you're a Spanish resident, you need Spanish coverage. S1 form provides limited coverage for UK pensioners but has restrictions.

What happens if I have a pre-existing condition?

Most insurers have a waiting period for pre-existing conditions (typically 6-12 months). Some may exclude them entirely or charge higher premiums. Be honest on your application - insurers can void your policy if you don't disclose.

Is emergency treatment free?

Public hospitals will treat emergencies regardless of insurance status. However, if you're not entitled to public healthcare, you may be billed afterward. Private insurance avoids this risk.

Which hospitals accept my insurance?

Check with your insurer for their network. In Marbella, major private hospitals like HC Marbella, Quirónsalud Marbella, and Hospital Ochoa work with most major insurers.

Health Insurance for Expats

Health Insurance in Spain: What Expats Need to Know

If you're moving to Spain, you'll need health insurance. It's required for visa applications and residency renewals. Even if you qualify for public healthcare, private insurance gives you faster access, English-speaking doctors, and more choice.

Here's what you need to know.

For Visa Applications

If you're applying for a Non-Lucrative Visa, Digital Nomad Visa, or other residency permit, you must have private health insurance. The requirements are specific:

Must have:

Full coverage in Spain (no geographic restrictions)

No co-payments (copagos) - the policy must cover 100% of costs

No deductibles (franquicias) for medical care

Coverage for hospitalisation, surgery, and specialist care

At least one year validity from visa application date

Why this matters:

Standard Spanish health policies often have co-payments (you pay €20-50 per specialist visit, etc.). These policies are rejected for visa applications. You need "sin copago" (without co-payment) coverage.

Recommended Providers

Sanitas Expat

Sanitas is Spain's largest health insurer, part of Bupa. Their expat-specific policies meet visa requirements.

Sanitas Estrellas:

Full coverage, no co-payments

Access to Sanitas network (extensive in Marbella area)

English-speaking customer service

Prices from €60-150/month depending on age

Caser Expat Insurance

Caser is a major Spanish insurer with policies designed for foreigners.

Caser Integral:

Visa-compliant coverage

Good network on Costa del Sol

Currently offering 30% discount on new policies

Prices competitive with Sanitas

Other Options

DKV: German insurer with good Spanish network. Slightly more expensive but comprehensive. Cigna Global: International coverage. Good if you travel frequently or might return to your home country. Asisa: Spanish cooperative insurer. Competitive prices, solid coverage.

What Does Insurance Cost?

Prices depend on your age and coverage level. Rough monthly costs for visa-compliant policies:

| Age | Basic | Comprehensive | |-----|-------|---------------| | 30s | €60-80 | €90-120 | | 40s | €80-100 | €110-150 | | 50s | €100-150 | €150-200 | | 60s | €150-250 | €220-350 | | 70+ | €250-400+ | €350-500+ |

Pre-existing conditions may increase premiums or be excluded from coverage.

Using a Broker

Insurance brokers like C1 Broker work with multiple providers and can find the best policy for your situation. They don't charge you - they're paid commission by the insurer. Worth using if you're unsure what you need or want to compare options.

After You Have Residency

Once you have residency and are working or paying into Spanish social security, you're entitled to public healthcare. You get a health card (tarjeta sanitaria) and can use public hospitals and clinics.

But many expats keep private insurance because:

Shorter waiting times (public system can mean months for specialist appointments)

English-speaking doctors more common in private

More choice of when and where to be treated

Dental and optical coverage (not included in public system)

The Convenio Especial

If you're retired or not working, you may not qualify for public healthcare through social security. Spain offers a "convenio especial" - paying into the public system voluntarily.

Cost: Around €60/month under 65, €160/month over 65 Pros: Access to full public healthcare Cons: Often long waits, Spanish language, may not cover everything private does

Many expats use the convenio especial as backup while maintaining basic private insurance for day-to-day care.

Emergency Care

In an emergency, everyone receives treatment at public hospitals regardless of insurance status. You won't be turned away. But for non-emergency care, you need either public healthcare rights or private insurance.

Dental and Optical

Neither public healthcare nor most basic private policies cover dental or optical care. You'll pay out of pocket or need to add dental coverage to your policy (typically €10-30/month extra).

Good news: dental care in Spain is much cheaper than the UK. A filling might cost €50-80, a crown €300-500.

Making a Claim

Private insurers in Spain work differently than the UK:

Direct billing: Most providers have agreements with the major insurers. You show your card, get treated, and the insurer pays directly. You pay nothing. Reimbursement: For providers outside the network, you pay and submit receipts for reimbursement. Authorisation: Some treatments require pre-authorisation from your insurer. Check your policy.