Public vs. Private Healthcare in Spain: Expat Overview
Spain’s healthcare system operates through the National Health System (Sistema Nacional de Salud – SNS), managed via regional health departments (such as SERMAS in Madrid, CatSalut in Catalonia, and SAS in Andalusia). It offers universal coverage for contributing residents and a high standard of medical infrastructure.
Accessing Public Healthcare (SNS)
- Employed and Self-Employed (Autónomos): Residents contributing to Spanish Social Security (Seguridad Social) receive full state healthcare access through their assigned local health clinic (Centro de Salud).
- State Pensioners (S1 Form): UK and EU/EEA state pensioners can register an S1 form with the Instituto Nacional de la Seguridad Social (INSS) to access Spanish public healthcare funded by their home country.
- Convenio Especial: A statutory pay-in program allowing long-term residents who do not qualify through employment to access public healthcare.
Convenio Especial Monthly Costs and Criteria in 2026
| Age Bracket | Monthly Cost | Census (Padrón) Requirement | Medication Coverage |
|---|---|---|---|
| Under 65 years old | €60.00 / month | 12 months continuous registration in Spain | Full medical treatment; prescriptions paid at 100% out-of-pocket |
| 65 years and older | €157.00 / month | 12 months continuous registration in Spain | Full medical treatment; prescriptions paid at 100% out-of-pocket |
Private Health Insurance Criteria for Spanish Visas
Non-EU citizens applying for visas such as the Non-Lucrative Visa or Digital Nomad Visa must secure a comprehensive private medical policy from a Spanish-authorized provider (Sanitas, Adeslas, DKV, Asisa, or Mapfre):
- Zero Copayments (Sin Copago): Full coverage for consultations, diagnostic imaging, and hospital care without per-visit fees.
- Zero Waiting Periods (Sin Carencia): Emergency and standard inpatient treatments must be available immediately upon policy activation.
- Complete Hospitalization & Repatriation: Full medical hospitalization, surgeries, and repatriation of remains to the home country must be included.
- Annual Policy Costs: Typically €600 to €1,400 per person per year, depending on age and medical history.
Emergency Medical Treatment and Emergency Numbers
Emergency medical assistance is guaranteed across all public hospitals (Urgencias). For general medical, fire, or police emergencies throughout Spain, dial the standard European emergency number 112 (multilingual assistance available).
For complete relocation budgeting and city guides, explore our Cost of Living in Spain Guide and Best Places to Live in Spain.