Health Insurance in Spain for Retirees — Sanitas, Adeslas, DKV & Asisa Compared
The four main retiree-friendly insurers, what their policies actually cost by age, what 'sin copago' and 'sin carencias' mean for visa applications, and how to avoid the common pitfalls.
The four main retiree-friendly insurers, what their policies actually cost by age, what 'sin copago' and 'sin carencias' mean for visa applications, and how to avoid the common pitfalls.
The four main insurers for retirees
| Insurer | Network strength | Retiree reputation |
|---|---|---|
| Sanitas | Quirónsalud + own clinics | Premium, best for over-65s, accepts older applicants |
| Adeslas | Largest network in Spain | Mainstream, very wide coverage, accepts to age 74 |
| DKV | German-owned, strong Costa Blanca | Very popular with Northern Europeans, good English support |
| Asisa | Cooperative, HLA hospitals | Cheaper, slightly narrower network |
Typical monthly premiums by age (sin copago)
| Age | Sanitas | Adeslas | DKV | Asisa |
|---|---|---|---|---|
| 50 | €75–€95 | €60–€80 | €70–€90 | €55–€75 |
| 60 | €110–€140 | €90–€120 | €105–€135 | €85–€110 |
| 65 | €150–€190 | €130–€170 | €145–€185 | €120–€155 |
| 70 | €210–€260 | €185–€235 | €205–€255 | €170–€215 |
| 75 | €280–€350 | €250–€310 | €275–€340 | €225–€285 |
| 80+ | Closed to new policies (most insurers) |
Once accepted, insurers cannot drop you for age or new conditions. The single most important retiree decision is to take out a policy BEFORE 70 — after that most insurers close to new applicants and your options shrink dramatically.
Visa-grade policies — what's mandatory
- ✦Sin copago — no per-visit charges (or the consulate may reject)
- ✦Sin carencias — no waiting periods on any service
- ✦Cobertura equivalente al SNS — coverage equal to Spanish public system
- ✦Repatriation usually NOT required (despite what some lawyers claim)
- ✦Issued by a Spanish-regulated insurer (not a UK/US policy)
What's typically included vs excluded
| Included | Excluded or extra |
|---|---|
| GP and specialist visits | Routine dental (separate add-on) |
| Hospitalisation and surgery | Cosmetic surgery |
| Maternity | Fertility treatment (usually) |
| Diagnostic imaging (MRI/CT) | Glasses and contact lenses |
| Physiotherapy (limited sessions) | Pre-existing conditions (case by case) |
| Psychology (limited) | Long-term residential care |
Co-pay vs no co-pay — which to choose
Con copago policies are 30–40% cheaper but charge €4–€15 per consultation. Good for healthy under-65s who rarely visit. Sin copago is required for visa applications and recommended for over-65s who use the system more often. Most retirees on NLV start sin copago, and once they have S1 they often switch to con copago for the cheaper top-up.
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