Healthcare in Spain for Expats: What It Really Costs

Spain runs a dual healthcare system, and understanding how the public and private sides work together is the key to budgeting correctly as an expat.

Public healthcare

Legal residents who pay into Spanish Social Security, or hold certain visas and registrations, can access the Sistema Nacional de Salud, which is largely free at the point of use and consistently rated among the best systems in the world.

Private insurance costs

Most non-lucrative visa and digital nomad visa applicants need private insurance anyway, since public access isn't automatic before residency is granted. Expect roughly €50-€100 a month in your 30s or 40s for solid comprehensive coverage, rising to €150-€300 a month in your 60s and beyond.

What private plans typically exclude

Many budget private plans exclude pre-existing conditions or charge extra for them, and some use co-payments to lower the monthly premium. Read the small print before picking a visa-qualifying policy.

Our take

Many long-term expats keep private insurance even after qualifying for public healthcare, using it for faster specialist appointments and English-language service, while relying on the public system for emergencies and major treatment.