January 22


Types of Health Insurance in Spain

January 22, 2023


Types of Health Insurance policies

There are two types of health insurance in Spain: COPAYMENT and NO COPAYMENT.


No Copayment is the option valid to gain residence in Spain and a NIE number. 


Co-Payment (with excess) is cover where the insured person pays towards the consultation or medical operation. This cover includes emergencies abroad.


No Co payment (no excess) is cover with no payment towards consultations or operations.


If you decide for no copayment then you can decide to either have a NATIONAL or INTERNATIONAL plan. These vary in price and understanding your needs will direct you to the right option.


National cover has unlimited medical cover in Spain with cover abroad for emergencies. This is usually 12000 euros of cover internationally. We always advise clients to take out a travel insurance to supplement the national cover, meaning you are 100% covered in Spain and 100% covered abroad.


International coverage covers 100% of medical costs in Spain and up to 90 % of costs incurred abroad.


At Bsure Insurance Brokers we can advise you on the best option and which insurance provider will best suit your needs. Policies can be complex and therefore it is recommended that you use an expert in this field when choosing a policy as there is small print in each contract which needs to be explained.


Which health insurance option for a Visa and NLV (non lucrative visa) and gain Residence

The option valid to gain residency (residencia) in Spain is the No Co-payment option. In Spansh they call this SIN COPAGO.


The contract will need to annual and renew on the same day that it was issued the following year. This is important as some companies although say they are annual, actually renew in January and so will not be accepted when applying from outside Europe. However, If you are a EU citizen then a policy will be allowed to renew in January.


Why choose a health policy with Co-Payment

The reason to choose an Excess/Deductibles option within the policy is purely price. This option will bring down the cost of the insurance considerably. If you do not visit the doctor and are rarely sick it makes sense to have a policy with an excess/deductible. However, if you are for example over 50, there is an increased likelihood of illness and therefore a policy with no excess would be a more prudent option.

Types of Health Insurance in Spain

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Options available to you based on your Personal Situation


Where you are based will affect types of health insurance policy in Spain that you choose

If you are based in Spain full time, a national policy will be the sensible option. A travel policy can always supplement your national policy. However, if you spend six months in Spain and six months in your home country or travelling, it will be worthwhile looking into an international policy to cover any unforeseen medical problems you may have.



Although the national policy covers 12000 euros outside Spain, if you are more than 3 months away this cover ceases. The 12000 euros limit is also very low.


Lastly the 12000 euros cover is only for emergencies within the national policy, where as an international policy covers non emergencies.


Pregnancy and Childbirth

If you are pregnant and have no policy in place it is not possible to take a private policy out to cover the birth. This is due to the fact that there is a minimum of a one month waiting period on a private insurance policy until conception period of the baby. Put in simple terms if you just find out you are pregnant you can start a policy, but you will have to act quickly as you only have 4 weeks to get the policy set up.


In many cases the 4 weeks will have passed. You will still be able to purchase a policy but there are certain conditions which your broker can explain on setting up the policy.


Pre-existing conditions

If the insurer decides a health issue that comes up during the policy is a pre-existing condition, they may deny the claim. For this reason it is important to outline your medical history when filling out the health insurance application.


In some cases, especially with chronic or terminal illnesses, medical insurers will reject your application. However, in most cases they will accept you on the policy with the condition excluded from cover. Therefore you will not have cover for that illness, however, any other condition or emergency you will have full cover.


It is rare that health insurers accept any pre-existing condition with an increased premium. However in case of travel insurance, this circumstance is very common.


Mild conditions are likely to be accepted with no exclusions. For example, a skin problem usually does not mean you will have cover excluded for that issue.


Ideally you will have no pre-existing conditions and in this case you will be accepted with no exclusions or conditions.


If you have a serious or terminal illness, we can source a company that will accept this, however certain conditions will be applied.


Emergency help

All policies come with 24 hr worldwide emergency cover in relation to medical emergencies, ambulances and home visits by doctors. Even co-payment and national coverage offers this when abroad, up to a monetary limit and providing you are not out of Spain for more than three months.


Repatriation to Spain

If when abroad and you are within the limits just explained, you will be flown or transported by land back to Spain in case of a medical emergency. If you have an international policy you will be covered 90% abroad and have the option of being repatriated back to Spain to receive 100% coverage.


Premiums and Payment options

Prices vary depending on the cover you have purchased. Discounts are given if premiums are paid up front. However, most people tend to purchase policies on a monthly basis with annual renewable contracts.


How to choose a private medical policy in Spain

Which insurer and what cover you will choose depends on many aspects and it is imperative you speak with an insurance broker to run through all your options.

About the author

David Bloomfield - Health and Liability insurance specialist

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