Moving to Spain from the U.S.? Learn what health insurance Americans need for residency or long stays. Visa rules, costs, compliant policies, and how to avoid rejection. 

Private Health Insurance in Spain for U.S. Citizens 

What Americans need to know about coverage, requirements, and the application process 

If you’re an American planning to move to Spain — temporarily or permanently — private health insurance will almost certainly be required. 

Whether you’re applying for a visa, seeking residency, or retiring abroad, Spanish immigration rules require specific, full-coverage private policies. U.S. health plans, Medicare, and travel insurance won’t meet the criteria. 

In this guide, we break down what U.S. citizens need to know about Spanish private health insurance, how much it costs, and how to choose a plan that won’t get your visa denied. 

Why U.S. Citizens Need Private Health Insurance in Spain 

Unless you’re employed in Spain and contributing to its social security system (Seguridad Social), you won’t qualify for public healthcare. That means: 

• If you’re moving to Spain on a non-lucrative visa 

• Applying for the digital nomad visa 

• Retiring early 

• Or relocating for lifestyle or family reasons 

…you’ll be required to submit proof of private health insurance with your visa application. 

See Who Needs Private Health Insurance in Spain for the full list of legal requirements. 

Travel Insurance Won’t Cut It 

Many Americans assume travel insurance is enough. It’s not. 

Spanish consulates are very strict. They require full medical coverage that: 

• Is issued by a Spanish-authorised insurer 

• Has no co-payments (sin copago) 

• Covers all medical needs: GP, hospital, diagnostics, emergencies 

• Lasts for at least 12 months 

• Is paid in full (not monthly) 

Travel policies and U.S.-based international insurance almost always get rejected — even if they offer “comprehensive” benefits. 

What the Policy Must Include 

Your health insurance must meet all Spanish visa and residency requirements: 

✅ Issued by a Spanish-authorised insurer 

Choose from approved companies like DKV, ASISA, Sanitas, Adeslas, or Axa. 

✅ Full coverage 

The policy must include: 

• GP visits 

• Specialists 

• Hospital stays and surgery 

• Diagnostics (X-rays, MRIs, bloodwork) 

• Emergency services 

See What’s Covered for details. 

✅ No co-payments 

You must select a “sin copago” plan, which covers 100% of all medical costs. Plans with co-payments will be rejected. 

Learn the difference in Types of Plans 

✅ Minimum duration: 12 months 

Your insurance must match or exceed the duration of your intended stay and be active from your planned arrival date. 

How Much Does It Cost for U.S. Citizens?

Premiums vary by age and plan type. Here’s a rough monthly estimate for a no co-pay plan accepted by consulates: 

Most providers offer annual contracts — expect to pay for 12 months upfront. See our full Cost Guide for examples.

Where to Buy a Compliant Policy 

Stick to major Spanish insurers known for visa-compliant plans: 

• DKV 

• Sanitas 

• ASISA 

• Adeslas 

• Axa 

Ask for: 

“Residency-compliant, no co-pay (sin copago) private health insurance for U.S. citizens applying for a Spanish visa.” 

Pro tip: Choose a provider that offers documents in English and Spanish. Some consulates require official translations, depending on jurisdiction.

Required Documents for Your Visa Application 

When submitting your application, you’ll need to include: 

• Insurance certificate with: 

• Your full name 

• Start and end dates (minimum 12 months) 

• Statement of full coverage 

• Confirmation of no co-payments 

• Name of Spanish insurer 

• Payment receipt or proof of full payment 

• Translations if required by your consulate 

Need more help? Visit Health Insurance Requirements for Residency 

Common Mistakes Americans Make

Avoid these visa delays and rejections: 

🚫 Submitting U.S.-based health insurance (including ACA or Medicare) 
🚫 Providing only a quote — not a paid certificate 
🚫 Buying a co-pay plan (even if it seems full coverage) 
🚫 Using a broker unfamiliar with Spanish visa law 
🚫 Missing the 12-month duration rule

Final Thoughts 

As a U.S. citizen moving to Spain, you must treat health insurance as a legal requirement, not just a practical one. Submitting the wrong plan — or an incomplete document — can easily result in a visa denial. 

Choose a no co-pay policy from a Spanish-licensed insurer, confirm the coverage meets the consulate’s standards, and get all paperwork ready before your visa appointment. 

Still confused? Start with What Is Private Health Insurance in Spain? or check if you’re eligible in Who Needs Private Health Insurance.