Healthcare in Spain — Public, Private & Everything Between
Spain has one of the best healthcare systems in the world — universal, high-quality and cheap. Here's exactly how to access it as an expat.
Spain's healthcare consistently ranks in the world's top 10. As a resident, you can access free public care, pay a small fee for Convenio Especial, or take out private insurance — most expats end up with a mix.
Public vs private — at a glance
| Public (SNS) | Private | |
|---|---|---|
| Cost | Free for contributors | €40–€200/month |
| Coverage | Everything | Most things — varies by policy |
| Waiting times | Sometimes long (specialists) | Days, not months |
| Language | Often Spanish only | Often English available |
| Visa-friendly | Only once you're insured | Accepted for all visa applications |
How to access public healthcare
- Become a legal resident (visa + TIE)
- Register on the padrón at your town hall
- Register with Spanish Social Security (employed, autónomo, or via Convenio Especial)
- Visit your local centro de salud with TIE + padrón + SS number to get a SIP card
- Use it at any GP, specialist or hospital
Convenio Especial
A special pay-in scheme for legal residents who aren't yet contributing to social security. €60/month if under 65, €157/month if 65+. Covers everything except prescriptions. Available after 1 year of padrón registration. It's a great backup if you're on the NLV.
Private insurance — what to buy
For visa applications you need a Spanish policy with full cover, no co-pay (sin copago) and no waiting period. The big players: Sanitas, Adeslas, Asisa, DKV, AXA. Expect €60–€120/month per adult under 50.
Pros
- Fast specialist appointments
- English-speaking doctors in expat areas
- Modern private hospitals (Quirón, HM, Vithas)
- Often cheaper than equivalent US/UK premiums
Cons
- Premiums rise sharply after 65
- Pre-existing conditions can be excluded
- Major surgery: many people prefer the public system anyway
Frequently asked questions
Need help moving to Spain?
Our local team helps with visas, NIE, healthcare, housing and more. One friendly point of contact for your whole relocation.