How to Get Healthcare in Spain as a New Resident
Healthcare in Spain is genuinely good. The public system (Sistema Nacional de Salud) is ranked among the best in Europe, and private healthcare is affordable by international standards. But figuring out how to access it as a new resident takes some work.
Here is how it all fits together.
Public healthcare: who gets it
The Spanish public healthcare system covers:
- Employees and self-employed workers (autonomos) who are paying into the social security system (Seguridad Social). This includes your dependents too.
- Registered unemployed people who are receiving benefits.
- Residents earning under a certain threshold who apply through the Convenio Especial (special agreement).
- EU citizens with a European Health Insurance Card (EHIC) for temporary stays, or who transfer their social security rights from another EU country.
If you are a new arrival on a non-lucrative visa or digital nomad visa and not yet working in Spain, you will not have automatic access to public healthcare. You will need private insurance initially.
How to register for public healthcare
If you qualify (typically because you are employed or autonomo), here is the process:
- Get your social security number. Your employer will usually handle this, or you can apply at the Tesoreria General de la Seguridad Social office.
- Get your SIP card (Tarjeta Sanitaria Individual). Go to your local Centro de Salud (health center) with your social security number, NIE, and empadronamiento. They will assign you a doctor (medico de cabecera) and give you your health card.
- Start using the system. Your assigned Centro de Salud is where you go for general health needs. Your GP there is your first point of contact for everything.
The whole process can take a few visits and some waiting, but it is straightforward once you have the right documents.
How public healthcare works in practice
The Spanish system is organized around Centros de Salud (local health centers) for primary care and hospitals for specialist and emergency care.
Primary care: You get assigned a GP at your local health center. For non-urgent issues, you book an appointment through the regional health service app or by phone. Wait times vary. Sometimes you can get in the same day, sometimes it takes a week or two.
Specialists: Your GP refers you to specialists if needed. The wait for specialist appointments in the public system can be long. We are talking weeks to months for non-urgent referrals. This is probably the biggest complaint people have about the public system.
Emergency care (Urgencias): Walk into any public hospital emergency department. No appointment needed. It can be busy and waits can be long for non-critical issues, but you will be seen.
Prescriptions: Most medications are subsidized. You typically pay 0 to 60% of the cost depending on your income level. Some medications that are expensive elsewhere are very affordable here.
Private healthcare
A lot of expats use private healthcare, either on its own or alongside the public system. The main reasons:
- Shorter wait times for specialists
- More English-speaking doctors
- Choice of doctor and hospital
- Required for certain visa applications
The main providers
Sanitas: One of the biggest. Good network of doctors and clinics. Plans start around 50 to 80 per month for a basic plan for someone in their 30s. They are popular with expats because they have English-speaking staff.
Adeslas: Another major provider with a large network. Similar pricing to Sanitas. Known for having a wide range of specialists.
Asisa: A bit cheaper than Sanitas and Adeslas. Good coverage but the network might be smaller in some areas.
Cigna, DKV: International options that can work well if you travel frequently.
What to look for in a private plan
- No co-pays (sin copagos) if you need it for a visa application. Many visa types specifically require this.
- Coverage area. Make sure the plan covers the region you are living in.
- Pre-existing conditions. Some plans have waiting periods (carencias) for pre-existing conditions, sometimes 6 to 12 months.
- Dental and optical. Usually not included in basic plans. You can add them for an extra fee.
- Mental health coverage. Check how many sessions are included.
Typical costs
| Age range | Basic plan | Comprehensive plan |
|---|---|---|
| 20s-30s | 40-70/mo | 80-130/mo |
| 40s-50s | 60-100/mo | 110-180/mo |
| 60s+ | 100-180/mo | 160-280/mo |
These are approximate. Costs depend on the provider, your health history, and the level of coverage.
The Convenio Especial
If you are a resident but do not qualify for public healthcare through employment, you can buy into the public system through the Convenio Especial. It costs around 60 euros per month (or 157 euros per month if you are over 65).
There is a 90-day waiting period before it kicks in, so plan accordingly. You apply at your local INSS office.
This is a good option if you are retired or not working and want access to the public system without paying for private insurance long term.
Pharmacies
Pharmacies (farmacias) in Spain are great. Pharmacists are well-trained and can help with minor health issues without needing to see a doctor. They can also sell some medications over the counter that would require a prescription in other countries (though this has been tightening up).
Look for the green cross sign. Pharmacies take turns being open 24 hours (farmacia de guardia), so there is always one open nearby.
Emergency numbers
- 112: General emergencies (works for everything)
- 061: Medical emergencies (in most regions)
- 091: National Police
- 062: Guardia Civil
If you are not sure, just call 112. They have operators who speak multiple languages.
Practical tips
- Get private insurance before you arrive if your visa requires it. Sorting this out after you land is stressful.
- Register at your Centro de Salud as soon as you can. Even if you have private insurance, having access to the public system is valuable.
- Learn basic medical vocabulary in Spanish. Not every doctor speaks English, especially in the public system outside of major cities.
- Download your region’s health app. Most autonomous communities have an app where you can book appointments, see your medical history, and access your digital health card. SaludResponde in Andalucia, GVA+Salut in Valencia, La Meva Salut in Catalonia, etc.
- Dental care is mostly private. The public system covers very limited dental care. Budget for a private dentist.
The healthcare in Spain is one of the things that genuinely impresses most expats. Whether you go public, private, or a mix of both, you will have access to good quality medical care at prices that are very reasonable by international standards.