The Best Private Health Insurance in Spain for Expats

Who the main insurers are

Spain's private health market is concentrated. According to ICEA figures for the first half of 2026, reported by El Español, health insurers wrote €7,251 million in premiums, up 6.91% on a year earlier, and the top three held 60.2% of the market.

DKV's fall reflects its exit from Muface, the civil servants' scheme, not a collapse in private customers. Cigna's Spanish life and health company was among the fastest growers (+14.94%).

Size matters for one practical reason: the bigger the network in your province, the more likely your nearest private hospital and an English-speaking GP are on the list. Check the network (cuadro médico) for your own postcode before anything else.

This site has no commercial relationship with any of these insurers. Everything below comes from the insurers' own websites and policy documents, checked in October 2026. See our commercial disclosure.

Comparison table

The products below are the ones each insurer markets to foreign residents or visa applicants, where one exists.

"From" prices are for the youngest, cheapest profile. Your premium depends on age and postcode: Sanitas's own tariff for its mainstream Más Salud Sin Copago policy is €89.53 a month at age 30–34 and €201.31 at 65–69 in its general "rest of Spain" zone, and higher in Madrid (€115.43 and €259.53). For realistic figures by age, see how much private health insurance costs in Spain.

The Spanish insurers in detail

Sanitas

Sanitas Residents is a comprehensive policy for foreigners with no co-payments. The visa version waives waiting periods and comes with an instant certificate. It can be taken out up to 75, with no maximum age for staying covered. It includes repatriation, emergency cover on trips abroad of up to 90 days and the Blua video-consultation service.

Sanitas publishes more English material than most: an English website, general conditions in English and a Mi Sanitas app with a filter for doctors who speak your language. Residents Platinum adds reimbursement of 90% of costs for doctors outside the network, up to €500,000 a year, but has a lower maximum entry age of 64.

SegurCaixa Adeslas

Adeslas is Spain's largest health insurer. Adeslas Welcome is an annual policy from €660 per person, paid in one instalment. It has no co-payments and no waiting periods and comes with a certificate for the immigration office. It is open to any nationality but requires an NIE and is sold up to age 70. Cover is Spain-only, and medicines, vaccines and professional sports injuries are excluded. Physiotherapy and podiatry are reimbursed at 50% up to an annual cap.

Sold through CaixaBank, the same product requires you to open a CaixaBank account and is not available in Asturias, Navarra or the Basque Country.

ASISA

ASISA describes itself as created and managed by doctors: its holding company, Lavinia, is a cooperative owned by more than 10,000 physicians, and the group owns 18 hospitals.

It sells two lines to foreigners. ASISA Health Residents is an annual visa policy with no co-payments, deductibles or waiting periods. You can buy it online up to 90 days before arrival without an NIE or Spanish bank account, and get an immediate certificate in Spanish. It is non-refundable once started.

ASISA Health Insurance is aimed at English speakers. It has an English-speaking call centre in Spain, a 24/7 English emergency line, lists of English-speaking GPs and contracts in English. New applicants are accepted up to 69. ASISA states that only its no-co-payment version is accepted for visa and residency applications.

DKV

DKV is owned by ERGO, part of the Munich Re group, and will start trading as Ergo DKV from the third quarter of 2027. It had 1.7 million customers at the end of 2025, according to Alimarket.

Its foreigners' range has two products. DKV Visado has no co-payments and is from €37 a month on promotion. DKV Mundisalud is a reimbursement policy from €61 a month that pays up to 90% of costs in Spain and abroad. Both come with an official certificate in Spanish, can be taken out up to 75 and can be paid annually by card if you have no Spanish bank account.

Its DKV Residentes page states that after more than three years the policy is maintained for life. That protection matters if you are worried about an insurer declining to renew later (see cancelling, renewing or switching).

Mapfre

Mapfre has more than 16 own medical centres and agreements with almost 300 hospitals. It does not market a product for foreigners or visas. Its no-co-payment Supra policy starts from €42 a month but carries waiting periods (eight months for surgery, hospitalisation and childbirth) and is sold up to age 65. Mapfre suits people already resident and registered who want a mainstream Spanish policy, rather than visa applicants.

International insurers

International health plans are designed for people who move between countries. They are usually more expensive than Spanish domestic cover but are not tied to a Spanish network.

• Cigna Global reports a network of around 2.5 million hospitals and professionals and 24/7 service in more than 50 languages. Its site states that policies are underwritten by Cigna Global Insurance Company Limited (Guernsey). For Spanish domestic plans, Cigna has a separate company, Cigna Salud.
• Allianz Care offers worldwide cover with the option to include or exclude the USA, a 24/7 multilingual helpline and a network of more than 2 million providers. It also has a short-term plan for stays of three to 12 months.

Neither publishes starting prices. For a visa, the Spanish consulate in London requires cover "contracted with an insurance entity authorized to operate in Spain" and covering all the risks of the public system. Before buying an international plan for a visa, find out which legal entity underwrites it and check that entity in the DGSFP register.

Which insurer fits which situation

These judgements are based only on the published facts above.

• Non-lucrative or other visa applicants: Sanitas Residents, DKV Visado, Adeslas Welcome and ASISA Health Residents all suit visa applicants. Each has no co-payments, no waiting periods and a certificate on purchase. ASISA lets you buy online before arrival without an NIE. Adeslas Welcome needs an NIE. See our non-lucrative visa insurance guide.
• People who want to deal with their insurer in English: ASISA Health Insurance publishes the fullest English service. Sanitas is next, with its English app and conditions.
• Over-65s: Sanitas Residents and DKV accept applicants up to 75. Adeslas Seniors accepts new customers from 55 to 84, from €67.50 a month with co-payments. Sanitas's Bluau Senior Easy product for over-60s states no maximum entry age. See cover for over-75s.
• Worldwide cover: Cigna Global and Allianz Care suit people who need full cover in several countries. Among Spanish insurers, DKV Mundisalud and Sanitas Residents Platinum reimburse treatment abroad.
• Long-term security of renewal: DKV publishes a lifetime-maintenance commitment after three years.
• Lowest published entry price for a visa policy: DKV Visado's promotional €37 a month and Adeslas Welcome's €660 a year are the lowest published figures. Real quotes depend on age and postcode.

Before you choose

Get quotes for the same people, postcode and start date. Read the general conditions and the list of exclusions, not just the brochure. Confirm the hospitals near you are in the network. Our checklist for comparing policies sets this out step by step. When you're ready, here's how to get comparable quotes, direct from insurers or through a registered broker.