Health insurance in Spain.
Spain has the strictest visa insurance rules in Europe: a Spanish-authorised insurer, no co-pays, no waiting periods. Here is what passes.
The rules
What Spain asks of you.
Checked against official sources on 23 October 2026. Rules change, so the broker confirms them again before you apply.
- Non-lucrative visa: insurer authorised in Spain
You need a policy from an insurer authorised to operate in Spain, covering everything the public system covers.
Source: exteriores.gob.es - No co-pays, no waiting periods, no limit
The policy must have no deductible, no co-pay, no waiting period and no cover limit, and pay 100% of medical, hospital and outpatient costs.
Source: exteriores.gob.es - Travel insurance is refused
Consulates do not accept travel insurance, even with medical cover.
Source: exteriores.gob.es - Digital nomad visa
If you pay into Spanish Social Security, that counts as cover. If not, you need a policy from an insurer on the official DGSFP register, for at least 1 year, with no co-pay, no wait and no limit.
Source: exteriores.gob.es - Student visa
Same rules: an insurer authorised in Spain, no co-pay, no wait, no limit, and at least 30,000 euros of cover.
Source: exteriores.gob.es - S1 holders
UK and EU pensioners with an S1 register it with Spanish Social Security and use public healthcare. The London consulate accepts it for the non-lucrative visa.
Source: prestaciones.seg-social.es
People who work in Spain get public care through Social Security. Non-lucrative visa holders must keep private cover. After 1 year of residence, people with no other public cover can join the convenio especial: 60 euros a month under 65, 157 euros at 65 or over.
Source: boe.esLocal or international
We compare both. You keep the one that fits.
Most visas need an insurer authorised in Spain, with no co-pays and no waiting periods. That usually means a Spanish plan, with an international one on top if you travel.
- Local plans
Plans sold in Spain. Often cheaper, sometimes required for your visa. Filed by a broker licensed in Spain.
- International plans
Plans that cover you in Spain and beyond, and stay with you if you move again. Filed by our international broker partner.
What it costs
Published prices in Spain.
List prices from insurers and official schemes. Your quote depends on your age, health and the cover you pick.
- Convenio especial, under 65
60 euros a month for access to the public health system, after 1 year of residence. Regions that add extra services can charge more.
Source: boe.es - Convenio especial, 65 or over
157 euros a month on the same terms. If the agreement is ended for some reasons, you may wait 1 year before you can sign a new one.
Source: boe.es
What to look for
Choosing a plan in Spain.
Ankyro checks each of these on every plan, so you don’t have to read the fine print.
- Insurer licensed in Spain
Check the insurer is on the DGSFP register and the certificate says so. A global policy from abroad is usually refused.
- The visa version of the plan
Standard Spanish plans often charge a small fee per visit. The visa version has no co-pay and no wait, in writing.
- Cover for the whole permit
The policy must start on your entry date and run for the full permit, usually 1 year. Renew it with every permit renewal.
- Your consulate’s extras
Some consulates also ask for repatriation cover, a 30,000 euro minimum, or proof the premium is paid. Check yours.
Step by step
Getting covered in Spain.
- 01Buy a Spanish visa plan before your consulate appointment. It must come from an insurer authorised in Spain, with no co-pay, no waiting period and no limit, and start on your entry date.
- 02Check the insurer on the DGSFP register. The DGSFP is Spain’s insurance supervisor. Digital nomads without Spanish Social Security must use an insurer on its register.
- 03Working? Pay into Social Security instead. If you work in Spain or pay into Spanish Social Security, that gives you public care and counts as cover for the nomad visa.
- 04Sign up on the padrón at your town hall. You must be on your town’s padrón (the local residents’ register) to apply for the convenio especial later.
- 05After 1 year, apply for the convenio especial. Once you have lived in Spain for 1 continuous year, you can buy into public care through your region or INGESA. Regions can charge more than the base fee.
Common mistakes
3 we see all the time.
- 01Buying travel insurance, or a global plan from an insurer not authorised in Spain. Both get rejected.
- 02Choosing a cheap plan with co-pays. Even a small fee per visit can get the visa refused.
- 03Expecting free public care on a non-lucrative visa. You need private cover, or the convenio especial after 1 year.
Real published prices, and the 6 things that move yours.
Just visiting?For a holiday or a short trip, travel insurance is enough. See what Spain asks of visitors, and what care costs.
Questions
People also ask.
Do I need private health insurance for the Spain non-lucrative visa?+
Yes, unless you have an S1. It must come from an insurer authorised in Spain, with no co-pays, no waiting periods and no limit.
Do digital nomads in Spain need private health insurance?+
Only if you do not pay into Spanish Social Security. If you don’t, you need a Spain-authorised policy with no co-pay, no wait and no limit.
Can foreigners pay to use public healthcare in Spain?+
Yes, through the convenio especial, after 1 year of residence. It costs 60 euros a month under 65 and 157 euros at 65 or over.
Can I use my EHIC to live in Spain?+
No. The EHIC is for temporary stays. Pensioners should register an S1 with Spanish Social Security instead.
Other countries
Going somewhere else?
Most UK visas don’t ask for private insurance. You pay a yearly surcharge instead, and it opens the NHS. Here is what the surcharge buys, and what you still pay for.
02AustraliaMost visitors can’t use Medicare, and many visas carry condition 8501. Here is what each visa asks for, who gets Medicare, and what to check.
03Dubai and the UAEIn Dubai, no insurance means no visa. Your employer covers you, but not always your family. Here are the rules, and what the basic plan leaves out.
04PhilippinesThe retiree visa asks for a medical certificate, not a policy. The new nomad visa does ask for cover. Here is what each visa needs, and how PhilHealth works for foreigners.
05NetherlandsIf you live or work in the Netherlands, Dutch basic insurance is the law. A few people are exempt. Here is who must sign up, by when, and what it costs in 2026.
06CanadaEach province runs its own health plan, and some make you wait. The super visa has strict insurance rules. Here is how Ontario and BC differ, and what the super visa needs.
07Saudi ArabiaIn Saudi Arabia, no insurance means no iqama. Your employer pays for you and your family, and visitors need a policy too. Here is who pays, and what each policy covers.
08JapanIf you live in Japan, joining public insurance is the law. A private plan can only sit on top. Digital nomads are the exception.
09GermanyEveryone in Germany must be insured, and a residence permit needs cover equal to the public system. Here is how to choose, and what gets rejected.
10SingaporeThe national plan is for citizens and PRs. Hospital bills for foreigners are high, and families are often left out. Here is what to check.
11ThailandRetirement visas have hard minimums, the DTV has none, and public care is not free for foreigners. Here are the rules, and what to check.
13MalaysiaPublic hospitals charge foreigners full price, and work schemes only cover injuries at work. Here is what each pass asks for, and what to check.
14QatarMost visitors need a QAR 50 a month policy before Qatar issues a visa. The law covers expats too, but that part is still rolling out. Here are the rules.
15FranceThe public system is open to residents, but not on day 1 if you don’t work, and it only pays part of each bill. Here is how to cover the gaps.
16PortugalThe visa asks for travel medical cover. The public system opens once you are a resident. In between, and after, here is what to check.
17MexicoNo visa asks for it, so many expats skip it. Then a private hospital asks for payment first. Here is how cover really works in Mexico.
18ItalyWorkers join the public system for free. Retirees and nomads need private cover for the visa, then pay at least €2,000 a year to join. Here are the rules.
19South KoreaStay more than 6 months and you must join the national plan. Before that, and for your share of each bill, you need your own cover.
20VietnamOnly long local contracts come with public cover, and most expats use private hospitals anyway. Here is what the rules say, and what to check.
21Bali and IndonesiaMost Indonesian visas don’t ask for insurance. But hospitals ask for payment first, and serious cases fly to Singapore. Here is what to check.
22GreeceThe consulate takes travel cover for the visa. The residence permit then asks for full health cover. If you don’t work for a Greek employer, that means a private plan.
23ColombiaNomads and retirees need a private policy with exact wording. Residents who work must join the public EPS system. Here are the rules.
24Costa RicaResidents must pay into the Caja, whatever private plan they have. Nomads need their own cover for the visa. Here is how it fits together.
25USAThe US has no public plan you can simply join. Some visas set minimum cover. Others leave it to you. Here is what a J-1 needs, who can use the Marketplace, and what plans cost.
26SwitzerlandBasic health insurance is compulsory for everyone who lives in Switzerland. You have 3 months to sign up. Here is how it works, and what to check.
27IrelandNon-EEA students must hold private medical insurance. Everyone else gets public care once they count as living in Ireland for 1 year. Here is what to check.
28Dominican RepublicThe residence visas for retirees and rentistas ask for a medical certificate, not an insurance policy. Public care is limited. Private care is good but costly.
29New ZealandStudent visas require insurance. A work visa of 2 years or more may open public health care. ACC covers accident injuries. Here is what to check.
30IsraelIn Israel, the public system is for residents. If your life is centred there, you join a health fund (kupat holim). If not, you need private cover.
31Hong KongPublic hospitals in Hong Kong are cheap for eligible persons. Many foreigners are not on that list. Here is who is, what the rest pay, and what to check in a plan.
32ChinaIf you work in China on an employment permit, your employer must enrol you in social insurance. That includes basic medical cover. Here is how it works, and what to check on top.
33ArgentinaEmergency care is open to everyone. For other care at national hospitals, foreigners without permanent residence must show insurance or pay first. The rules are new, so check them.
34IndiaWe found no official rule that ties health insurance to an Indian work visa. We also could not confirm a public scheme for foreign residents. So the plan is yours to choose. Here is what to check.
35TurkeyA residence permit application needs valid health insurance for the whole permit. Most new expats buy a private policy. The public SGK system opens later, after 1 year of residence.
36BrazilThe digital nomad visa needs health insurance valid in Brazil. The public system is open to migrants by law. Many expats add a private plan for speed.
37PanamaThe Pensionado visa asks for a health certificate, not an insurance policy. The public system is tied to the Caja. Private care is the main option for most expats.
38South AfricaStudy and exchange visas ask for proof of cover from a registered medical scheme. Public clinics offer free primary care. Here is what to check.
39KenyaKenya’s public fund is run by the Social Health Authority (SHA). A foreigner who lives in Kenya for more than 12 months pays into it. Shorter stays need travel health insurance instead.
40TaiwanTaiwan has one national health insurance. Foreigners with a residence certificate can join. If you have a job, you join through your employer. If not, there is a wait.