How to get health insurance in Spain (UK expat guide)

Planning a move to Spain? Whether it’s a short trip, an extended stay or a permanent relocation from the UK, you’ll need to make sure you have the right health insurance.

Healthcare isn’t usually straightforward, and when you add insurance into the mix, it gets even more complicated. When you’re headed to a new country, there are going to be new rules, new regulations and new forms to fill out before you can receive treatment.

If you’re headed to Spain, you’re in luck - it has one of the best public healthcare systems in the world. However, this doesn’t mean you can’t or shouldn’t get insurance.

In this guide, we’ll cover everything you need to know about getting health insurance in Spain as a UK national. This includes info on whether you can access public healthcare, how much private insurance costs, and which providers to get quotes from.

We'll also introduce the Wise account from the money services provider Wise that allows you to send and receive international payments for low, transparent fees* and mid-market exchange rates.

🔎 Learn more about the Wise account

How does the Spanish healthcare system work?

Spain is known for having one of the top healthcare systems in the world. The country has a universal healthcare system and also offers private insurance options for those who want to expand their coverage.

The overwhelming majority of Spaniards and expats use the public Spanish National Health System (SNS, which stands for Sistema Nacional de Salud). This is paid for by social security contributions. The system is decentralised, meaning that each of Spain’s 17 autonomous regions runs its own hospitals and care facilities.

SNS doesn’t cover every health expense though. For example, dentist treatments are additional out-of-pocket expenses, and prescriptions and pharmacy costs are only subsidised - where individual payments are used to supplement the full price of the services.

Private insurance can be an alternative to cover these added expenses, but it's good to keep in mind that the insurance company will often limit the list of services that are available and also have a list of preferred care providers you can visit. Make sure to check with your insurance company about this before you visit a specialist.

People sometimes turn to private insurers because there's some concern about the lengthy wait times to see public health providers. Still, by all accounts and comparisons, the public Spanish healthcare system is robust and high-quality.

Can I access the SNS as a foreigner or UK expat?

Foreign citizens can access SNS healthcare in Spain if they are a permanent resident and pay social security contributions. You’ll need to meet the following requirements:¹

• Live in Spain for at least 183 days in a year
• Be registered with the local municipality
• Be registered with social security.

Children under the age of 18 are automatically eligible for public healthcare, regardless of their nationality or residency status.

You may also be entitled to SNS healthcare through your Spanish employer, and there’s also a pay-in scheme called Convenio Especial for unemployed people. For a small monthly fee, you get some public health insurance coverage.

Spain health insurance - what’s covered

Here’s a quick look at what’s covered -and what’s not - under SNS public healthcare:¹

Service/treatment	Covered by SNS
GP appointments	Yes
Specialist medical appointments	Yes
Emergency care and hospital stays	Yes
Mental health care	Yes
Maternity care	Yes
Vaccinations	Yes
Dentistry	No
Prescription medication	Partially - SNS covers 40-60%

Do I need private health insurance for Spain?

You’ll need - or may want - to sort out your own private Spain health insurance if any of the following apply:

• You need supplementary coverage for services the SNS doesn’t cover, such as dentistry
• You want more convenient appointments and shorter waiting times for treatment
• You’re applying for a Spanish visa, which requires proof of health insurance as part of the application
• You’ve moved to Spain but aren’t yet making social security contributions - it can often take a few months to complete registration processes. This includes registering at the town hall, applying for residency and setting up your social security account
• You’re on a short-term visit to Spain and won’t stay long enough to be considered a permanent resident.

What happens if I don’t have private health insurance in Spain?

If you’re only visiting on a short-term basis (i.e. for a tourist visit), your travel insurance should cover you for healthcare costs. What and how much is covered though depends on the provider and the policy limitations.

British citizens can also use the coverage provided by their UK Global Health Insurance Card (GHIC). This helps you access necessary state healthcare if you suddenly fall ill or have an accident while you’re away.

The GHIC replaced the European Health Insurance Card (EHIC) after the UK left the European Union. It’s free to get through the NHS. There’s an important limitation with this card though, as it only entitles you to free public healthcare for the first three months of your stay.² So if you’re staying for longer, you might need to get your own private health insurance.

In all other situations, you’ll be able to access state healthcare services and treatment but will be liable for 100% of the cost.

How much is health insurance in Spain for foreigners and UK expats?

On average, the cost of private health insurance is roughly around €50 to €200 EUR a month.¹

However, the cost varies considerably depending on the provider, and on the individual. You’ll need to get quotes from several providers, making sure to provide honest, accurate and detailed information about your health and circumstances - making sure to disclose any pre-existing medical conditions.

Your quotes will be based on factors such as age, coverage level and whether you have any pre-existing illnesses or conditions. You can usually expect to pay more if you’re older, and if you want coverage worldwide as well as in Spain.

How to get health insurance in Spain - a step-by-step guide

The first important step is to determine whether or not you’re eligible for SNS public healthcare. If you live and work in Spain, you should be - regardless of your nationality.

If eligible, here’s how to register for public healthcare services:

1. Make sure you’re registered with social security - Tesorería General de la Seguridad Social (TGSS). You’ll also need to register with the town hall (empadronamiento) when you move to Spain
2. Go to the Social Security e-Office website and download a certificate stating that you’re eligible for public healthcare
3. Head to a local primary health centre (centro de atención primaria - CAP) with your certificate, valid ID and proof of registration. Here, you can apply for a Spanish health card and then register with an SNS doctor or health centre in your area.

If you’re not eligible for SNS access, you’ll need to arrange your own private healthcare cover. This is as simple - although it is time-consuming - as going online and getting quotes from providers. We’ll look at a few expat-friendly insurance companies below, to give you a few places to start.

You’ll need to provide extensive details about yourself and your circumstances, including your age and medical history. You can then choose a policy based on the price and coverage.

Important - you should always read the details of any health insurance policy carefully, to make sure it meets your needs and you understand what’s covered and what isn’t.

Which providers offer Spain health insurance for expats?

Here are some of the providers offering private healthcare insurance in Spain for UK expats:

AXA Global Healthcare

A familiar name in the UK, AXA has an international private medical insurance arm called AXA Global Healthcare. It has options for both annual cover (for people who live in Spain) and flexible cover for shorter-term stays.

At the time of writing, AXA Global Healthcare currently has a ‘Great’ rating of 4.2 on Trustpilot.³

Its annual plan covers:⁴

• Emergency cover, including ambulance transport and overnight hospital stays
• Evacuation and repatriation, if the necessary care isn’t available where you are
• Cancer care
• Virtual doctor service - speak to a qualified doctor wherever you are in the world.
• Mind Health service - connecting you to a qualified psychologist via phone or video call
• Second Medical Opinion service, giving you an independent review of any diagnosis or treatment plan.

Feather

Feather is a great option for expats seeking easy and quick EU-wide health insurance coverage. You can get a written confirmation to use for your visa application in just minutes.⁵

At the time of writing it has an ‘Excellent’ 4.8 rating on Trustpilot.⁶

Feather says it doesn’t cover pre-existing conditions, routine check-ups, regular vaccinations and mental health therapy.

Its expat health insurance does cover:⁵

• Accidents and emergencies along with associated follow-up costs.
• Any medication prescribed by a doctor for an unforeseen illness.
• Transportation to a medical facility by ambulance if you have an injury or illness.
• Repatriation – return to your home country for either treatment or in case of fatality for burial.
• Pain relief for dental treatments and tooth replacement after an accident are each covered for up to €500 per year.
• Health insurance while you’re travelling in any EU countries.

DKV

DKV has a few different options for expats, ranging from budget-friendly options to packages that offer truly wide coverage. Notably, they cover mental health services and you’ll also get dental coverage. Most services can be used from day one.

However, one negative point is that as of time of writing the company has a ‘Poor’ rating of 2.2 on Trustpilot,⁷ with some reviewers unhappy about customer service. It could be worth researching further if you have any concerns.

The provider’s most popular package is called Integral Elite and it comes with 100% coverage. This means that you don’t need to pay anything yourself when you use any of the services.

DKV’s expat insurance covers:⁸

• Primary care, including general medicine, emergencies, paediatrics and more.
• Access to video consultations and chats with doctors, health coaches and midwives. You'll also have access to a 24-hour on-call doctor by phone and a 24-hour pediatric medical line.
• Access to all specialties directly without getting a referral from the family doctor first.
• Surgery and hospitalisation. You'll always have a single room and a bed for a companion.
• Dental coverage, including more than 50 free services and the rest come discounted.
• When you travel abroad you will have coverage for up to 20,000 euros in worldwide emergency assistance.
• You can also get access to psychotherapy (20 or 40 sessions per year depending on the emotional health problem) and a nutritionist for the treatment of obesity.
• Podiatry, physiotherapy and rehabilitation
• Optionally, you can add paediatric or gynaecology services, even if it's not included in the original policy.

Pay healthcare costs like a local - and save money - with the Wise account

If you have health insurance payments or medical bills to pay while in Spain - or when between countries - you’ll need a way to pay in euros without losing out to high fees or poor exchange rates.

The Wise account is the perfect solution. You can set it up either in the UK or in Spain, and gain access to a powerful online account where you can hold 40+ currencies all in one place - including both GBP and EUR.

Send payments to Spain in EUR for low fees and mid-market exchange rates, or use your Wise card to spend in EUR when paying online or in person.

It’s easy, secure and could save you money on healthcare costs while living, working or travelling in Spain.

➡️ Learn more about the Wise account

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After reading this, you should have a better idea of how the healthcare system works in Spain, whether you’re eligible for public healthcare and how to get private insurance cover if you need it.

Just make sure to get lots of quotes, read the policy terms carefully and compare all available options before taking out a policy.

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Sources used:

1. Expatica - who can access SNS, costs and what’s covered
2. AXA Global Healthcare - GHIC only covers first three months
3. Trustpilot - AXA Global Healthcare reviews
4. AXA Global Healthcare - AXA International Health Insurance coverage
5. Feather - Feather Insurance coverage
6. Trustpilot - Feather reviews
7. Trustpilot - DKV reviews
8. DKV - DKV Insurance coverage

Sources last checked 05-Nov-2025