Health Insurance for Family Reunification in Spain

Three different family routes

"Family reunification" covers three legally separate routes. The health insurance answer is different for each:

Two more situations are not reunification but are often confused with it. Under the non-lucrative visa, family members apply alongside the main applicant, who must show 100% of the IPREM (Spain's benchmark income index) for each of them as well as health insurance (Hoja 6). Students' accompanying relatives must each have sickness insurance (Hoja 1). See student visa health insurance.

General family reunification

This route is governed by Articles 65 to 68 of Real Decreto 1155/2024, the immigration regulation in force since 20 May 2025. Hoja 8 requires:

• "Tener un seguro de enfermedad para la persona reagrupante y los miembros de su familia reagrupados" (sickness insurance for the sponsor and the reunited family members)
• from each reunited relative, "documentación acreditativa de tener garantizada asistencia sanitaria" (documents showing guaranteed healthcare).

The sheet does not say whether the cover must be public or private. A sponsor working in Spain is already covered by Social Security. Relatives arriving from abroad cannot be added as Social Security beneficiaries until they are legally resident, so a private policy is the straightforward way to cover them at application stage.

Other conditions that affect the policy

The sponsor must normally have lived in Spain for at least a year and have permission to reside for at least another. There are exceptions for long-term residents bringing ascendants. Income must reach 150% of the IPREM a month for a two-person household, plus 50% for each extra member.

The relatives who qualify are:

• a spouse or partner
• children under 18, or older children with a disability who cannot support themselves
• first-degree ascendants over 65 who are dependent on the sponsor
• an adult child who will act as carer where the sponsor has a recognised dependency.

Parents need particular attention. They are the relatives least likely to qualify for public beneficiary status later (see below), and premiums are highest at their age. Check insurers' entry-age limits, which are typically 70 or 75 for full cover, before starting the application. See health insurance for over-75s.

Family members of EU citizens

Relatives of EU, EEA or Swiss citizens apply for a tarjeta de residencia de familiar de ciudadano de la Unión (EU family member residence card) under Real Decreto 240/2007. You must apply within three months of entering Spain, and the card is valid for five years.

The health requirement follows the EU citizen's status:

Qualifying relatives include a spouse, a registered partner, children under 21 or dependent, and dependent ascendants. Ascendants are not included where the EU citizen is a student. Hoja 62 also covers unregistered stable partners and other dependent relatives.

Becoming a public healthcare beneficiary

Once your relative is legally resident, they may no longer need private cover. If the sponsor is insured through Social Security as a worker, self-employed person or pensioner, the Social Security beneficiary form lets them add:

• a spouse or pareja de hecho (registered partner)
• children, grandchildren or siblings under 26
• relatives over 26 with a recognised disability of 65% or more
• minors under guardianship or foster care.

Foreign beneficiaries must show legal residence in Spain and must not have healthcare cover by another route. Income must be declared, except for a spouse or partner.

Parents are not on the list. A parent brought over under reunification normally keeps private insurance, unless they have an S1 from their own state pension or later qualify for the convenio especial after a year of continuous residence with padrón registration.

Recognition as a beneficiary is not the end of the process. Each person must then register with the regional health service to get a health card. See public healthcare for dependants and beneficiaries and how to get a Spanish health card.

Relatives of Spanish nationals

Since RD 1155/2024, non-EU relatives of Spanish citizens have their own residence authorisation (Articles 93 to 98). Hoja 18, updated April 2026, lists no health insurance requirement, only the absence of serious public-health diseases. Real Decreto 316/2026, in force from 16 April 2026, also allows adult children and first-degree ascendants of Spanish nationals to apply from within Spain (Derecho Local).

Putting the evidence together

1. Identify the route and download its Ministry information sheet.
2. List everyone who must be insured. Under Hoja 8 that is the sponsor and every relative. Make sure each person is named on the certificate.
3. Match the policy dates to the expected arrival date and the length of the permit.
4. Check the sponsor's own cover. A Social Security certificate covers the sponsor, but not relatives still abroad.
5. Plan the switch. After arrival, add eligible relatives as beneficiaries and cancel private cover only once public cover is confirmed.

For the wider picture by route, see health insurance requirements for Spanish residency. When you're ready, here's how to get comparable quotes, direct from insurers or through a registered broker.