healthcare in spain, hospital image

Understanding Healthcare in Spain: A Guide for Expats

When my husband and I moved to Spain, I expected the culture shock to come from things like late dinners, the slower pace of life, or navigating Spanish bureaucracy. But honestly? One of the biggest surprises has been the healthcare of Spain.

Since moving almost a year ago, we’ve been able to book appointments quickly, doctors don’t hesitate to run tests, and we’ve never had to argue with an insurance company about what’s “covered.” Coming from the U.S., where every check-up feels like you’re bracing for the next bill, this has been such a breath of fresh air.

Whether you’re moving to Spain like us or just researching for an upcoming trip (because accidents happen), here’s what you should know about the universal healthcare in Spain and how private insurance works for expats.


How the Healthcare System Works in Spain

Spain’s healthcare is built on a universal system funded through taxes, which means locals and legal residents can access most services with little or no out-of-pocket costs. For more information on how exactly this works, I recommend visiting Spain’s Ministry of Health website.

It still blows my mind when I hear stories of people spending two nights in the ER and the only bill they received was for hospital meals. In the U.S., that same stay could set you back thousands, or land you with a lifetime of medical debt.


Public vs. Private Healthcare in Spain

Public Healthcare

Public healthcare in Spain is reliable and widely respected, covering nearly all medical needs. However, it can involve long wait times for specialists. Expats are not eligible to use the system until they’ve been contributing to Spanish social security for at least a year.

Private Healthcare

Expats (like us) are required to get private health insurance, especially when applying for long-term visas. Private care is faster, flexible, and still incredibly affordable compared to U.S. standards. Many Spaniards also choose to supplement their public coverage with private insurance for quicker access to specialists.

Pro Tip: If you’re applying for a Spanish visa, you’ll need proof of private health insurance that meets specific requirements. Here’s a helpful resource on visa requirements.


Private Health Insurance as an Expat

When we first arrived, I found it overwhelming to learn a new healthcare system. Thankfully, my husband’s employer provided private coverage at no cost to him—and adding me cost just €30 per month. That’s all we pay for insurance.

For context, in the U.S. we used to pay over $500 a month for a plan that still managed to surprise us with ridiculous bills.

On average, private insurance in Spain costs:

  • €40–€70/month for young adults
  • €100–€200/month for families or older expats

What Our Private Insurance Covers

Our private plan is extremely comprehensive. It includes:

  • Primary care & preventative medicine
  • Specialists (dermatology, psychiatry, oncology, etc.)
  • Diagnostics & labs (radiology, blood tests, endoscopy, sleep tests, etc.)
  • Maternity care
  • Travel insurance (including foreign hospitalization reimbursement up to €20,000)
  • Hospital care & emergency visits (including ambulance)
  • Dental & vision

Most appointments are available within 1–2 weeks, and many can be booked directly through the insurer’s app. It’s a little sad how exciting this is coming from the U.S.!


Our Personal Experience with the Spanish Healthcare System

It’s not always perfect—sometimes appointments feel a bit disorganized, and language barriers can make things tricky. But compared to the U.S., the healthcare of Spain feels stress-free and accessible.

The “worst” wait I’ve experienced at a doctor’s office here was about 30 minutes. Honestly, I think I’ve experienced the same wait times in a doctors office in the U.S.

From my experience, doctors in Spain are friendly, knowledgeable, and focused on prevention. The peace of mind that comes from knowing we won’t face surprise $1,000+ bills? Priceless.

Pharmacy in Madrid, Spain
Pharmacy in Madrid, Spain

FAQs About Healthcare in Spain

1. Is healthcare free in Spain?
Not 100%—but due to universal healthcare in Spain, residents pay very little for services. Out-of-pocket costs are minimal compared to the U.S.

2. Do expats get access to healthcare in Spain?
Yes, but most start with private insurance (required for visas). Once you’re contributing to social security, you can access public care too.

3. How much does private health insurance cost?
Typically €40–€70/month for individuals, €100–€200/month for families. Many employers cover costs as part of their benefits.

4. Is Spanish healthcare better than U.S. healthcare?
In my personal experience—yes. It’s more affordable, more accessible, and much less stressful.

5. Can you use both public and private healthcare?
Absolutely. Many people use public healthcare for emergencies and private for quicker specialist appointments.


Final Thoughts

For me, the healthcare of Spain has been one of the most positive aspects of moving abroad. It’s affordable, accessible, and (mostly) efficient. Even when it feels a little confusing, the fact that my bill is €0 makes it all worth it.

If you’re considering a move, rest assured: the combination of universal healthcare in Spain and affordable private coverage makes this one of the best countries to stay healthy without financial stress.

Thinking about moving to Spain? Check out my guide on what to do in your first week abroad and start your new life prepared!


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