Frequently asked questions

Yes. Private insurers assess each application through their health questionnaire and can accept you on normal terms, exclude the condition, raise the premium or decline. Public routes such as the S1 and the convenio especial do not assess your health. Read the full guide.

Under Article 10 of Ley 50/1980 the insurer can cancel the policy within one month of discovering the omission. If you claim before then, it can reduce the payout, or refuse to pay at all where you acted deliberately or with gross negligence. Read the full guide.

Rastreator's 2025 price index gives an average of €46 a month for a basic policy without co-payments and €74 a month for complete cover. Averages hide a wide spread by age: complete cover averaged €59 for under-25s and €125 for over-55s. Read the full guide.

Consulates generally want complete cover with no co-payments, so expect the higher end of the market. Sanitas's published standard-zone price for its no-co-pay Más Salud policy is €89.53 a month at 30–34 and €137.16 at 55–59; Sanitas's dedicated visa product starts from €95.15 a month. Read the full guide.

No. Medicare says it usually does not cover care outside the US; the exceptions involve emergencies in or near the US, cruise ships near US ports and travel through Canada to Alaska. Medicare drug plans do not cover prescriptions bought abroad. Read the full guide.

Normally not. Spanish consulates in the US ask for a policy from an insurer authorised to operate in Spain that covers everything the Spanish public system covers, with no deductible or copayment. US domestic plans rarely meet that. Read the full guide.

Any policy with an insurer authorised in Spain, full public-system-equivalent cover, no co-payments and no waiting periods will usually do. Sanitas Residents, DKV Visado, Adeslas Welcome and ASISA Health Residents are all built for this and issue a certificate on purchase. Read the full guide.

ASISA Health Insurance runs an English-speaking call centre and 24/7 English emergency line. Sanitas offers an English website, English policy conditions and an app filter for doctors who speak your language. Other insurers publish less detail about English support. Read the full guide.

An ambulatoria (outpatient) policy covers GP visits, specialists and tests but not hospital stays or surgery. A completa policy adds hospitalisation, surgery and hospital emergency care. Read the full guide.

A reimbursement policy lets you see doctors and hospitals outside the insurer's network and claim back a share of the bill. Most also include the insurer's network, which you can use without paying upfront. Read the full guide.

Usually not outside hospital. Adeslas Plena excludes medicines of any kind, and some higher tiers only refund part of the cost, such as 50% up to €200 a year on Adeslas Plena Total Vital. Read the full guide.

Not as standard. Adeslas Plena lists congenital and pre-existing conditions as not insured, while DKV says some pre-existing conditions can be covered for an extra premium after underwriting. Read the full guide.

It means a policy without co-payments, so you pay nothing at the point of use for covered consultations, tests or treatment. You pay only the fixed premium. Read the full guide.

For most residence routes, yes. Consulates such as Chicago and São Paulo explicitly ask for cover with no co-payment, and many also want no waiting periods, so check your consulate's checklist before you buy. Read the full guide.

Yes, but the choice is narrow. Adeslas Seniors accepts new applicants up to 84, ASISA Esencial (outpatient care only) up to 85, and Cigna Global states that it places no age limit on applications. Read the full guide.

Spanish law allows an insurer to refuse renewal with two months' written notice, so check the contract. Sanitas and ASISA state there is no maximum age for staying insured, DKV says it keeps customers of more than three years for life, and Adeslas Seniors commits not to refuse renewal for policyholders over 65 with five years' continuous membership. Read the full guide.

Not for people already entitled to public healthcare. It is effectively required for most non-EU residence visas, such as the non-lucrative visa, where applicants must show public or private health insurance with an insurer authorised to operate in Spain. Read the full guide.

Yes. Holding a private policy does not affect any public entitlement you have, and many people use private cover for specialists and tests while staying registered with their public GP. Read the full guide.

Yes, if you knew about it and did not declare it on the health questionnaire. If you declared it, the insurer can still exclude it by name in your personal conditions, which you sign. Read the full guide.

On Adeslas Plena, emergency care for some excluded causes (drunkenness, addiction, dangerous sports, work accidents) is covered while the emergency lasts, with any admission covered for 24 hours only. Read the full guide.

Not for everyone. It is required for certain residence routes, such as the non-lucrative visa, student stays and family reunification, and for EU citizens who live in Spain without working or an S1. Workers paying Spanish Social Security and S1 holders have public cover. Read the full guide.

No. Registration with Spanish Social Security as an employee or autónomo gives you public healthcare, and your spouse or partner and children under 26 can be added as beneficiaries. Many workers still buy private cover for faster specialist access. Read the full guide.

Usually not. The contract runs for its annual term and you stop it by giving written notice at least one month before expiry. Exceptions include the 14-day withdrawal period for policies bought online or by phone, and mid-term changes to price or cover by the insurer. Read the full guide.

Yes. Article 22 of the Insurance Contract Act lets either party oppose renewal, and the insurer must give at least two months' written notice. Some insurers limit this voluntarily, and courts have occasionally treated a non-renewal without good reason as abusive. Read the full guide.

Insurers' own rules often say two months; Sanitas's conditions, for example, promise a reasoned written decision within that period. For consumers, the DGSFP accepts a case once one month has passed without a reply. Read the full guide.

No. The DGSFP's final report is expressly not binding and cannot be appealed as an administrative act, but it gives you an independent written view to put to the insurer, and filing interrupts limitation periods. Read the full guide.

Not on standard comprehensive policies. They are usually available at the dental network's patient prices, and some top tiers such as Adeslas Plena Total Vital include implantology with a patient payment per treatment. Read the full guide.

It depends on the insurer. Adeslas requires a prescription from a network psychiatrist or oncologist plus prior authorisation; Sanitas Más Salud Familias needs neither for its 20 sessions. Read the full guide.

The Dirección General de Seguros y Fondos de Pensiones is the part of Spain's Economy Ministry that authorises and supervises insurers, insurance distributors and pension funds. It also runs a free complaints service for insurance customers. Read the full guide.

It is usually printed in the insurer identification section of the general or particular conditions, along with the company's NIF and registered office. You can also search the register by name or NIF if you do not have the code. Read the full guide.

You can usually buy a policy, but the birth will not be covered if it falls within the 8-month waiting period, and the pregnancy may be treated as pre-existing. Pregnancy consultations may still be available. Read the full guide.

On Adeslas Plena, 15 days from the baby's hospital discharge and no later than 30 days from birth. Miss it and the baby needs a health questionnaire and may be refused. Read the full guide.

It is the insurer's directory of contracted doctors, clinics and hospitals. Using them, you show your card and the insurer pays the provider directly. Read the full guide.

Often, yes. Mapfre's reimbursement product lets you use its network by showing your card, and some services, such as basic dental and assisted reproduction, are available only through the network. Read the full guide.

The general conditions, your particular conditions or a draft of them, the product information document (IPID), the network list for your area, and for a visa, a sample of the insurance certificate. Read the exclusions and waiting periods in the general conditions, not just the brochure. Read the full guide.

Yes, you must answer every question in the health questionnaire accurately. If you misstate something, the insurer can rescind the contract within one month of finding out, and your benefits can be affected. Read the full guide.

Yes. Visa-oriented products are sold sin carencias, and some insurers waive waiting periods if you switch from a similar Spanish policy held for at least a year. Childbirth usually keeps its waiting period even when switching. Read the full guide.

Not when your life is at risk. Adeslas Plena and DKV Integral both exempt life-threatening emergencies and urgent surgery from waiting periods. Read the full guide.

Yes. Public urgencias treat anyone who needs urgent care. If you have public entitlement it costs nothing; if you do not, the hospital can bill you at its regional public prices, and a network private policy will not usually refund it. Read the full guide.

Usually, within limits. Typical policies cover ambulance transport arranged through the insurer, often within your province of residence and on a network doctor's prescription except in emergencies. An ambulance you arrange yourself, or a public one, is often excluded. Read the full guide.

For most non-work routes, yes. Non-lucrative, student and family reunification applicants must show sickness insurance, and non-working EU citizens need cover for all risks in Spain. Employees and the self-employed who register with Social Security are covered publicly. Read the full guide.

For non-EU routes, the insurer must be authorised to operate in Spain, which you can check in the DGSFP register. It need not be Spanish-owned. EU citizens can use public or private insurance taken out in Spain or another country if it gives equivalent cover in Spain. Read the full guide.

Only if you are not covered by Spanish public healthcare or an accepted foreign equivalent. Registration with Spanish Social Security as an employee or in RETA gives public cover; otherwise you need a private policy with a Spain-authorised insurer, with no co-payments or waiting periods. Read the full guide.

It settles where you pay Social Security, not your healthcare. The SSA says the US–Spain agreement does not include health insurance, so US employees covered by a certificate still need a private Spanish policy. Read the full guide.

For most US and Canadian consulates, yes: Washington, Los Angeles, New York, Chicago, Boston, Houston, San Francisco, Miami and Toronto all state no co-payment. London's and Sydney's pages do not mention co-payments, but a sin copago policy satisfies every version of the rule, so it is the safe choice. Read the full guide.

Only if the insurer is authorised to operate in Spain, which most US and UK domestic plans are not. People with a UK S1, such as UK State Pension recipients, can instead register it with Spanish Social Security; the London and Edinburgh consulates accept the registration receipt. Read the full guide.

No. The London, Los Angeles and New York consulates all refuse travel insurance for long-stay study. You need a health policy from an insurer authorised to operate in Spain, or accepted public cover such as a UK GHIC. Read the full guide.

The London consulate accepts the UK GHIC as medical insurance for all student visas, provided it is valid for the whole stay. UK residents studying in the EU can get a student GHIC that lasts for the length of the course. Read the full guide.

At Houston and San Francisco, yes. Washington accepts a certificate in another language only with an official or sworn Spanish translation. Spanish insurers issue visa certificates in Spanish, which avoids the issue. Read the full guide.

No. Washington, Houston and San Francisco state that insurance cards are not accepted. Submit the insurer's certificate, and keep the full policy conditions in case they are requested. Read the full guide.

Under general reunification, yes: the Ministry sheet requires sickness insurance for the sponsor and each reunited relative. If you are insured through Spanish Social Security, your spouse can later be added as your beneficiary once legally resident. Read the full guide.

Only if the EU citizen is not working. Relatives of a self-sufficient EU citizen need public or private insurance giving cover equivalent to the Spanish system. Relatives of a worker rely on that employment. Read the full guide.

You need health insurance, but the renewal rule does not say it must be private. Public cover such as a registered S1 or the convenio especial is health insurance too; confirm your Oficina de Extranjería accepts it before cancelling a private policy. Read the full guide.

Article 64 requires you to have maintained health insurance for the whole period of the permit, so a gap puts the renewal at risk. Arrange new cover immediately and keep evidence of the dates; an immigration lawyer can advise on how to present it. Read the full guide.

Only if you are a student, and the card must be valid for the whole period of residence. Other non-working EU citizens need an S1 or a public or private policy giving cover in Spain. Read the full guide.

Not if you are working in Spain, which gives you Social Security cover. If you are not working and have no S1, you need a policy, which can be Spanish or from another country as long as it covers you in Spain to a standard equivalent to the public system. Read the full guide.

No, not as your main cover. The GHIC is for medically necessary state healthcare during temporary stays. Residents need an S1, Spanish Social Security entitlement, private insurance or the convenio especial. Read the full guide.

Not on the basis of a private or workplace pension. The S1 follows a UK State Pension or certain exportable benefits such as contribution-based ESA, so early retirees usually need private cover until they reach State Pension age. Read the full guide.

Pensioners with public entitlement, either a Spanish pension or a registered S1 from another European country, use the public system without paying for consultations or hospital care. They still pay a share of prescription costs: since 14 May 2026 most pensioners pay 10%, with monthly caps, and the highest earners 60%. Read the full guide.

It varies by insurer. Rastreator's 2025 summary lists 65 at AXA and Mapfre, 69 at ASISA and 75 at DKV, with some exceptions for family policies. Read the full guide.

No. The padrón shows where you live, but the card is only issued once your entitlement to public healthcare has been recognised, usually by the INSS. Read the full guide.

SIP is the name of the health card in the Comunitat Valenciana, after its Sistema de Información Poblacional. It is the same thing other regions call the tarjeta sanitaria or TSI. Read the full guide.

Neither the INSS nor the UK authorities publish a standard processing time. Apply as soon as you have your residence document and padrón, and use the online service's 'Ya he presentado una solicitud' option to track progress. Read the full guide.

No. The INSS online S1 service confirms your identity on screen, including a photo of you holding your ID, so a digital certificate or Cl@ve is not required. Read the full guide.

Not as a rule. The main difference is access, not the doctors: private cover buys speed and choice of specialist, while public care has no premiums, no medical underwriting and subsidised prescriptions. Read the full guide.

Yes. If you have public entitlement you can also hold a private policy and use whichever suits each problem. The two systems do not share records automatically, so carry your reports between them. Read the full guide.

Not in practice. You need a year of prior residence and padrón registration to apply, so first-time applicants from outside Spain rely on private insurance for at least the first year. Read the full guide.

Yes. The legal requirements are residence, padrón and no other public entitlement, with no health questionnaire, and the Ministry of Health says there are no waiting periods. Read the full guide.

Not as your residence cover. The GHIC is for temporary stays. Residents need Spanish entitlement or private insurance, although UK S1 holders registered in Spain can get a UK GHIC for trips to other EU countries. Read the full guide.

Do not rely on it. Visa health insurance requirements are set by the immigration rules and consulates, and an EHIC proves something different. Use the consulate's own checklist. Read the full guide.

Usually yes, if your entitlement is already recognised. Take your INSS document or social security number and ID to your health centre; Madrid's official guidance tells residents to go to their centre if they need care before the card arrives. Read the full guide.

You may be billed if you have no recognised entitlement, card or insurance. Keep every invoice and receipt: UK visitors without a GHIC, EHIC or PRC who pay in full can claim a refund from the NHS. Read the full guide.

10% of the price, capped at €8.23 a month with income under €18,000, €13.37 between €18,000 and €60,000, and €18.52 between €60,000 and €100,000. Pensioners on €100,000 or more pay 60% up to €61.75 a month. Those receiving the minimum-pension supplement pay nothing. Read the full guide.

Only for exempt groups, such as recipients of non-contributory pensions or the ingreso mínimo vital, unemployed people who have lost benefit, and pensioners receiving the minimum-pension supplement. Everyone else in the public system pays a percentage. Read the full guide.

Yes, if you hold public healthcare entitlement in Spain as an insured person, your spouse or partner can usually be registered as your beneficiary. They need to be legally resident and you need to apply to add them; it does not happen automatically. Read the full guide.

Until 26. A child aged 26 or over can remain a beneficiary only with a recognised disability of 65% or more; otherwise they need their own route, such as work or the convenio especial. Read the full guide.

Yes. Once you are registered (in alta) in RETA you are insured for public healthcare, the same as an employee. Your monthly contribution is what pays for it, so there is no separate healthcare fee. Read the full guide.

Yes. The €80 reduced contribution is still a full RETA registration, so you are insured from your alta. The reduction affects what you pay, not what you are covered for. Read the full guide.