Healthcare System in Spain

Last Updated: February 2026
Source: Community knowledge and expat experiences

Overview

Spain has one of the best healthcare systems in the world. As a legal resident, you have access to excellent public healthcare. This guide covers both public and private options.

Two Systems

Public Healthcare (Seguridad Social)

Coverage:

• ✅ Free (covered by contributions)
• ✅ Comprehensive care
• ✅ Hospitals, specialists, emergency
• ✅ Medications (subsidized)

Who gets it:

• Employed workers (automatic)
• Autónomos (self-employed paying contributions)
• Pensioners
• Dependents of above
• Some others (check eligibility)

Quality: Excellent, but can have wait times for non-urgent care

Private Insurance

Coverage:

• Faster appointments
• More doctor choice
• Private hospitals/clinics
• English-speaking doctors often available

Cost: €40-100/month per person

Who needs it:

• Required for visa applications
• During first months (before public access)
• Anyone wanting faster service
• Supplement to public

Getting Public Healthcare

If You're Employed

Automatic:

• Employer registers you
• You get social security number
• Receive tarjeta sanitaria (health card)
• No action needed from you

If You're Autónomo

After registering as autónomo:

1. You start paying monthly contributions
2. You're automatically enrolled in healthcare
3. Register at local centro de salud
4. Receive tarjeta sanitaria

Timeline: Access after first contribution paid (usually immediate)

Registering at Centro de Salud

What you need:

• NIE/TIE
• Empadronamiento
• Social security number
• Passport

Process:

1. Find your assigned centro de salud (based on address)
2. Visit during office hours
3. Register ("alta" in the system)
4. They assign you a GP (médico de cabecera)
5. Receive tarjeta sanitaria (health card)

Timeline: Same day or within 1 week

Using Public Healthcare

Centro de Salud (Health Center)

Your GP (Médico de Familia):

• Primary care doctor
• First point of contact
• Prescriptions
• Referrals to specialists

Booking appointments:

• In person: Visit centro and book
• By phone: Call your centro
• Online: Some regions have apps/portals
• Emergency: Walk-in usually available

Wait times:

• Routine: 1-7 days
• Urgent: Same day

Specialists

Referral required:

• Can't book specialist directly (public)
• GP refers you
• Specialist appointments: 2-8 weeks typically

Common specialists:

• Traumatology (orthopedics)
• Dermatology
• Gynecology
• ENT (ear/nose/throat)
• Cardiology

Hospitals

Emergency (Urgencias):

• No appointment needed
• Free with health card
• Wait times vary (priority based)
• Bring tarjeta sanitaria + ID

Non-emergency:

• Only with referral
• Surgery, specialist treatment
• Fully covered

Pharmacies (Farmacias)

Prescriptions:

• Doctor gives prescription
• Take to any pharmacy
• Pay subsidized price:
  • Employed: 40% of cost
  • Pensioners: 10%
  • Chronic conditions: Even less

Over-the-counter:

• Many medicines available without prescription
• Pharmacists very knowledgeable
• Green cross sign

Private Healthcare

Why Use Private

Advantages:

• ✅ Faster appointments (days vs weeks)
• ✅ Choose your doctor
• ✅ English-speaking doctors
• ✅ Nicer facilities
• ✅ Skip referral system
• ✅ Less bureaucracy

Disadvantages:

• ❌ Monthly cost
• ❌ May have copays
• ❌ Pre-existing condition exclusions
• ❌ Annual limits on some treatments

Top Insurance Companies

1. Sanitas ⭐⭐⭐

• Largest network
• Good coverage
• €50-90/month
• English support

2. Asisa

• Comprehensive
• Competitive prices
• €45-80/month

3. Adeslas

• Well-established
• Good hospitals
• €50-85/month

4. DKV

• International network
• Good for expats
• €55-100/month

5. Axa

• International company
• English support
• €60-110/month

What's Covered (Typical)

Included:

• GP visits
• Specialists
• Tests (blood work, X-rays, etc.)
• Emergencies
• Hospitalization
• Surgery

Usually NOT included:

• Dental (separate insurance)
• Pre-existing conditions (first 6-12 months)
• Cosmetic procedures
• Some experimental treatments

Costs

Premiums:

• Age 18-30: €40-60/month
• Age 31-50: €50-80/month
• Age 51-65: €70-120/month
• Age 65+: €100-200+/month

Copays:

• Some plans have €0-20 copay per visit
• Others include visits in premium

Deductibles:

• Rare in Spain
• Most plans: direct coverage

Emergency Services

Calling Emergency Number

112 - Universal emergency number

• Ambulance
• Fire
• Police
• English operators usually available

061 - Direct to ambulance

Hospital Emergencies

Urgencias:

• Open 24/7
• Free with health card
• Triage system (priority based)
• Wait times: 30min - 4 hours (depends on severity)

Private emergency:

• Faster but may have copay
• Call your insurance first
• Or pay and claim back

What to Bring

Always carry:

• ✅ Tarjeta sanitaria (health card)
• ✅ ID (NIE/TIE or passport)
• ✅ Private insurance card (if you have it)
• ✅ List of medications
• ✅ Allergies/conditions info

Common Situations

New to Spain (No Healthcare Yet)

Options:

1. Travel insurance - First 1-3 months
2. Private insurance - Required for visa anyway
3. Pay out-of-pocket - Emergencies at public hospitals (cheaper than many countries)

Pregnant Women

Public:

• Full maternity care
• Prenatal visits
• Hospital birth
• Postnatal care
• All covered

Private:

• Choose your doctor
• Private room for birth
• More flexibility
• €2,000-5,000 for birth (if no insurance)

Children

Public:

• Pediatrician assigned
• Vaccinations included
• School health checks
• Fully covered

Private:

• Faster appointments
• More pediatrician choice
• €30-50/month extra

Chronic Conditions

Public:

• Excellent care
• Heavily subsidized medications
• Regular monitoring
• Free disease management programs

Medications:

• 10% for chronic conditions
• Some 100% covered

Mental Health

Public:

• Available but limited
• Long waits for psychologists
• Psychiatrists available sooner
• Medications covered

Private:

• Much faster access
• More therapists available
• English-speaking options
• €50-100/session

Specialists & Services

Dental

NOT covered by public healthcare (except emergencies)

Private options:

• Dental clinics everywhere
• €40-80 for cleaning
• €50-100 for filling
• Dental insurance: €20-40/month

Optical

Public:

• Basic coverage
• Prescriptions free
• Glasses: partial subsidy

Private:

• Many optical chains
• Affordable compared to US/UK
• €100-300 for glasses

Maternity/Obstetrics

Public:

• Comprehensive
• Regular checkups
• Ultrasounds included
• Hospital birth

Private:

• Choose obstetrician
• More frequent visits
• Private birth
• Partner can stay

Finding Doctors

Public

Assigned GP:

• Based on your address
• Can request change if issues

Find your centro de salud:

• Google: "centro de salud [neighborhood]"
• Ask at ayuntamiento

Private

Check insurance network:

• Insurance company website
• List of approved doctors/hospitals

English-speaking doctors:

• Many in expat areas
• Search: "English speaking doctor [city]"
• Ask in expat groups

Private clinics:

• Hospital Quirónsalud
• Hospital 9 de Octubre (Valencia)
• Hospital Vithas
• IMED Hospitals

Medications

Prescriptions

How it works:

1. Doctor prescribes
2. Receive paper or digital prescription
3. Take to pharmacy
4. Show health card
5. Pay subsidized amount

Without health card:

• Pay full price
• More expensive but still reasonable

Bringing Medications from Home

Allowed:

• Up to 3 months supply
• Keep in original packaging
• Bring prescription
• Declare at customs

Narcotics/controlled substances:

• Need special permission
• Check before traveling

Health Insurance for Visa

Digital Nomad Visa Requirement

Must have:

• Private insurance with comprehensive coverage
• Valid for entire visa period
• Minimum coverage: No specific amount but must be comprehensive
• No deductible or low deductible preferred

Accepted companies:

• Spanish insurers (Sanitas, Adeslas, etc.)
• International insurers (AXA, Cigna, etc.)
• Travel insurance with minimum €30,000 coverage

Duration:

• Must cover entire visa period
• Renew before visa renewal

Costs Comparison

Public Healthcare

Private (No Insurance)

Much cheaper than US/UK even without insurance!

Tips from Community

✅ Register at centro de salud immediately - Don't wait
✅ Keep private insurance first year - Backup while settling
✅ Learn medical Spanish - Basic terms help
✅ Keep emergency numbers saved - In phone
✅ Find English-speaking doctor - Ask in expat groups
✅ Bring prescription history - From home country
✅ Download regional health app - Online booking

Regional Differences

Healthcare is regional (Comunidad Autónoma manages it)

Valencia:

• App: GVA+Salut
• Portal: www.san.gva.es

Madrid:

• App: Tarjeta Sanitaria Virtual
• Portal: www.comunidad.madrid/servicios/salud

Catalonia:

• App: La Meva Salut
• Portal: catsalut.gencat.cat

FAQs

Q: How long until I get public healthcare?
A: As soon as you're employed or registered as autónomo and paying contributions.

Q: Can I use public healthcare from day one?
A: Only if already enrolled. Otherwise use private/travel insurance first months.

Q: What if I lose my health card?
A: Request replacement at centro de salud. Use NIE as backup.

Q: Can I choose my doctor?
A: Public: assigned but can request change. Private: full choice.

Q: Do I need private insurance if I have public?
A: No, but many keep it for faster service and English support.

Q: What about my kids?
A: Covered automatically if you're enrolled. Register them at centro de salud.

Q: Is everything really free?
A: Healthcare yes. Prescriptions: you pay 10-40% depending on status.

Q: What if I don't speak Spanish?
A: Public: may be challenging. Private: easier to find English speakers. Bring translator or use app.

Important Numbers

Emergencies:

• 112: Universal emergency
• 061: Ambulance direct

Health Info:

• Each region has health hotline
• Valencia: 900 161 161
• Madrid: 112 (option for health)

Spain's healthcare is world-class. Whether you use public, private, or both, you'll receive excellent care.