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.
So let’s break it down—no jargon, just the stuff people usually 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. 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… yeah, no.
Mental Health — Often Just the Bare Minimum
This catches a lot of people. 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.
And inpatient psychiatric care? Basically never included unless you’ve gone for one of those top-shelf policies with a price tag to match.
Long-Term Conditions Are Where It Gets Messy
Private insurance 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… tends to 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 your premium is.
Dental? Optical? You Wish
No, you don’t get a crown covered. Or a root canal. Or glasses.
You might get one scale-and-polish a year and a bit of a discount if you go to a clinic on their list. That’s it.
You’ll still be paying €70 for a filling like everyone else.
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 won’t cover it.
Most policies require you to have been insured for 8–10 months before conception for maternity to be included. Otherwise, you’re paying for scans, delivery, the lot.
Stuff That Sounds Nice but Isn’t 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 a battle.
And no, they’re not paying for that fancy €1,500 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.
Some policies have limited emergency cover abroad, but for the most part, once you’re outside Spain, you’re on your own. You need separate travel insurance.
So What’s Left?
All the core stuff—GP appointments, blood tests, scans, surgery, emergencies in Spain, provided you use their clinics.
But not public hospitals. Not random specialists. Not long-term anything. And not everything your old NHS or HSE brain expects.
The Bottom Line?
Private health insurance in Spain isn’t bad. It’s just not magic.
It covers a lot, but it also dodges a lot. Know what lane you’re in. Know what’s off-limits. And ask awkward questions before you sign anything.