Healthcare in Spain: What Expats Need to Know
Spain has one of the best healthcare systems in Europe, consistently ranked in the top 10 globally. As an expat, your access depends on your residency status, employment situation, and whether you opt for public or private healthcare. Understanding your options before you move is essential.
The Public Healthcare System (SNS)
Spain's Sistema Nacional de Salud (SNS) provides universal healthcare. You can access it if you:
- Are employed or self-employed in Spain and paying social security contributions
- Are a legal resident registered on the padron and earning below a certain threshold
- Are an EU citizen with a European Health Insurance Card (EHIC) for temporary stays
- Pay the voluntary contribution (convenio especial) of approximately €60-157 per month
The public system covers GP visits, specialist referrals, hospital care, emergency treatment, and prescriptions (with co-pays ranging from 0% to 60% depending on income). Quality is high, but waiting times for specialist appointments and non-urgent procedures can be long.
Accessing Public Healthcare
To register, visit your local Centro de Salud (health center) with your SIP card application, padron certificate, NIE, and social security number. You will be assigned a GP (medico de cabecera) at your nearest health center. Referrals to specialists go through your GP.
Private Health Insurance
Many expats choose private insurance, either as their sole coverage or as a supplement to the public system. Benefits include:
- Shorter waiting times for specialists and procedures
- Choice of doctor and hospital
- English-speaking medical staff
- Coverage across Spain without regional restrictions
Major providers on the Costa del Sol include Sanitas, Adeslas, Asisa, DKV, and MAPFRE. Monthly premiums typically range from €50-150 for adults under 55, increasing significantly for older applicants. Most insurers have age limits for new policies, commonly 65-70 years.
Important: Insurance for Visa Applications
If you are applying for a non-lucrative visa, Golden Visa, or digital nomad visa, you need private health insurance that meets specific requirements: full coverage in Spain, no co-pays, no coverage gaps, and no annual limits. Not all standard policies qualify. Check the requirements with your consulate before purchasing.
Costs Comparison
- Public healthcare (via social security): included in your contributions (approximately 6.35% of salary)
- Convenio especial (voluntary public access): €60-157 per month
- Private insurance: €50-300 per month depending on age and coverage
- GP consultation (private, without insurance): €40-80
- Specialist consultation (private): €80-200
Use our free calculator to estimate your total costs for healthcare and other essential expenses when moving to Spain.
Pharmacies and Prescriptions
Pharmacies (farmacias) are plentiful and identified by a green cross. Many medications that require a prescription in the Netherlands are available over the counter in Spain. Pharmacists can also provide basic medical advice. Prescription co-pays in the public system depend on your income level.
Emergency Care
Emergency rooms (urgencias) are available at all public hospitals and treat everyone regardless of insurance status. For emergencies, call 112. The Costa del Sol has several well-equipped hospitals, including Hospital Costa del Sol in Marbella and Hospital Regional de Malaga.