Spanish private health insurance explained

Picture this: you’ve just settled into life under the Spanish sun. You’ve found your favourite café, your mornings start with a stroll past palm trees instead of your old grey-skied commute and you’re beginning to make headway with learning the language.

Life is good…

Until you suddenly need to see a doctor.

If you’re new to Spain, one of the first big questions you’ll face is how to handle healthcare. Spain’s public healthcare system is efficient, high-quality and largely free for residents. But for many expats, it can prove challenging to navigate: appointments can require lots of paperwork, wait times for certain specialists can be long and language barriers can make explaining symptoms or understanding medical advice tricky. That’s where private health insurance comes in.

In this guide, we'll explore:

• Why consider private health insurance
• Eligibility and requirements
• Coverage options
• Costs and premiums
• Choosing the right provider
• How to use your insurance policy.

Why consider private health insurance?

While Spain’s public healthcare system is excellent, it’s not a perfect fit for expats. Private health insurance in Spain offers a level of comfort and control that the public system can’t match.

Private health insurance provides faster access to specialists and diagnostic tests. Waiting months for a dermatology or orthopedic appointment isn’t uncommon in the Spanish public healthcare system, whereas private patients can often book one within days.

You’ll also have access to a wider network of hospitals and clinics with private health insurance, many of which cater to international patients with multilingual staff.

Private health insurance also provides greater peace of mind: if you’re an expat, you won’t have to navigate complex bureaucracy in a second language or worry about what’s covered as a non-citizen. And if you’re applying for a residency visa, such as Spain’s popular non-lucrative or digital nomad visa, private insurance is actually a requirement.

Choice, speed and comfort are all major benefits of private health insurance and highly valuable when your health is on the line.

Private vs. expat health insurance: what’s the difference?

Many newcomers to Spain get confused between private health insurance and expat health insurance. These two insurance types serve very different purposes.

Expat health insurance is designed mainly for people who are new to Spain and need coverage to meet visa or residence permit requirements. It’s an entry-level option that covers emergencies, accidents and sudden illnesses, but usually excludes pre-existing conditions, routine check-ups or ongoing treatments.

This kind of plan is meant to help you get settled and is often only available for the first few years of your stay, typically up to five years after arrival.

Private health insurance, on the other hand, is a long-term solution for residents who plan to stay in Spain. It offers broader coverage, including access to specialists, hospital care, surgery and sometimes extras like dental or vision benefits. It’s better suited for people who want to supplement the public health system and are looking for more extensive coverage.

Both are non-public insurance options; the difference is who they’re for and how comprehensive they are. Expat health insurance is a short-term, visa-friendly plan for newcomers, while private health insurance is a long-term, more complete option for residents. Fully private health insurance is also more expensive because of its more favourable terms and conditions.

Differences between private and expat health insurance: at a glance

Who is eligible for Spanish private health insurance?

The good news is that almost anyone is eligible for private health insurance in Spain.

Both residents and non-residents can purchase a policy: expats, retirees, digital nomads and students often find private insurance to be the easiest and most straightforward way to access healthcare in Spain.

In fact, if you’re not paying into the country’s social security system yet, it may be your only option for full coverage.

When applying, insurers typically ask for:

• Your passport or NIE (foreign identification number)
• Proof of address in Spain
• Bank details for direct debit
• Sometimes a short health questionnaire to be completed.

It’s usually a fairly simple process, and if you’re working with a trusted health insurance provider, you should be able to complete the process online, in English and without endless paperwork.

What does private health insurance cover?

Spanish private health insurance isn’t one-size-fits-all; plans vary widely depending on how much coverage you want and what you’re willing to pay for. Still, most comprehensive policies typically include:

• Primary and specialist care: from general practitioners to cardiologists, dermatologists and more
• Hospitalisation and surgeries: inpatient care in private hospitals, often with your own room
• Emergency care: both in Spain and sometimes abroad
• Diagnostic tests and imaging: such as bloodwork, MRIs and ultrasounds
• Maternity and pediatric care: prenatal visits, delivery and newborn care
• Dental coverage: this is sometimes included and sometimes offered as an add-on.

Some private health insurance plans will also offer optional extras, like international coverage, mental health support, sexual health or alternative therapies.

One key thing to keep in mind is that all policies have limits and exclusions. Pre-existing conditions, elective or cosmetic treatments and long-term chronic care may not be covered or they might come with waiting periods. It’s always best to read the fine print before signing up.

How much does private health insurance cost?

The cost of private health insurance in Spain depends on your age, health, location and the type of plan you choose.

Prices also vary by region: living in Madrid or Barcelona often costs a bit more than smaller cities or coastal towns.

It’s important to remember that healthcare isn’t just another monthly bill. View it instead as an investment in security and peace of mind. And if you ever need a specialist or an unexpected hospital stay, you’ll be glad to have it.

Choosing the right health insurance provider

With so many insurance companies in Spain, choosing the right one can feel like a pretty daunting task. But if you look for a provider that offers simple and clear coverage, great customer service and an easy claims process, you’ll be on the right path.

It’s best to do research to find a health insurance provider that:

• Offers transparent policies with no hidden fees or confusing terms
• Has an extensive hospital network that includes clinics near to where you live (Feather’s private health insurance does not have a network; you can choose freely)
• Provides English-speaking support and an easy-to-use online portal
• Has plenty of good reviews and processes insurance claims quickly.

How to use your insurance policy

Once you’re covered by a trusted provider, using your private health insurance in Spain should be very simple.

When you book an appointment at a hospital or clinic that is part of your insurer’s network, just present your insurance card; there should be no need to pay any fees upfront.

For out-of-network providers, you might have to pay the medical bill first and then later submit a claim for reimbursement; if that’s the case, be sure to obtain an invoice or receipt that you can use later when you file your claim. Most insurers now offer easy online claim systems that will handle your reimbursement efficiently.

You can also register with specific doctors or clinics if you prefer, making it easy to build continuity of care. Many insurers now also offer 24/7 helplines or virtual consultations for minor concerns.

Move to Spain with peace of mind

Settling into life in Spain is about more than sunshine, delicious food, and a slower pace: it’s also about feeling secure in your day-to-day life. As you’ve seen, private health insurance touches so many aspects of that security. Understanding why it matters, knowing what’s required to get coverage, weighing your options, considering your costs, choosing the right provider is time well spent, and essential to feeling confident in how to use your policy.

All of these pieces come together to give you peace of mind. With the right insurance in place, you can truly embrace life in Spain, knowing that if the unexpected happens, you’re covered, quickly, comfortably, and in your own language.

It’s a small step that makes a big difference in enjoying your new chapter with confidence and ease.