Spain Healthcare Guide
Everything you need to know about healthcare as an expat in Spain.
Healthcare System Overview
Spain operates **Sistema Nacional de Salud (SNS)**—a universal public healthcare system ranked **7th globally** by WHO. Tax-funded, decentralized across 17 autonomous communities, free at point of delivery for registered residents. **Key metrics:** - Life expectancy: **84.1 years** (highest in EU) - Infant mortality: 2.5/1,000 (well below OECD average) - Healthcare spending: $5,346 per capita (~9.2% GDP) - 86% of chronic condition patients rate care "good"
Public Healthcare
**Public Healthcare (SNS) Coverage:** **Included:** Primary care, specialists, hospital care, surgeries, emergency services, maternity, pediatrics, mental health (limited), vaccinations, cancer treatment, rehabilitation, ambulance **NOT included:** Adult dental (children under 15 covered), optical, full prescription costs (co-payment required), cosmetic procedures **Wait Times (2024-2025):** - Primary care appointment: 8-12 days - Specialist consultation: **90-115 days** - Non-urgent surgery: **115-128 days** - MRI: Weeks to months Regional variations: Basque Country best (64 days surgery); Catalonia worst (151 days).
Private Healthcare
**Private Healthcare Quality:** Excellent in major cities with modern facilities and shorter waits. **English-speaking doctors:** Widely available in Madrid, Barcelona, Valencia, Costa del Sol through private insurers. **Major Private Insurers:** - **Sanitas:** Spain's largest; excellent digital services; €31-90/month starting - **Adeslas:** Largest network; good for expats; €49-58/month starting - **ASISA:** No waiting periods; broadest hospital network; €60-180/month - **DKV:** No financial limit; immediate coverage; €89+/month - **MAPFRE:** Repatriation worldwide including USA - **Cigna Global:** Best for US coverage; worldwide; $3,000-12,000/year **Private Wait Times:** - Primary care: Same day to 2 days - Specialist: Days to 2 weeks - Non-urgent surgery: 2-4 weeks - MRI: Days
Healthcare for Expats
Access & Eligibility
**Can Americans access public healthcare? Yes, through these routes:** 1. **Employment:** Automatically enrolled through salary deductions 2. **Self-Employment (Autónomo):** Register with RETA and make monthly contributions (~€230/month) 3. **Convenio Especial:** Pay-in scheme for non-workers after 12 months residency **Convenio Especial costs:** - Under 65: €60/month (~$68 USD) - 65 and over: €157/month (~$179 USD) - **Catalonia:** FREE for residents **Major advantage:** Covers pre-existing conditions at standard rate.
Recommended Approach
**Recommended approach for American expats:** 1. **First year:** Private insurance required for most visas anyway 2. **Once working/autónomo:** Automatic SNS enrollment through contributions 3. **If not working:** Apply for Convenio Especial after 12 months 4. **Long-term:** Many expats maintain dual coverage—SNS for routine care, private for faster specialist access **Emergency number:** 112 (police, fire, ambulance) **Ambulance costs:** Emergency transport free; non-emergency €20-120 **Pharmacies:** Green cross signs; 24-hour farmacias de guardia on rotation. Pharmacists can advise on minor ailments. Prescription costs much lower than USA.
Typical Costs
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Health Insurance
Requirements
**Visa insurance requirements:** Most long-term visas require private insurance with: - Full coverage within Spain - No co-payments or deductibles - Minimum €30,000 coverage - Repatriation coverage - 12-month upfront payment often required Digital Nomad Visa, Non-Lucrative Visa, and Student Visa all require compliant private health insurance.
Recommended Insurance Providers
- Sanitas
- Adeslas
- ASISA
- DKV
- MAPFRE
- Cigna Global
Medical Tourism
Spain is a popular medical tourism destination for Europeans, with high-quality care at lower costs than Northern Europe. Dental care is particularly popular—50-70% cheaper than USA with comparable quality.
Popular Procedures
Recommended PartnerDon't skip health insurance
Cost estimates are great for budgeting, but real coverage protects you when something goes wrong.
A portion of affiliate revenue is donated to UNHCR
Compare Healthcare Systems
See how Spain's healthcare compares to other countries.