What Does Private Health Insurance in Spain Cover?

Short answer

A comprehensive (completo) policy covers GP and paediatric visits, specialists without referral, emergencies, diagnostic tests including MRI and CT, surgery, hospital stays and childbirth, all within the insurer's network in Spain. It does not usually cover outpatient medicines, most dental treatment, glasses or pre-existing conditions. Expect caps such as 20 psychology sessions a year (Adeslas Plena, DKV Integral, Sanitas Más Salud) and waiting periods of 3 to 10 months before surgery, hospital admission and childbirth.

Key facts

Adeslas, DKV and Sanitas all cap psychology at 20 sessions a year, 40 for eating disorders.
Childbirth has an 8-month waiting period at Adeslas, DKV and Sanitas.
Adeslas Plena excludes medicines of any kind outside hospital.
Travel cover abroad is emergency-only: €12,000 for trips under 90 days on Adeslas Plena.
Sanitas waives most waiting periods if you held Spanish cover for a year, except childbirth.

What a comprehensive policy includes

Spanish insurers sell several tiers, from GP-only plans to hospital-only cover (see types of private health insurance). When people say "full" private health insurance, they mean a seguro completo (comprehensive policy): outpatient and hospital care through the insurer's cuadro médico (network of doctors and hospitals).

The core of a completo policy is very similar across the big insurers. Taking Adeslas Plena as a typical example, its product information document lists:

Block of cover	What it includes in practice
Primary care	GP, paediatrics and nursing, at the clinic or at home
Emergencies	24-hour urgent care at network centres and home visits
Specialists	Cardiology, gynaecology, ophthalmology, oncology, traumatology, urology and others
Diagnostics	Blood tests and X-rays through to MRI and CT scans
Hospital	Surgical, medical, paediatric, ICU, psychiatric and day-hospital admissions
Implants	Listed items only, such as pacemakers, internal orthopaedic prostheses and monofocal or bifocal lenses after cataract surgery
Special treatments	Chemotherapy, radiotherapy, pain treatment, bone marrow and cornea transplants
Extras	Ambulance, childbirth preparation classes, podiatry

If you use the network, you show your card and the insurer pays the provider. On a sin copago policy (no co-payments) you pay nothing per visit. On a con copago policy you pay a small fee per use, capped each year: Sanitas caps it at €360 per insured person a year on Más Salud Familias. For visa applications, a sin copago policy is normally required.

How three popular policies compare

The headline cover is similar. The differences are in the limits and waiting periods. These figures come from each insurer's own documents.

	Adeslas Plena	DKV Integral	Sanitas Más Salud Familias
Psychology	20 sessions a year, 40 for eating disorders	20 a year; 40 for eating disorders, bullying, work stress, gender or family violence, and anyone under 24	20 a year with no prescription needed; 40 for eating disorders
Psychiatric admission	50 days a year	60 days a year (acute episodes)	Not stated on product page
Dental	Basic treatment (curas), extractions, one clean a year	Unlimited check-ups, extractions and cleans; fillings to age 14; 50+ free treatments	45+ included services, up to 21% off other treatment
Travel emergencies	€12,000 per claim, trips under 90 days	€30,000, trips up to 180 days	€12,000 a year, stays up to 90 days
Childbirth waiting period	8 months	8 months	8 months
Hospital admission waiting period	8 months	8 months	10 months (surgery groups III–VIII)

Sources: Adeslas Plena IPID and 2025 general conditions; DKV Integral practical guide and DKV Integral Infinity 2026 conditions (psychiatric days); Sanitas Más Salud Familias.

Sanitas also lists a maximum joining age of 75, with no upper age limit once you are insured. Premiums depend heavily on age and province; see how much private health insurance costs.

The limits inside "comprehensive" cover

"Comprehensive" does not mean unlimited. These are the caps most likely to affect you:

Session caps. Psychology, speech therapy and podiatry have annual session limits. Adeslas Plena allows 12 podiatry sessions a year. On DKV, extra psychology sessions beyond the cap can be paid for at a reduced franchise price.
Prosthesis caps. Adeslas covers only the implants listed in its contract. DKV caps cardiac and vascular prostheses at €12,000 per year.
Lens choice. After cataract surgery, Adeslas covers monofocal and bifocal lenses but excludes toric, EDOF and trifocal lenses.
Partial refunds for therapies. Adeslas Plena refunds 50% of physiotherapy and rehabilitation outside the network, up to €500 a year, and 50% of podiatry up to €200.
Medicines. Adeslas Plena excludes medicines of any kind outside a hospital stay. Its top tier, Plena Total Vital, refunds 50% of prescribed outpatient medicines up to €200 a year, only for medicines funded by the public system (IPID).
New technology. Robotic surgery is a common carve-out. Adeslas excludes it outside the indications listed in the contract; on Plena Total Vital the policyholder pays €6,000 towards robotic gynaecological or urological surgery and €8,000 for thoracic surgery.

Waiting periods before you can use some cover

A new policy starts immediately for GP and specialist visits and simple tests. Bigger items open later. Adeslas Plena's 2025 conditions set:

3 months: high-technology diagnostics such as MRI, and outpatient surgery (groups 0–II)
6 months: interventional diagnostics, tubal ligation and vasectomy
8 months: any hospital admission, implants, childbirth, chemotherapy, radiotherapy, dialysis and pain treatment

Life-threatening emergencies are exempt. Sanitas waives most waiting periods if you have held similar cover with another Spanish insurer for at least a year, but never for childbirth. Full detail is on our waiting periods page.

Maternity, dental, optical and mental health

These four areas cause the most surprises:

Maternity: pregnancy check-ups are covered from day one, but childbirth needs 8 months of cover at Adeslas, DKV and Sanitas. Sanitas states its pregnancy cover applies only if the policy started before the pregnancy. See maternity cover.
Dental: basic care only. Beyond check-ups, cleans and extractions you usually pay the network's set fees; DKV, for example, covers fillings only up to age 14 and publishes a dental tariff for other treatment.
Optical: eye consultations and eye surgery are covered; glasses and contact lenses are not on Adeslas Plena or DKV Integral. Sanitas sells an optical add-on that refunds 50%.
Mental health: covered, but capped. Adeslas requires a prescription from a network psychiatrist or oncologist and prior authorisation for psychology.

All four are compared in detail in dental, optical and mental health cover.

Cover outside Spain

A standard Spanish policy covers you in Spain through its network. Abroad, you get travel assistance for emergencies only, with a cash limit and a maximum trip length (see the comparison table above). Planned treatment abroad is not covered.

Some products add more. DKV Integral individual policies refund 80% of treatment abroad for serious illnesses, up to €16,000 per person per year. Reimbursement policies such as Sanitas Premium 500.000 refund 90% of costs worldwide. If you split your time between countries, read network versus reimbursement insurance.

Which document tells you what is covered

Marketing pages summarise. Three documents decide what you are actually covered for:

IPID or nota informativa (product information document): a two-page summary of what is and is not insured.
Condiciones generales (general conditions): the full wording, including the list of covered services, exclusions and waiting periods.
Condiciones particulares (personal conditions): your start date, premium and any personal exclusion added after the health questionnaire.

Under Article 3 of the Insurance Contract Act, clauses that limit your rights must be highlighted and specifically accepted by you in writing. If you are asked to sign a page of highlighted clauses, that page is where the restrictions are. The DKV guide itself states that the general and personal conditions prevail over its summary.

Comprehensive cover and visas

For residence visas, a completo policy is usually needed, but the policy must also meet immigration rules. The Unidad de Grandes Empresas, which handles digital nomad applications, does not accept travel insurance, reimbursement-only policies, or policies with co-payments or waiting periods. An ordinary completo policy with 8-month waits can therefore fail a visa application even though its medical cover is good. Insurers sell visa versions without co-payments or waiting periods for this reason; see the non-lucrative visa guide.

Our guide to getting quotes explains how to compare prices direct or through a DGSFP-registered broker.

Common questions

Does private health insurance in Spain cover prescriptions?

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.

Does private health insurance in Spain cover pre-existing conditions?

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.

Does Spanish private health insurance cover me abroad?

Standard policies include emergency travel assistance only, for example up to €12,000 on trips under 90 days with Adeslas Plena or €30,000 on trips up to 180 days with DKV Integral. Planned treatment abroad needs a reimbursement or international plan.

Is cancer treatment covered by private health insurance in Spain?

Chemotherapy and radiotherapy are included in comprehensive policies such as Adeslas Plena and DKV Integral, but usually after a waiting period (8 months on Adeslas Plena) and never for a cancer diagnosed before you joined.

What is the difference between completo and hospitalario?

A completo policy covers outpatient and hospital care. A hospital-only policy covers admissions and surgery but not routine GP and specialist visits.

Sources

Written by Jon Grocott

Jon lives in Spain and runs this site independently. He isn't an insurer, broker or lawyer: every rule and figure is checked against the official or named source linked on the page. Spotted something out of date? Report a correction.