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HEALTH

The best private healthcare for foreigners in Spain

If you're planning on moving to Spain and are applying for certain visas, then you will need to get private healthcare as part of your residency application.

Published: 9 January 2023 16:40 CET
The best private healthcare for foreigners in Spain
Best private health insurance for foreigners in Spain. Photo: Accuray / Unsplash

Those wanting to move to Spain and applying for residency visas, such as the non-lucrative visa, will need to get private health coverage. You will also need private healthcare if you are not working in Spain and are not paying into the social security scheme, as you won’t be eligible for public healthcare.

Currently, public healthcare is offered in Spain to those earning state pensions from certain countries Spain has deals with, Spanish state pensions and those who pay social security, whether they are employed by a company or are self-employed.

Although Spain is considered to have a good public healthcare system, many residents in Spain choose to go private, even if they do have access to the public healthcare system, due to the affordability of private healthcare and the added benefits, such being able to see a specialist and shorter wait times.

According to data from UNESPA (the employers’ association for insurers), more than 11.5 million Spaniards have some type of private health insurance.

READ ALSO: Why people in Spain are facing longer waits to see a doctor 

Madrid is the region that has the most people with private health insurance (37 percent) and Cantabria has the least (8 percent).

The Organisation for Economic Cooperation and Development (OECD) states that wait times for public healthcare in Spain are between 74 and 147 days for specialist surgeries such as cataracts, hip replacement and knee replacement.

If you have private healthcare, wait times are drastically reduced to just a few weeks. What’s more, you don’t have to wait for a referral from your GP to see a specialist; with most private health insurers in Spain, you can make an appointment with a particular specialist when you want to.

Recently the Spanish Association of Consumers and Users (OCU) released a study revealing the opinions of 6,451 people about their private health coverage in Spain.

Participants rated their insurance on covered treatments, medical staff, quality of services, customer service and authorisation of tests, as well as price, premiums and co-payments.

Taking all of these into account, the best value health company is ASC – Asistencia Sanitaria Colegial, followed by CIGNA and then Generali.

Those with the best coverage were ASC and Agrupación Mutua, while ASC and Generali were also rated highly for the quality of their healthcare services.  

Clients of AEGON and Sanitas insurance complained the most about rising premiums, but despite this, Sanitas came seventh out of the 16 companies listed. AEGON on the other hand came in at number 15.

READ ALSO: When, where and how to get the flu vaccine in Spain 

Top five health insurance companies in Spain

The top five private health insurance providers on the list were: 

ASC – Asistencia Sanitaria Colegial

The company offers three different health plans, from basic to comprehensive, plus one for frequent travellers. They also offer 24-hour emergency services 365 days a year, plus online services, direct specialist access, and no wait times.

CIGNA

CIGNA also offers three levels of coverage – full, blue or gold. You only have to add on co-payments for the full, while blue and gold also include dental care. Clients have direct access to medical specialists as well as psychologists.

Generali

Generali again has three levels of coverage, as well as extra insurance for those with serious illnesses, hospitalisation or who are pregnant. They have over 51,000 specialists in different fields and you can choose from coverage with or without co-payments.

FIATC

FIATC offers either full or basic coverage with or without co-payments, insurance where medical bills are reimbursed and dental coverage. As well as 24-hour home care, they offer complimentary health services such as prenatal service, gynaecology, rehabilitation, physiotherapy, psychology and nutritional services. Waiting times are also greatly reduced.

Agrupación Mutua

Agrupación Mutua offers six different types of health plans without waiting times that cover appointments, emergencies, tests, hospitalisation and more. Prices start from €17.49 a month for the most basic plan up to €66.82 per month for the most comprehensive.

The five insurance companies with the lowest satisfaction scores from customers were Divina Pastora, ASISA, ADESLAS Segurcaixa, AEGON and DKV.

Keep in mind that not all types of private health insurance will serve if you have to get it as a visa requirement. Most of the time you will have to get a plan without co-payments, which are typically the most comprehensive ones.

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For members

HEALTH

Do all foreigners in Spain have access to free public healthcare?

There's always been a lot of confusion regarding whether public healthcare in Spain is free for all and whether those who aren't officially residents can get treatment. The Spanish Health Ministry has made a move to clear this up.

Published: 16 May 2024 09:23 CEST
Updated: 18 May 2024 11:18 CEST
Do all foreigners in Spain have access to free public healthcare?

Most people are aware that Spain has a free public healthcare system and many automatically assume that everyone who moves here will have access to it.

This is not necessarily true, however, and the rules are a little more complicated than that.

According to Spanish Law (Ley Orgánica 4/2000, de 11 de enero), all foreigners in Spain (legally resident or undocumented) have the right to public healthcare in Spain. 

On the other hand, General Health Law (14/1986 of April 25, Article 1.2) states that All Spaniards and foreign citizens who have established their residence in the national territory are entitled to the right to health protection and health care.

The second refers only to those who have legal residency here, so not including undocumented migrants and other non-residents.

If you do legally move here and are a third-country national from the UK or the US for example, you will only be able to register with a public doctor for the first five years initially if you are:

  • Employed or self-employed and therefore paying social security contributions.
  • Able to register a social security exchange form that grants you the right to public healthcare in Spain (such as the S1 form for Brits in Spain).
  • Paying into the convenio especial social security scheme that gives access to public healthcare after one year living in Spain.

Many of these conditions will be part of being granted your visa or residency permit.

After getting permanent residency after five years, you will theoretically have access to public healthcare without the need to pay for it.

But this is also confusing as previously many people have reported on forums such as Citizens Advice Bureau that some regions won’t allow you to register with a doctor without proving that you pay social security.

READ ALSO: Does permanent residency in Spain equal free public healthcare?

Recently Spain’s Ministry of Health made a move to clear up the confusion in the laws, as well as access for undocumented migrants.

In 2012, the ruling party at the time, the PP approved a law in order to exclude migrants without legal residency from accessing public healthcare.

But on Tuesday May 14th 2024, this all changed when the Spanish cabinet approved a draft bill aimed at recovering the “universality of the healthcare system”, so that all people living in Spain, regardless of their administrative status, may be treated in health centres, without being denied assistance or later receiving an invoice demanding payment.

The decision comes a few months after the controversy generated by the mayor of the town of Ripoll in Catalonia, Sílvia Orriols. Orriols restricted migrants from registering, making it difficult for them to get a health card and see a doctor.

The law was modified in 2018 to allow those without papers to submit a report to social services, but in reality, many were denied from doing this or were forced to wait for months.

“We want to close that wound” and, in moments of “exclusionary discourses”, harness healthcare universality “as a tool to have more cohesive, efficient and fair societies”, Health Minister Mónica García explained.

READ ALSO: Spain’s plan to stop the privatisation of public healthcare

The new draft rule states that foreigners not registered or authorised as residents in Spain must only sign a responsible declaration, “with which they will never be denied healthcare,” according to the minister.

The law also aims to guarantee healthcare to Spaniards residing abroad and their family members, as well as the children of foreigners residing in Spain who agree to reunification, provided that there is no third party who is obliged to pay for care.

The bill also aims to reduce co-payments, so that all the groups mentioned above will not have to pay 100 percent of their medications either, but it’s unclear yet or not whether this will go through.

The draft law will now need to be studied by both advisory bodies and the government, so it will not be published in the Official State Gazette and come into force for several months or even years.

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