Healthcare in Spain

The Spanish Healthcare System

Spain has excellent healthcare—ranked among the best in Europe. You have two main options: the public system (Seguridad Social) and private healthcare.

Public Healthcare

The Spanish public healthcare system is high quality and covers most medical needs. Once you're in the system, it's essentially free.

Who Qualifies?

• **Employed in Spain:** Automatically covered through social security contributions

• **Self-employed (autónomo):** Covered through your contributions

• **Pensioners with S1 form:** UK state pensioners can access Spanish public healthcare

• **Residents who pay convenio especial:** A monthly fee for those not otherwise covered

How to Register

1. Get your social security number from Tesorería General de la Seguridad Social

2. Request your health card (tarjeta sanitaria) from the regional health service

3. Register at your local health centre (centro de salud)

4. Choose your GP (médico de cabecera)

In Andalucia, health services are managed by the Servicio Andaluz de Salud (SAS).

What's Covered?

• GP consultations

• Specialist referrals

• Hospital treatment

• Emergency care

• Prescriptions (small co-pay for working age, free for pensioners)

• Mental health services

The Downsides

• **Waiting times** for non-urgent specialist appointments and procedures

• **Language barrier** - most doctors speak limited English

• **Bureaucracy** - the system can be frustrating to navigate

• **No choice** of specialist - you see whoever is assigned

Private Healthcare

Most expats use private healthcare, either exclusively or alongside public care. It's faster, more comfortable, and English-speaking doctors are easier to find.

Private Health Insurance

• **Sanitas** - Largest, wide network

• **Adeslas** - Good coverage, competitive

• **ASISA** - Affordable, decent network

• **DKV** - Known for customer service

• **AXA** - International, good for travelers

• 30-40 years old: €50-80/month

• 50-60 years old: €80-120/month

• Over 65: €120-200/month

What Insurance Covers

Standard policies include:

• GP and specialist consultations

• Diagnostic tests

• Hospital treatment

• Day surgery

• Some dental

• Some mental health

• Pre-existing conditions (may have waiting periods)

• Cosmetic surgery

• Alternative therapies

• Long-term care

Pay-As-You-Go

Many expats simply pay for private care when needed:

• GP consultation: €50-80

• Specialist consultation: €80-150

• Blood tests: €50-100

• X-ray: €50-100

This works if you're healthy and just need occasional care.

For Visa Applications

Most visa applications require private health insurance. The policy must:

• Be from a Spanish or EU-authorised insurer

• Cover you fully in Spain (no repatriation clauses)

• Have no co-payments or excess for essential services

• Cover pre-existing conditions (some policies)

Emergencies

• Public: Hospital Costa del Sol (Marbella)

• Private: Hospital Quirónsalud Marbella

Emergency treatment is provided regardless of insurance status. You may be billed later if you're not in the public system.

Pharmacies

Pharmacists in Spain can advise on minor ailments and sell some medications without prescription that would require one in the UK. Look for the green cross sign.

Mental Health

Mental health services exist in both public and private systems, but provision is more limited than physical health. Private psychologists and therapists are widely available, including English-speaking practitioners.