How does access to public healthcare in Spain work?
Spain is one of the countries with the best public healthcare systems in the world. This is evident from its consistent ranking in the top 10 in most lists. The system is entirely free and of very high quality.
As a foreigner, can I access the Spanish public healthcare system?
Anyone who lives and works in Spain can access the National Health System (SNS) because they contribute to Social Security.
Therefore, to access the SNS, you must reside and work in Spain or meet one of the following conditions:
1. As a citizen of the European Union or the EEA, you are entitled to access public healthcare in Spain if:
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You reside permanently in Spain: you need to register with the local municipal registry and obtain a Foreigner Identification Number (Número de Identificación de Extranjero - NIE). Then, you can enroll in the Spanish Social Security system and gain access to the SNS.
Until you can access the SNS, you need private health insurance to ensure your health coverage. This applies to both workers and retirees.
If you are already registered in the local municipal registry and are waiting to meet the requirements for permanent residency, you can apply for a special agreement insurance to access the SNS. - You are a tourist: you can use your European Health Insurance Card (EHIC) or the Global Health Insurance Card (GHIC) to access the SNS free of charge for up to three months, after which you will need to obtain private insurance.
2. You are from outside the EU or EEA: typically, you will need private health insurance for your stay in Spain, although some Latin American countries have agreements with Spain that allow their citizens to use the SNS in emergency cases.
Do I need private health insurance in Spain?
As mentioned in the previous section, there are certain cases where having mandatory private health insurance in Spain is required to reside legally in the country. However, this is not the only reason to consider getting health insurance in Spain.
Over the years, Spain has been experiencing a gradual aging of its population due to significant medical advancements. However, this has led to increased demand on the National Health System. As a direct consequence, specialist consultations and diagnostic tests can take months within the SNS, resulting in long waiting lists.
For this reason, many expats choose to complement their free access to public healthcare with private health insurance, as it allows them to access these services within hours or days.
What are the best private health insurance options in Spain?
There are over 200 health insurance providers operating in Spain, so if you reside in the country and decide to purchase private health insurance, you will find a wide variety of options. Choosing from such a large selection can be challenging.
To make this process easier, we have selected the best health insurance options in Spain for expatriates, grouping them by type and suitability for working-age individuals or those over 70 years old.
1. Comprehensive Health Insurance with No Copay
Comprehensive health insurance with no copay allows you to access any coverage without paying extra fees. This means you pay the same amount every month, regardless of how often you use the insurance.
2. Comprehensive Health Insurance with Copay
Comprehensive health insurance with copay requires a payment each time you use the insurance. However, in exchange, the monthly fee is lower.
3. Health Insurance for Seniors
In Spain, most health insurance plans have a maximum age limit for enrollment, typically 70-75 years. This makes finding insurance for older individuals challenging. For this reason, we present the only available options:
Keep in mind that if you do not have access to the Spanish National Health System, you may need insurance that includes hospitalization in order to reside in Spain.
Cheapest Health Insurance in Spain
If you're looking for the cheapest health insurance in Spain, you're in the right place, as we've selected the ones with the lowest prices for each type of insurance:
1. Without Hospitalization
| Type | Insurance | Price |
|---|---|---|
| Basic with copay | Caser Salud Médica Copago limitado | From 13,99 €/month |
| Basic with copay | FIATC Start | From 20,12 €/month |
| Basic with copay | Sanitas Accede | From 22,1 €/month |
| Basic with copay | Adeslas Go | From 21 €/month |
| Basic with copay | Aegon Salud Básico | From 24,35 €/month |
Health insurance without hospitalization is usually chosen when you already have access to the National Health System (Sistema Nacional de Salud), but you want to complement it with private insurance that allows you to quickly access consultations with specialists and diagnostic tests.
In Spain, it's common to wait several months to see a specialist and even more months to have the necessary tests performed. For example, you might have to wait 6 months for an MRI. With private health insurance, this can be resolved in a matter of days, which is why many people choose to take out this type of insurance.
2. With Hospitalization
We have selected the cheapest comprehensive health insurance plans in Spain, taking into account whether they are with or without copayments:
| Type | Insurance | Price |
|---|---|---|
| Comprehensive with Copay | DKV Integral Complet | From 17 €/month |
| Comprehensive with Copay | FIATC Medifiatc P15 | From 31,06 €/month |
| Comprehensive with Copay | Caser Integral Con copago limitado | From 32,14 €/month |
| Comprehensive with Copay | Adeslas Plena Vital | From 38 €/month |
| Comprehensive with Copay | Sanitas Más Salud Plus | From 50 €/month |
| Comprehensive with No Copay | DKV Integral Élite | From 39 €/month |
| Comprehensive with No Copay | Caser Adapta + Dental | From 52,48 €/month |
| Comprehensive with No Copay | FIATC Medifiatc | From 47,15 €/month |
| Comprehensive with No Copay | Adeslas Plena Plus | From 62 €/month |
| Comprehensive with No Copay | Sanitas Más Salud | From 66,31 €/month |
If you want a detailed breakdown of how much each type of plan costs depending on your age and family situation, check out our full guide to health insurance costs in Spain, where we analyse real 2026 prices by profile.
Do I need dental coverage with my health insurance in Spain?
In Spain, the National Health System offers very limited coverage in the field of dental health, mainly focused on infection control and tooth extractions. For this reason, it is very common to have dental insurance or include dental coverage in your health insurance plan.
What does the dentist cover under Spain's National Health System?
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Treatment of acute dental conditions:
- Infectious and/or inflammatory conditions affecting the oral-dental area.
- Dental bone trauma.
- Wounds and lesions on the oral mucosa.
- Acute pathology of the temporomandibular joint.
- Pharmacological treatment for necessary oral conditions.
- Extractions.
- Surgical extractions.
- Minor oral cavity surgery.
- Oral examinations for the early detection of pre-malignant lesions.
- Biopsy of mucosal lesions.
The coverage provided by Spain's public health system falls short in addressing the range of dental issues that may arise, such as cavities.
Due to these limitations, it is highly recommended to purchase private dental insurance or a health insurance plan that includes dental coverage.
To make it easier for you, Selectra has chosen the three best dental insurance plans and three health insurance plans that include dental coverage.
In addition to being able to purchase dental insurance on its own, you also have the option of acquiring health insurance that includes dental coverage. The following options offer the best value for money:
| Type | Insurance | Price |
|---|---|---|
| Comprehensive with dental | DKV Integral Élite | From 39 €/month |
| Comprehensive with dental | FIATC Medifiatc | From 47,15 €/month |
| Comprehensive with dental | Sanitas Más Salud Familias | From 65,77 €/month |
| Comprehensive with dental | Adeslas Plena Total | From 83 €/month |