Find out when you are entitled to Spanish public healthcare, when you are covered by bilateral treaties between your home country and Spain, and when you will need to buy private health insurance…

Non-EU citizens who are legal residents of Spain are generally able to access the public health system like any other Spanish citizen. See the Healthcare in Spain page for a list of those who qualify.

Anyone under 18, regardless of nationality, is also able to access the public healthcare system and be treated in the same manner as a Spanish citizen. This right is extended to pregnant women (regardless of age or nationality) during their pregnancies, the birth, and post-natal care in Spain.

Bilateral agreements with non-EU countries

Nationals of countries with which Spain has bilateral healthcare agreements will be given free emergency treatment upon presentation of their Certificate of Right to Medical Care. This certificate is issued by the patient’s home country before leaving for Spain and confirms that the bearer has contributed to their local social security system. It is also possible for nationals of these countries to register for Spanish healthcare online in some regions. See the Asturias online portal for an example.

Spain currently has bilateral healthcare agreements with:

  • Andorra
  • Brazil
  • Chile
  • Ecuador
  • Paraguay
  • Peru
  • Morocco (only those working in Spain)
  • Tunisia (only those working in Spain)

This entitles visiting nationals from these countries access to free emergency treatment in state hospitals in the event of an accident or illness. Valid certificates must be presented.

Temporary stays

For temporary visits, non-EU citizens who need a visa to visit Spain will usually be asked to provide proof of medical insurance as part of their visa application. This applies to holidaymakers and some students. Medical coverage may or not be included in a travel insurance package.

Non-EU citizens who can visit Spain without a visa are strongly encouraged to take out travel insurance that will cover any medical expenses incurred. Insured or not, these visitors will need to pay their medical expenses on the day. For those with insurance, reimbursement must be negotiated with their insurance company, not with the medical provider. Occasionally payment may be deferred if the patient signs a Declaration of Ability to Pay but this depends on the individual facility and is exceedingly rare for a visit to a General Practitioner.

Private Insurance

As many public health facilities in Spain also offer private facilities, some Spanish citizens and residents as well as non-EU citizens buy private health insurance, especially as the public health system does not cover dental care.

Private health insurance may also cover the gap between the subsidised portion of prescriptions and hospitalisation and the portion paid by the patient.

There are many English-speaking companies that sell Expat Health Insurance. For those already living in Spain, comparison engines like Rastreator (in Spanish) are an easy way to see available policies.