Spain is an amazing country to live in. Its warm climate, vibrant culture, and high quality of life make it attractive to expats.
Public vs Private Healthcare in Spain
When considering the costs of moving to or living in Spain, health insurance should be a priority. Although Spain’s National Health System (SNS — Sistema Nacional de Salud) is world-renowned, it may not cover certain medical needs in some cases, and certain limitations apply depending on one’s country of origin and residency status.
EU citizens with a valid European Health Insurance Card (EHIC) are covered for medically necessary, state-provided care during temporary stays; as well as residents enrolled in Spain’s Social Security and pensioners registered via an S1 generally have access to the public system. However, many non-EU nationals – such as non-lucrative visa applicants, retirees from non-EU countries and some digital nomads – must hold private health insurance, with requirements varying by visa and personal circumstances.This, along with the waiting times in the public system is why many expats choose private health insurance in Spain, to ensure that they have quick, high-quality access to the healthcare they may require at any time.
In any case, it is possible to enjoy the peace of mind that comes with having everything under control while saving money at the same time.
Practical Ways to Save on Private Health Insurance
There are several simple measures that can be taken into account when taking out or renewing a health insurance policy, which can lead to significant savings, especially in the medium and long term, without compromising the quality of the contracted services.
Pay Annually Instead of Monthly
One of the factors that causes healthcare costs in Spain to go up is the frequency of payments. Annual vs monthly payments can make a difference, because many insurers in Spain add small administrative fees to monthly payments, which add up over time.
By paying your premium annually, you can avoid these extra costs or even face smaller upfront payments. This is a simple change that could save you 5% or up to 8% a year.
Choose a Higher Deductible
If you are generally healthy and rarely visit the doctor, opting for a higher deductible (excess) can significantly reduce your monthly premium. This approach makes sense for low-risk individuals who seek coverage for emergencies and major health issues rather than routine checkups. However, note: for some Spanish visas/residency permits, authorities often require private health insurance with no deductibles/excesses or co-pays. If that requirement applies to you, a policy with deductibles/co-pays won’t be acceptable.
Select Only the Coverage You Need
Keep in mind the required coverage for students and retirees is not the same. Check the policy and choose what you need. Many policies have extras like dental care, which is optional with some insurers..
By customising your policy, you avoid paying for services you will never use.
Compare Insurers
Many people use health insurance comparison sites to make sure they choose the best option. Spain has several strong local providers – DKV, AXA, Adeslas, Sanitas, Mapfre, Asisa, Salus – and it’s important to understand how each operates in Spain. Keep in mind that these platforms typically compare prices only, not the specific cover details or the network of approved clinics in each region..
Comparing can be easier if you work with a health insurance broker in Spain, especially when you choose one that specialises in providing services to expats.
Consider Family or Group Plans
If you’re moving to Spain with your partner or children, a family plan can be significantly cheaper per person than buying individual policies.
Watch Out for Premium Increases
Insurance premiums in Spain might experience a yearly increase. Don’t accept increases blindly. Notice the policy’s end date, review your conditions not later than 1 month before renewal and don’t hesitate to renegotiate or switch providers if the price jump seems unreasonable.
Additional Money-Saving Strategies
Some other strategies can help you save extra money in your health insurance.
Tax Benefits for Freelancers and Companies
If you’re self-employed in Spain (autónomo), private health insurance premiums are deductible from taxable income; the deduction has a limit but still offers meaningful savings. Companies can deduct premiums paid for employees and provide private health insurance as a tax-efficient benefit to employees.
Use Brokers or Agents
Insurance brokers can often secure better deals than going directly to an insurer. They understand the market, know which companies are most flexible with expats, and can help avoid hidden fees. Since brokers are typically paid by insurers, their service is usually free for the customer.
For many expats in Spain, private health insurance is a requirement. For others, it is a way to minimise the waiting times and get peace of mind, knowing they will get the care they need. Anyway, health insurance in Spain can be cheaper and safe if you know where to look to save money.
