Spanish immigration laws require you to have healthcare for most long-term visas and residency permits. We’ll look at who can use public healthcare and who will need private health insurance in Spain. We’ll explore the specific requirements for Spanish Health Insurance for Residency & Visas in 2024.
Who Needs Spanish Health Insurance for Residency & Visas?
There are some broad groups that need to prove that they have sufficient healthcare coverage.
1) Long-Term Visas & Residence Permit Applications & Renewals
Youโll provide the declaration of coverage letter to the consulate as part of your visa application package.
2) European (EU) & EEA Citizens (plus family) Moving To Spain
All EU and EEA citizens applying for residency in Spain. All family members of EU citizens will also need healthcare coverage.
3) Family Reunion Applicants
Any dependent person applying for a Family Reunion Visa.
4) Non-European (EU) & non-EEA Citizens studying in Spain
Anyone on a Spain Student visa and residency will need coverage, with different requirements we’ll cover below.
Tip: If you are unsure about the cover you need for your visa, we offer a 30-minute consultation with our immigration partners. They’ll confirm the best visa or residency option for you and advise you on your insurance and other requirements.
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Who Can Use Public Healthcare In Spain To Meet The Requirement?
If you are eligible for public healthcare in Spain, then you can use this as your residency or visa healthcare. Here are the most common groups.
- Residents who pay social security contributions (employed or self-employed).
- Residents who receive qualifying benefits or a Spanish pension.
- Pregnant residents.
- Students under 26 who are registered to study in Spain.
- European Union (EU) citizens visiting Spain with an EHIC card.
- Retirement-age EU citizens resident in Spain with an S1 authorization (note: British pensioners may also be able to use the S1 route).
- People who make non-employment contributions to social security via el convenio especial con la Seguridad Social. Note: This is only possible after the first year of your residency.
Note: US Social Security payments or Medicare membership will not qualify, as the US does not have a reciprocal agreement with Spain.
Spanish Private Health Insurance For Visas and Residency
Many Expats in Spain need Spanish Private Health Insurance when they move to Spain. Choosing the right healthcare option is critical as not all policies meet the Spanish Immigration Department’s requirements. There are seven key attributes required by law.
- No Exclusions for Pre-existing Conditions: Spainโs immigration authorities require a policy that covers pre-existing conditions without exclusions or waiting periods.
- Full Coverage: It should cover many medical services without significant limitations.
- No Co-payments: The policy should not include co-payments.
- Coverage for All Territories in Spain: The policy must be valid nationwide.
- Full Validity Period: The insurance policy must be valid for the duration of the visa or residency.
- Issued by an Insurer Authorized to Operate in Spain: The insurance company must be licensed to operate within Spain and approved by the Spanish Immigration Department.
- Documented Proof in Spanish: Applicants must provide documented proof of the insurance policy in Spanish.
Important: We recommend only considering well-known companies that have strong immigration policy experience. You can find out more about our recommended insurance companies for Spanish immigration here. Our recommend companies can issue a valid insurance certificate within three days of acceptance for rush applications.
Additional Option: International Health Insurance
International (or Expat Health Insurance covers you in a range of countries or regions. This insurance solution suits some Expats planning to stay in Spain for a limited time before moving to a third country. You’ll need to ensure the policy meets the requirement, and if the policy documents are not in Spanish, you’ll need authorized copies and translations.
Cover That Is Not Suitable
Private Insurance From Another Country
A standard private medical insurance policy from a country other than Spain will not meet the requirements.
Non-EU/Non-EEAPublic Healthcare
Public healthcare (including Medicare or Medicaid in the US) is not eligible without a reciprocal social security agreement and access to an S1 form.
Standard Travel Insurance
Standard travel insurance is unsuitable for Spain’s long-term visa and residency applications or renewals. These policies are designed for short-term visits from your country of residence and so do not meet the requirements.
EHIC or GHIC
Similarly, a European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC) won’t be accepted. They fulfill similar roles to travel insurance and so do not meet the requirements.
Tricare or Medicare (US)
While there are facilities to access Tricare in Spain (predominantly the US Naval base at Rota), no US government healthcare meets Spanish immigration requirements. This includes Tricare ] Overseas Program (TOP), Tricare Prime, Tricare for Life, or Medicare.
Note: If eligible, you can still access remote and telehealth services through the program.
Conclusion
There are four steps to this process
- Decide if you need healthcare for your move to Spain.
- Ascertain if you qualify for public healthcare.
- Find a qualifying private insurance policy and complete your application.
- Submit your policy documents in a suitable format.
We’re happy to assist you with any of these steps to Spanish Health Insurance for Residency & Visas.
FAQs – Spanish Health Insurance for Residency & Visas
Who needs healthcare coverage for Spanish immigration?
Anyone applying for long-term visas and residence permits, including Non-lucrative, Golden, and Digital Nomad visas, needs sufficient healthcare coverage. EU and EEA citizens moving to Spain and their family members, as well as non-EU/EEA citizens studying in Spain, also require coverage.
Can I use public healthcare in Spain to meet visa or residency requirements?
Yes, if you’re eligible for public healthcare in Spain through employment, receiving qualifying benefits, or being a pension recipient, you can use this coverage to meet residency or visa healthcare requirements.
Are all private health insurance policies accepted for Spanish visas and residency applications?
No, only policies from insurers authorized to operate in Spain and that meet specific immigration requirements are accepted. It’s recommended that you choose well-known Spanish Health Insurance companies with strong immigration policy experience.
Is travel insurance sufficient for Spanish long-term visa or residency applications?
No, standard travel insurance does not meet the requirements for long-term visas or residency applications in Spain, as it’s designed for short-term visits and lacks comprehensive coverage.
Can I get a Spanish Visa if I have a pre-existing condition?
Yes, but you’ll need a health insurance plan that covers pre-existing conditions without exclusions or waiting periods, as required by Spanish immigration authorities.
How fast can I get a Health Insurance certificate for my Spanish residency or visa application?
If a client gets a qualifying Spanish Health Insurance quote and wants to proceed, they will receive the insurance documents via email within three working days. Insurance documents can be sent shortly after the purchase if needed, such as an emergency or rare case. The process can be accelerated if clients need the documents sooner than three working days.ย
Legal References
- Ley 16/2003, de 28 de mayo, de cohesiรณn y calidad del Sistema Nacional de Salud.
- Real Decreto 240/2007, de 16 de febrero, sobre entrada, libre circulaciรณn y residencia en Espaรฑa de ciudadanos de los Estados miembros de la Uniรณn Europea y de otros Estados parte en el Acuerdo sobre el Espacio Econรณmico Europeo.
- Real Decreto-ley 16/2012, de 20 de abril, de medidas urgentes para garantizar la sostenibilidad del Sistema Nacional de Salud y mejorar la calidad y seguridad de sus prestaciones.
Is a returning Spanish citizen who’s lived in the US for over 20 years eligible for public healthcare if she’s living on US social security and personal investments & thus not be working or self-employed?
Hi Jim – yes, all Spanish citizens who are resident in Spain are eligible to register for public healthcare in Spain. All the best, Alastair
Hi – if you’ve purchased a Spanish healthcare policy, do you need a resident visa in order to use or benefit from the policy while visiting Spain as a tourist?
Hi Daniela – I checked this with our Spanish Private Health Insurance partner, and they confirmed that “you can use the policy during your insurance coverage period no problem, you do not need to be on a visa or a resident. You can use it as a tourist.” Regards, Alastair
Hello,
What exactly the following means:
“Full Validity Period: The insurance policy must be valid for the duration of the visa or residency.”
Do I need to have a health insurance for 5 years? Do I need to pay upfront for the entire period or can I have monthly payments?
Is the health insurance bought via partner’s Spanish employer enough (taking into account that it meet all of the aforementioned criteria e.g. Sanitas)?
Hi Kathy. You need to pay for a year’s renewable cover. Our insurance company partners will quote for a valid immigration policy period as standard. You won’t need to take out a specific policy if you already have a qualifying cover. All the best, Alastair
I am planning to move to Spain from UK when I am 66 will I need to take out private health insurance
Hi Kevin. Most Spanish Visas for UK Citizens (including the non-lucrative/retirement visa) require private health insurance in Spain. All the best, Alastair
Hello Alastair, I have British & Irish nationality and my husband is a British citizen. He will start claiming a UK state pension in a couple of months and I will not get mine for a few more years. We are planning to move to Spain in Jan/Feb next year. My question is my husband has recently been diagnosed with Parkinsonโs (apart from a tremor in the hand) heโs in pretty good health. Would we need private health insurance? If so, will his condition be included? Also, we need insurance for the first year or longer? Are we able to use the Spanish health system at all? Finally, how to we find a suitable insurance company or can some one do this for us as part of the application process? Sorry! Lots of question, I do hope you can give me some help and guidance. Many thanks.
Hi Wendy. You’ll need qualifying health insurance (private or public) to apply for Spanish residency. You can see the pathways to public healthcare in Spain in this article: https://movingtospain.com/spanish-health-insurance-for-residency-and-visas/ – if you don’t meet any of the options, you’ll need private cover. I’d suggest exploring the S1 options for your husband when he starts to draw his pension. For private cover, you’ll need pre-existing conditions covered (otherwise, the policy is not valid). You can get quotes here from our preferred insurance companies – not all will cover Parkinson’s as a pre-existing condition, but you will get quotes from eligible companies. All the best, Alastair
Hi, I need an insurance letter to submit with my visa application. However, if I pay for the cover, but are denied our visas, would we lose our full premium?
Hi Mick – I checked with our insurance partner and your cover (if you use on of our partners) will be refunded – the longer answer “If a client’s visa is rejected, once they send us the letter of rejection, they will be refunded all unused months. If the policy has not started, it will be a full refund although 3rd party charges and fluctuations due to exchange rates are not covered.” Regards, Alastair
Hi Alastair
We bought a house in Spain and are planning after retirement on staying there 2-3 months and then back to the States and then back again. I’m German and my spouse is American. Can we get insurance for the perรญods we are in Spain?
Hi Carlos – the minimum policy length is usually 3 months, and that is restricted to short-term student visas. I’d suggest a travel insurance policy for the cost and access for short visits. All the best, Alastair
Hello.
Please may you confirm if EHIC is sufficient for applying for Spanish Residency (Irish Citizen)?
Thank you.
Hi Kevin. In most cases, your EHIC will not cover the requirement for healthcare for residency in Spain. You’ll need private health insurance unless you pay social security contributions. All the best, Alastair
Hello,
Would American citizens who have carried into their retirement a federally-managed private health insurance plan designed for the U.S. Foreign Service (i.e., with worldwide comprehensive coverage and nil- to low-co-payments and deductibles), meet the compliance requirements for the NLV visa application? Under the plan I carry, local Spanish physicians, hospitals and clinics are treated as “in-network providers.”
If not, do any Spanish or international policy carriers provide low-cost coverage that would bridge any small gaps and meet the visa eligibility requirement?
Hi Andrew. Your US policy won’t meet the requirement, and you’ll need an authorized Spanish policy. You can aim for the lowest level of coverage with a Spanish provider (which will be a fraction of US pricing) and then choose which cover to use in Spain. All the best, Alastair
If you have an Irish passport do you still need a full year upfront or can you pay it monthly
Hi Amanda. If you are not working in Spain and paying social security you’ll generally need to sign a year’s contract for immigration. All the best, Alastair