A Guide to Healthcare in Spain for Expats

Spain is a hugely popular destination for expatriates relocating from all over the world, thanks to the laid back lifestyle, stunning natural beauty, abundance of beaches, and its climate providing year-round warmth. Some expats relocating to Spain also highlight the health benefits as a factor in their move. But how does healthcare in Spain for expats work? The Mediterranean diet, regular sunshine, and an active stress-free lifestyle contributes to Spain being one of the World Health Organisation’s (WHO) healthiest places to live. Fortunately, when medical care is required, Spanish healthcare is outstanding. The level of medical care in Spain has previously been ranked amongst the Top 10 in the world by WHO, and it later took 1st place in Bloomberg’s 2019 Healthiest Country Index, ensuring you’ll be in good hands. 

In order to apply for a long stay Visa, entitling you to stay in Spain for longer than three months, or to register as a resident of Spain, you are required to prove you have medical cover. This rule applies to all the main long-stay routes – non-lucrative, investment and the 2023 digital-nomad visa – and the policy must provide nationwide cover with no co-payments, waiting periods or reimbursement limits. But what are the options for healthcare in Spain for expats? Does Spain have a public healthcare system that expats can access? Or do relocated citizens require private Spanish healthcare? We’ve detailed all the information in this article, providing you with everything you need to begin accessing medical care in Spain.

What are the Options for Healthcare in Spain for Expats?

Spain has a public health system, the Sistema Nacional de Salud (SNS), providing its citizens with a service similar to the National Health Service (NHS) in the UK. The SNS is a state-funded service providing almost entirely free medical care in Spain, and is one option for healthcare in Spain for expats.

Alternatively, it is possible to receive private healthcare in Spain.

How to Access the National Spanish Healthcare System

Expats in Spain can have access to the SNS public Spanish healthcare system, provided they have registered for the service. Receiving public healthcare in Spain for UK citizens who have relocated to the country requires proof that you fulfil the government’s conditions. In short, you are required to prove either you make Spanish social security contributions through your employment, or you pay into a health insurance scheme, or you are entitled for the UK government to pay for your healthcare in Spain. 

The full list of options that entitle you to register for Spanish public healthcare are:

• If you are employed, or self-employed, in Spain, and you make Spanish social security contributions, then you are entitled to public Spanish healthcare.
• If you are eligible for an S1 form, entitling you to Spanish public healthcare that is paid for by the UK government. For example, if you are a Spanish resident eligible for a UK State Pension.
• If you have lived in Spain for over a year, you can join the public health insurance scheme (Convenio Especial) by paying a flat monthly fee – currently €60 if you are under 65 and €157 if you are 65 or over – but note that it does not subsidise prescription charges.
• You are a dependant of someone entitled to Spanish state healthcare.
• If you have lived in Spain for 5 years, you could be entitled to Spanish healthcare through permanent residency.
• If you are in Spain temporarily, you can use a UK-issued Global Health Insurance Card (GHIC); an older EHIC remains valid only until the expiry date printed on it.

For more information, the British government website provides more details on public healthcare in Spain for UK citizens.

I’m Retired, Can I Access Spanish Healthcare?

Yes, healthcare in Spain for expats that have retired can be possible on the SNS public health service, by paying into the Convenio Especial (see fees above), which accepts pre-existing conditions but excludes prescription subsidies. Alternatively, you can take out private medical insurance.

Is National Spanish Healthcare Free?

Once registered for the SNS, basic healthcare in Spain for expats is free. This covers most essential medical procedures. Just like the UK, you will be covered for appointments with a doctor, as well as emergency visits. Most healthcare providers, including doctor surgeries and hospitals, provide both private and state-funded care, so be sure they know in advance which you require.

However, some specialist services, such as certain physiotherapies, may require a contribution to the costs. A Universal Health Care Bill passed in 2024 bars any new copayments and keeps the current income-based caps in place. And similarly to the UK, you may be required to also pay a contribution to receive prescriptions. The amount you pay depends on your circumstances. Prescriptions can be picked up at any pharmacy, farmacia, with some offering a 24-hour service for urgent needs.

What about Dentists in Spain?

Most routine adult dental care is still not covered, so you usually pay for these treatments out of pocket. Since the SNS Oral-Health Plan was extended in 2022–2024, children and adolescents, pregnant women, adults with intellectual disabilities, and head-and-neck-cancer patients can now receive a basic package of free public dental services (check-ups, fillings, extractions, cleaning, sealants, etc.). Private insurance can cover wider dental procedures, and dental-specific insurance plans also exist.

What is the National Healthcare Like in Spain?

Spain is one of the largest healthcare system funders in the whole of Europe, and healthcare in Spain for expats benefits from the same rule that obliges the state to provide emergency and basic care for all citizens. As a result, the quality of medical cover on the SNS is impressive.

To receive medical care, you are required to show your health insurance card, which is provided once you have registered with the SNS. Since a 2024 royal-decree, every region also issues a virtual TSI in the free “Tarjeta Sanitaria Virtual / Mi Salud” app, so you can just show the QR/NFC code on your phone instead of the plastic.

You can visit a doctor at a GP surgery, médico de cabecera, or visit a health centre, centro de salud or centro de asistencia primaria, which is staffed by a broader range of medical specialists. To receive specialist treatment, you have to be referred through a Spanish doctor.

A list of Spanish hospitals and clinics can be found by clicking the link, showing your local services in English.

What About Spanish Healthcare for Children?

Dependants of beneficiaries of the SNS, including direct family and children, are also able to register to the SNS to gain access to public Spanish healthcare. Child healthcare also covers dental care (up to the age of 16 under the 2024 Oral-Health Plan), vaccination costs (up to 14 years old, with a good national vaccination programme) and paediatric care.

What do I do in a Medical Emergency?

For everyone — including those relying on healthcare in Spain for expats — if urgent and life-threatening medical treatment is required, you can contact the emergency services by calling 112, which is free from both mobile and landline phones. Hospitals have an emergency response/A&E department that can be visited in emergencies, ambulances carry trained first responders, and emergency care is covered by the public health service.

Am I still Eligible to UK Healthcare?

Receiving public healthcare in Spain for UK citizens may mean you lose access to free NHS healthcare back in the UK. The UK system is residency based, and expats who have permanently relocated abroad will not receive free healthcare back in the UK. Exceptions to this include war pensioners and UK government employees, who would not have to pay for healthcare in the UK.

Private Healthcare in Spain

You can also opt to receive private healthcare in Spain. If you choose to not register for the SNS, you will need to prove you have the private medical coverage required to obtain a visa/residency in Spain, with a private medical insurance plan.

Thanks to the high coverage and top-quality medical care available from the public SNS service in Spain, private health insurance is a far less common option for healthcare in Spain for expats and locals, with over 90% of the population choosing the public service. 

However, there are some instances where private healthcare is advantageous. Just like the UK, waiting lists for some medical procedures on the public service can be lengthy, and faster treatment can be sought privately. In addition, as some services, including glasses/optical prescriptions, dental procedures and sports physiotherapy are not included in the national cover, some choose a private medical plan. Alternatively, private healthcare plans exist to complement the services provided by the national health cover. Lastly, as medical coverage may not be attainable immediately after relocating, sometimes it may be practical to get short-term private healthcare in Spain for UK citizens who have recently moved to the country.

As expected, the cost of private healthcare in Spain depends on a range of factors, such as the age and current health condition of the individual. A range between €60 and €230 per month would be a practical estimate, which also depends on the level of coverage desired. You can sign up for private healthcare in Spain online.

Summary

To relocate to Spain, you are required to prove you have sufficient health care. This can be through private medical insurance, or, along with 90% of Spanish citizens, you could be eligible to join the Spanish national health service, aka the SNS. If you contribute with social security payments in Spain then you are eligible for the public health cover, or you may be able to pay monthly into the Convenio Especial to also receive national health care. 

Overall, the SNS provides an outstanding level of healthcare in Spain for expats and Spanish citizens. You may also decide to get private medical healthcare in Spain, with complete medical coverage or to compliment the SNS service. Whichever option suits you best, you can be sure that you will experience high levels of care from well-trained staff in excellent medical facilities in Spain.