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  • Pasquale Specchio

Health Insurance in Spain

Public Healthcare:

 In 2019, in Spain, approximately twelve million people opted for a private health insurance policy, or in other words, roughly ¼ of the population. This fact may seem benign given the formidable reputation of the Spanish public healthcare system, however, below I will cover the main reasons why people are opting out of public healthcare and choosing private.

One of the primary reasons why one would choose private healthcare as opposed to public healthcare is because of the ever-increasing wait periods in the public healthcare system.

Depending in which autonomous community one lives, the average waiting period can vary greatly. For example, the Canary Islands and Andalucía by far have the longest waiting period to be seen by a medical professional. The waiting period could also be exacerbated by the treatment that one needs.

There is no doubt that in recent years the quality of the Spanish public healthcare system has increased exponentially. That being said, the aforementioned problem of extensive wait periods for treatment still persists. Moreover, with the current world wide crisis of Covid-19 this crucial problem of public healthcare will only become greater. During the last ten years the people on wait lists for elective and non-elective surgeries alike has increased by almost 80%. Looking forward, if this trend continues by 2029 there could be more than 1.2 million people on wait lists. This may seem trivial but when one takes into account that the Spanish population is expected to decline by 11% by 2050 the severity of the problem becomes clear: the wait periods will increase, the efficacy of treatment could decline, leading to a public health sector that would be overburdened with patients.

Financial Benefits:

 Another reason why a high number of Spanish residents, have opted for private health insurance is because of the financial benefits. In almost all states except Pais Vasco, you can deduct 100% of the insurance premium for you and your family up to 500€ per person.

When self-employed “autonomo” you will deduct it as an expense. If you are employed by a company, the practice would be that you get healthcare as opposed to the equivalent amount of the premium in your gross salary resulting on average a 30% net saving. 


While there are many providers one should always search for the solution that suits their unique needs. When choosing the provider for a private health insurance it basically comes down to three main factors.

1.      Collaborators list

2.      Exclusions

3.      Service

In the picture below are illustrated the 10 biggest insurance providers and their most recent score in a survey conducted by the consumer organization OCU. 

Some companies like Sanitas in the figure above, have their own clinics and hospitals. Where others like Cigna Life and Mapfre, are collaborating with the clinics and therefore tend to be more unbiased, regarding where the client might seek treatment. 

Typical cover:

The typical cover can very a great deal among the earlier described providers, for private healthcare services in Spain. However, listed below you have a summary of how the health insurance is constructed as a whole.

·      Primary care

·      Medical and surgical specialties

·      Travel assistance

·      Preventive medicine

·      Hospitalization due to illness or accident

·      24-hour online doctor

·      Dental cover  


When choosing your policy, one has the possibility of with or without a copayment. A copayment is essentially the same principal as a waiver for using the policy. In some companies the copayment is progressive in relation to use. Other companies have flat-rate copayment which remains fixed over the lifespan of the policy.

Choosing the right policy for you and your family is an important decision that should not be taken lightly and can be based either on medical history or preferences, an easy way to get perspective is by calculating the difference in yearly insurance premium. For example, if a family of four has an option A, where there is no copayment at a yearly rate of 2.000€. Where, option B costs 1.000€ but with a copayment of 15€ per visit, the family would have to use the insurance more than 1.000€/15€=67 times between the four family members per year, for option A to be more advantageous.

“Please take notice that if you are from a Non-EU country an insurance with copayment is not valid for applying or renewing your residence visa in Spain”.

If you would like to work with a successful insurance broker, one who will have your interests in mind, please contact Pasquale using the information below.

Phone/whatsapp: +34 639268780


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