How much does private health insurance cost in Spain?

Private health insurance in Spain costs an average of €46 a month for a basic policy without co-payments and €74 for a complete one. For people over 55, a complete policy averages about €125 a month. These figures come from the December 2025 health insurance price index by Rastreator, a Spanish comparison site, which also shows premiums rising by around 19% during 2025.

That cost matters beyond budgeting. Private cover is a requirement for some residence visas and often the only option before you qualify for public healthcare. It is also a popular way to see specialists sooner, and more than 12 million people in Spain hold a private health policy, according to the insurance research body ICEA. Here, we cover what you can expect to pay, what drives the price and how to choose a policy.

What is the average cost of private health insurance in Spain?

The answer depends on what is measured. Rastreator's index, built from quotes made through its site in 2025, puts the average at €46 a month for a basic policy without co-payments and €74 for a complete one.

ICEA measures something different. Across every individual policy in force, the average premium was €975 a year per insured person in 2024, about €81 a month, and €1,477 a year for reimbursement policies. That figure is higher than most advertised prices because it includes older policyholders, whose premiums are far above those quoted to new, younger customers.

^{Source: Rastreator price index, December 2025, based on quotes made through its comparison site. Individual quotes vary by insurer, location and health.}

Treat the over-55 average with caution. Quotes for people in their 60s and 70s are often much higher, particularly for policies without co-payments. One 2026 expat guide from WaypointSur puts comprehensive cover without co-payments for people aged 60 to 70 at roughly €250 to €400 a month. Getting several quotes is worth the effort, and Rastreator estimates that comparing policies can save up to €122 a year.

What affects the price of private health insurance?

Four factors explain most of the difference between one quote and another.

Age and health

Age is the biggest factor, and Rastreator found that prices can vary by up to 72% between age groups. Insurers also ask you to complete a health questionnaire when you apply. Conditions you declare may be excluded or priced in. A known condition you do not declare can lead to an exclusion or a refused claim, so answer honestly.

Co-payments

Policies with co-payments (copago) charge a fixed fee each time you use a service, in exchange for a lower premium. The fee is often a few euros for a GP visit and more for a specialist. Policies without co-payments (sin copago) cost more each month but nothing per visit, and some consulates ask for them when you apply for a visa.

Type of cover

Most policies give access to a network of doctors and hospitals (cuadro médico). Reimbursement policies let you choose any provider and claim back a share of the cost. They are noticeably more expensive: the ICEA average is €1,477 a year, against €975 for individual policies as a whole. Dental treatment is often excluded or sold as an add-on, so check what is included.

Where you live

Prices vary by region because insurers price in local healthcare costs. Rastreator's index found the Balearic Islands the most expensive, at an average of €57 a month for a basic policy, followed by Catalonia at €51. Extremadura (€39), Asturias (€42) and Murcia (€43) were the most affordable. If you are still deciding where to settle, Find Your Place lets you compare areas against your own priorities.

Can I have private health insurance in Spain?

Yes. Private cover is open to residents and non-residents of any nationality, subject to the insurer's age limits and health questionnaire. Insurers typically ask for a passport or NIE (Número de Identidad de Extranjero), the identification number for foreigners. Most also need a Spanish bank account for the monthly direct debit, so confirm what your chosen insurer needs before you arrive.

People usually take out a policy for one of 3 reasons:

• To apply for a visa. The Non-Lucrative Visa and the Digital Nomad Visa both require health insurance, and the conditions differ by visa and by consulate. Many consulates ask for a policy without co-payments or waiting periods, so ask the insurer to confirm in writing that yours meets the requirements. The other routes are covered in Spanish visa types and requirements.
• To bridge the gap before public access. Residents who are not working and have not yet been registered for a year usually need private cover until they qualify for the Convenio especial or another public route.
• For speed and choice. Many people who are entitled to public care also pay for a private policy to reach specialists sooner, and the two can be used side by side.

Age limits matter too. Many insurers restrict new applicants somewhere in their late 60s or early 70s, depending on the insurer and the product, although existing customers can usually renew beyond that age. If you are approaching that range, arrange cover before you move. The wider considerations for retirees are covered in  why you might need private health insurance when retiring in Spain.

What is the best private health insurance for expats in Spain?

There is no single best policy. The right one depends on your age, where you live, your health and what your visa requires. By premium income, SegurCaixa Adeslas, Sanitas and Asisa lead the Spanish health insurance market, followed by Mapfre, according to ICEA data for June 2026.

We do not rank individual insurers, but these are the points that separate a good fit from a poor one:

• Network: whether the doctors and hospitals near your home are in the insurer's network, which can differ between products from the same insurer
• Co-payments: whether you need a policy without them, for a visa or because you expect to use it regularly
• Waiting periods (carencias):  consultations and emergencies are usually covered from the start, but non-emergency hospital admission and major surgery often have waiting periods of 6 to 10 months
• Exclusions: pre-existing conditions, dental treatment and mental health sessions, which are usually capped
• Renewal: premiums can rise each year, and the insurer must notify you of a change at least 2 months before renewal
• Language: English-speaking support varies by insurer and product, so ask before you buy

Independent brokers can compare several insurers and are usually paid by the insurer rather than by you. Whichever route you take, read the full policy document rather than the summary before signing.

Private or public: what do you get for the money?

For most residents, private cover is a choice rather than a replacement for Spain's national healthcare system, and the two can be used together. The table compares the 3 main options.

^{Sources: Ministerio de Sanidad (average waiting times at 31 December 2025; Convenio especial fees and conditions); Rastreator (private prices).}

Waiting times vary widely by region and specialty, so the averages hide large differences. The Ministry of Health's waiting-list statistics give the national picture. To join the Convenio especial, you also need to be on the padrón (municipal register).

Who can access the public system for free depends on whether you are working, not working, studying or retired. Before paying for private cover you may not need, it is worth checking  expats can access free healthcare in Spain.

Is private health insurance tax-deductible in Spain?

Mostly not, with two exceptions. If you are registered as self-employed (autónomo), you can deduct premiums for your own cover, your spouse and children under 25 who live with you. The limit is €500 per person a year, or €1,500 for someone with a disability, according to the Agencia Tributaria. Premiums paid by an employer as a benefit are generally exempt from income tax within similar limits. Anyone else usually cannot claim relief, and the tax guide for expats in Spain covers the wider picture.

What to do once you have a private health insurance policy in Spain

Most insurers work through a network. You find an in-network doctor in the insurer's app or directory and book directly. The insurer then pays the provider, so you rarely submit claims for planned care. Emergency treatment at a registered hospital is normally covered even if it is out of network, subject to the policy's terms. For registering with a doctor, booking appointments and seeing specialists, see how to see a doctor in Spain.