Spain

Are you planning to study abroad in Spain? Dreaming of living in Barcelona, the home of Gaudi’s amazing architectural wonders? Or are you looking forward to enjoying Spain’s famous cuisine while you’re working in Madrid?

Whether you’ll be moving to Spain for work, school or travel, it’s helpful to understand their public and private healthcare system. While it may feel overwhelming, we can help.

Understanding the healthcare system in Spain.

Spain has a public and a private healthcare system. Its public system, the Sistema Nacional de Salud (National Health System), is widely regarded as high-quality and reliable. Public healthcare is funded through taxes and social security contributions. There are no upfront costs for doctor visits, hospital stays or surgeries for those using the public health system.

Each of Spain’s 17 autonomous regions manages its own healthcare services, which means care quality and availability can vary slightly by region. Major cities like Madrid and Barcelona offer more specialists and facilities, while rural areas may require travel for advanced care.

Spain’s health insurance requirements for expats and students.

Expats

Expats and third-country nationals working in Spain on a local payroll have to pay into the Spanish social security system, which grants them and their dependents access to the public healthcare system. They then have the option to take private insurance as a supplement.

Expats and third-country nationals on a foreign or U.S. payroll do not have access to the public system and must have a private international health insurance plan.

The latest changes to the Spanish requirements mean foreign policies must have a higher level of coverage that includes the following. Note that travel insurance is not accepted.

• No deductible or copay.
• No waiting periods (hospitalization waiting periods of six months or less).
• Repatriation coverage.

Students Studying Abroad in Spain

International students must have private health insurance to meet visa requirements. The policy must:

• Include no deductibles or co-payments.
• Offer full coverage equivalent to the public system.
• Include repatriation coverage.
• Not be a travel insurance policy.
• Be valid from at least one month before the start of studies until 15 days after the end of the studies, or for one year if the duration of the studies is longer than one year.

Students under 26 may be eligible for public healthcare through university arrangements or as dependents, but this is not guaranteed. EU students can use their European Health Insurance Card (EHIC) to access public healthcare during their studies.

Practical considerations for accessing healthcare in Spain.

Pharmacies are easy to find and play a central role in everyday care. Spanish pharmacies (farmacias) are widespread, clearly marked with a green cross, and staffed by licensed pharmacists who can provide consultations, dispense prescriptions, and advise on minor health concerns. Many operate extended hours.

If you need specialized care, expect to go through your primary care doctor first, as referrals are required for most specialists in the public system. Private healthcare offers more direct access to specialists and shorter wait times, which is why many residents choose to supplement their public coverage with a private plan.

Short-term visitors are not covered by the public system and should carry travel medical insurance. Without it, expect to pay out of pocket for care.