You wouldn’t think you’d need a translator for insurance exclusions, but here we are.
So here’s the bit they don’t put on the front of the brochure: most “full” private health policies in Spain leave out some pretty big stuff. And unless you read the small print (in Spanish, obviously), you might only find out when someone behind a reception desk is shaking their head and pointing at a bill that needs paying.
So let’s break it down – no jargon, just the stuff people often discover too late.
Pre-Existing Conditions? Usually a No
If you’ve got something going on already – high blood pressure, back issues, whatever – don’t assume it’s covered. Most insurers will say no, at least for a while. Some might reassess after a year, but even then it’s patchy at best. You’ll often be stuck paying for related meds or checkups yourself.
If you’ve moved to Spain thinking your plan would just slide over your previous UK medical history then have a rethink.
Mental Health – Often Just the Bare Minimum
This catches a lot of people out. Most standard policies don’t include proper therapy. You might get 6 sessions a year with someone on their list, but forget anything long-term, or being able to choose someone who suits you or is handy to where you live or work.
And inpatient psychiatric care? Basically never really included unless you’ve gone for one of the much more expensive policies.
Long-Term Conditions can be Where It Gets Messy
PHI here is mainly for short-term, fixable problems. Break a leg? Covered. Need physio every week for six months? Maybe not. Chronic stuff like diabetes, cancer follow-up, or anything that drags on can fall through the cracks.
They’re not designed for it. You can push for it, or pay extra, or try to get into the public system but don’t assume it’s all there just because you are paying a fair whack each month. Research.
Pregnancy – But Only If You’re Already Insured
Big one. If you’re planning on having a baby soon after moving here and you take out a new policy, they probably won’t cover it.
Most policies require you to have been insured for 8–10 months or so before conception for maternity to be included. Otherwise, you’re paying for everything. But policies vary so check the small print.
Things That Sound Nice but aren’t often Covered
Alternative therapies? Acupuncture, osteopathy, that sort of thing – only included on very specific plans, if at all.
Cosmetic surgery? Not unless it’s for medical reasons, and even then it’s an uphill battle anecdotally.
And no, they’re not paying for that expensive MRI scan unless one of their doctors asks for it.
Travel Insurance? No, That’s a Different Thing
People assume their Spanish private insurance travels with them. It doesn’t usually.
Some policies have limited emergency cover abroad, but for the most part, once you’re outside Spain, you’re on your own. You probably need separate travel insurance. Check your policy carefully and if this is a concern, check before you buy.
So What’s Left?
All the core stuff – GP appointments, blood tests, scans, surgery, emergencies, provided you use their clinics.
The Bottom Line?
PHI in Spain isn’t bad. It’s just not as comprehensive as the policy fee may suggest.
It covers a lot, but can also dodge a lot.
Ask awkward questions before you sign anything!