Spanish Healthcare System: Complete Expat Guide 2025
Navigate Spain's dual healthcare system with confidence - from SNS registration to choosing between public and private care
We regularly verify this information against official sources. Always check official websites for the most current details before travel.
Quality Ranking
#26
Legatum Prosperity Index 2023 (Health)
Health Centers
13,000+
Nationwide
Prescription Cost
40-60%
Subsidized
Emergency
112
EU-wide number
Your Healthcare Options in Spain
Public Healthcare (SNS)
Universal coverage for residents
Cost: Free at point of use (via social security contributions)
Advantages
- •Comprehensive coverage
- •No bills or paperwork
- •Excellent emergency care
- •Free prescriptions for pensioners
Limitations
- •Long waiting lists for specialists
- •Language barriers
- •Limited choice of doctors
- •No dental/optical
Best for: Long-term residents, families, those with chronic conditions
Private Health Insurance
Varies by plan (€50-200/month)
Cost: Monthly premiums + potential co-pays
Advantages
- •Short waiting times
- •English-speaking doctors
- •Choice of specialists
- •Private rooms
Limitations
- •Pre-existing conditions excluded
- •Age limits
- •Annual price increases
- •Coverage caps
Best for: Working expats, those wanting quick access, English speakers
Convenio Especial
Buy into public system (non-EU)
Cost: €60/month (under 65) or €157/month (65+)
Advantages
- •Full public system access
- •No exclusions
- •Predictable costs
- •Same as Spanish citizens
Limitations
- •Not available everywhere
- •Waiting period
- •Must prove residency
- •Monthly fee
Best for: Non-EU retirees, those with pre-existing conditions
How to Register for Public Healthcare
Get Your NIE
Foreign identity number required for all official procedures
Required Documents:
- • Passport
- • EX-15 form
- • Proof of appointment
Timeframe:
Same day with appointment
Register on Padrón
Municipal registration at your local town hall
Required Documents:
- • NIE
- • Rental contract/property deed
- • Passport
Timeframe:
Immediate
Obtain Social Security Number
Register at local INSS office if employed/self-employed
Required Documents:
- • NIE
- • Padrón certificate
- • Employment contract
- • TA.1 form
Timeframe:
1-2 weeks
Apply for Health Card
Get your tarjeta sanitaria at your local health center
Required Documents:
- • NIE
- • Padrón
- • Social Security number
- • Passport
Timeframe:
2-4 weeks for card arrival
💊 Prescriptions & Medications
- •Working adults: Pay 40-50% of medication cost
- •Pensioners: €8-18/month cap (income-based)
- •Chronic conditions: 10% with annual cap of €4.24
- •Unemployed: Free if no unemployment benefits
Tip: Generic drugs (genéricos) are 60% cheaper and widely available
🚨 Emergency Services
Note: ER visits are free for everyone in life-threatening situations
Special Considerations by Nationality
🇪🇺 EU/EEA Citizens
- • S1 form for pensioners
- • EHIC for temporary stays
- • Register as resident after 3 months
- • Same rights as Spanish citizens
🇬🇧 UK Citizens (Post-Brexit)
- • S1 form if receiving UK pension
- • GHIC replaces EHIC
- • TIE card required for residency
- • May need private insurance initially
🌍 Non-EU Citizens
- • Private insurance for visa
- • Convenio Especial option
- • Work permit = public healthcare
- • Reciprocal agreements vary
Major Private Health Insurers in Spain
Sanitas
Largest network, English support
Adeslas
SegurCaixa group, wide coverage
DKV
German insurer, expat-friendly
AXA
International coverage options
Mapfre
Spanish company, competitive rates
Asisa
Good value, extensive network
Compare tip: Use comparators like Acierto.com or Rastreator.com for quotes
What's NOT Covered by Public Healthcare
Generally Excluded:
- • Adult dental care (except extractions)
- • Optical care and glasses
- • Cosmetic procedures
- • Repatriation costs
- • Private room requests
Limited Coverage:
- • Mental health (long waiting lists)
- • Physiotherapy (limited sessions)
- • Hearing aids (partial coverage)
- • IVF (age/attempt restrictions)
- • Alternative medicine
Practical Tips for Using Spanish Healthcare
✅ Do's
- • Always carry your health card and NIE
- • Learn key medical Spanish phrases
- • Register with local health center ASAP
- • Keep all medical documentation
- • Ask for "justificante" for work absences
- • Use health app (Mi Carpeta Salud)
❌ Don'ts
- • Don't go to ER for non-emergencies
- • Don't expect appointments immediately
- • Don't miss appointments without canceling
- • Don't forget to update your padrón
- • Don't assume English will be spoken
- • Don't ignore preventive care programs
Healthcare by Autonomous Community
Each region manages its own health service with slight variations:
Best Rated Regions:
- • País Vasco: Osakidetza - Shortest wait times
- • Navarra: Osasunbidea - Excellent facilities
- • Madrid: SERMAS - Most specialists
- • Asturias: SESPA - Best patient satisfaction
Card Names by Region:
- • Valencia: SIP Card
- • Catalonia: TSI Card
- • Andalusia: Tarjeta Sanitaria
- • Madrid: Tarjeta Sanitaria
Essential Resources & Contacts
Official Websites:
- Ministry of Health- National health policies
- Seguridad Social- Social security registration
- Cita Sanitaria- Online appointments (varies by region)
Useful Apps:
- • Salud Responde: Health advice app
- • Mi Carpeta de Salud: Medical records
- • Radar COVID: Contact tracing
- • GVA +Salut: Valencia region health app