As an FCA-authorised UK broker that has helped arrange over 800,000 policies, WeCovr specialises in finding the right private medical insurance for your needs. This guide explains everything British citizens need to know about securing health cover when relocating to the sunnier climes of Spain.
A guide for Brits relocating to Spain and needing health cover
Making the move to Spain is an exciting prospect. The promise of over 300 days of sunshine a year, a relaxed lifestyle, and a rich culture is a powerful draw for thousands of Brits every year. In fact, according to the Office for National Statistics (ONS), Spain remains one of the most popular countries for UK citizens choosing to live abroad.
But amidst the excitement of house-hunting and learning Spanish, there's a critical piece of planning that can't be overlooked: your healthcare.
Once you become a resident of Spain, you are no longer covered by the NHS for most treatments. Your Global Health Insurance Card (GHIC) is only for temporary stays, not for residents. This means you need a robust plan to cover your medical needs.
This is where Private Medical Insurance (PMI) specifically designed for expats comes in. This guide will walk you through Spain's healthcare system, why you need private cover, what to look for in a policy, and how to navigate the process with ease.
Understanding Spain's Healthcare System: Public vs. Private
Spain has an excellent healthcare system, but it's important to understand how it works and who is eligible for state cover. The system is divided into two main parts: the public system and the private sector.
The Public System: Sistema Nacional de Salud (SNS)
The SNS is Spain's state-run healthcare service. It's funded by social security contributions and is highly regarded, offering a good standard of care.
Who is eligible for the SNS?
- Employees and the Self-Employed: If you are legally working in Spain and paying social security contributions (seguridad social), you and your registered dependents are entitled to state healthcare.
- State Pensioners: British citizens receiving a UK state pension can access the SNS. You'll need to apply for an S1 form from the NHS Business Services Authority before you leave the UK. This form proves your entitlement to healthcare funded by the UK.
- Long-term Residents: After five years of continuous legal residence, you can apply for permanent residency, which may also grant access to the SNS.
This leaves a significant gap for many early retirees, non-working individuals, and students who are not yet eligible for state cover. For many, private health insurance isn't just an option; it's a necessity.
The Private Healthcare Sector
Alongside the public system, Spain has a thriving private healthcare sector. Many Spaniards and expats alike choose to use private facilities, even if they have access to the SNS.
Why choose private healthcare?
- Shorter Waiting Times: Waiting lists for specialist appointments and non-urgent surgery can be long in the public system. Private healthcare offers much faster access.
- Choice of Doctor and Hospital: You can choose your own specialist and hospital from the insurer's network.
- English-Speaking Staff: Most private hospitals and clinics in areas popular with expats have English-speaking doctors, nurses, and administrative staff, which is a huge comfort when you're feeling unwell.
- Private Rooms: You are almost always guaranteed a private room with an en-suite bathroom for hospital stays.
Why UK Expats in Spain Need Private Medical Insurance
For many Brits moving to Spain, private health insurance is essential for several key reasons.
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Visa and Residency Requirements: This is often the most pressing reason. To secure a residency visa, such as the popular Non-Lucrative Visa (NLV), Spanish authorities require you to have comprehensive private health insurance. The policy must be with an insurer authorised to operate in Spain and provide cover equivalent to the SNS, with no co-payments or deductibles.
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Bridging the Healthcare Gap: If you are moving to Spain before retirement age and are not planning to work (e.g., an early retiree), you won't be paying into the social security system and therefore won't be entitled to state healthcare. A private policy is the only way to ensure you are medically covered.
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Supplementing the Public System: Even if you are entitled to state care via an S1 form or by working, you may still want the benefits of private cover. Many expats use a private policy to skip long waiting lists for diagnostics or to see a specialist quickly, while still using the public system for emergencies or major treatments.
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Peace of Mind and Convenience: Knowing you can quickly access high-quality medical care in a language you understand provides invaluable peace of mind. It removes the stress of navigating a new and complex public system, especially during a medical emergency.
What is International Private Medical Insurance (IPMI)?
It's crucial to understand that a standard private medical insurance UK policy will not cover you once you become a resident abroad. These domestic policies are designed for UK residents using UK hospitals.
For expats, you need a specific type of policy: International Private Medical Insurance (IPMI).
IPMI policies are designed from the ground up for people living and working outside of their home country.
Key Features of IPMI:
- Global or Regional Cover: Policies can cover you just in Spain, across Europe, or even worldwide.
- Designed for Expats: They understand the needs of an international community, often offering multilingual support and direct billing with hospitals.
- Medical Evacuation and Repatriation: Many plans include cover to transport you to a centre of medical excellence or even back to the UK for treatment if necessary.
- Annual, Renewable Contracts: You pay a premium for 12 months of cover, which you can then renew each year.
A key point to remember, which is true for both UK PMI and IPMI, is that these policies are designed to cover acute conditions. An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery.
Crucially, standard private health cover does not cover chronic or pre-existing conditions. A chronic condition is one that is long-lasting and needs ongoing management, like diabetes or asthma. A pre-existing condition is any ailment you had before your policy's start date. Always be completely honest about your medical history during the application process.
Key Considerations When Choosing an Expat Health Insurance Policy
Choosing the right policy can feel daunting, but it's simpler when you break it down. An expert PMI broker like WeCovr can guide you through these options to find a policy that fits your budget and needs perfectly.
Here are the main things to consider:
1. Level of Cover
- In-patient Only: This is the most basic level. It covers costs associated with a hospital stay, such as surgery, accommodation, and specialist fees.
- In-patient and Out-patient: A more comprehensive option that also covers treatments that don't require a hospital stay. This includes things like specialist consultations, diagnostic scans (MRI, CT), and therapies.
- Fully Comprehensive: The highest level of cover. It often includes everything above, plus benefits like dental treatment, optical care, and wellness checks.
2. Area of Cover
- Spain Only: The most affordable option, providing cover only within Spain.
- Europe: Covers you in Spain and across the rest of Europe, ideal if you plan to travel frequently.
- Worldwide excluding USA: A popular choice that provides global cover but excludes the USA, where medical costs are exceptionally high. This keeps premiums more manageable.
- Worldwide including USA: The most expensive option, providing cover everywhere.
3. Deductibles and Excess
An excess (or deductible) is the amount you agree to pay towards a claim. For example, if you have a £250 excess and your treatment costs £2,000, you pay the first £250 and the insurer pays the remaining £1,750. Choosing a higher excess will lower your monthly or annual premium.
Important Note for Visa Applicants: For many Spanish visas, you must have a policy with zero excess and no co-payments (sin copagos). WeCovr can help you identify policies that meet this specific requirement.
4. Underwriting Options
This is how the insurer assesses your medical history to decide what they will cover.
- Full Medical Underwriting (FMU): You provide your complete medical history on the application form. The insurer then decides if they will exclude any pre-existing conditions from your cover. It provides clarity from day one about what is and isn't covered.
- Moratorium Underwriting: You don't declare your medical history upfront. Instead, the policy automatically excludes any condition you've had symptoms of, or received treatment for, in the last 5 years. These exclusions can be lifted if you go for a set period (usually 2 years) without any symptoms or treatment for that condition after your policy starts.
How WeCovr Can Help You Find the Best PMI for Spain
Navigating the world of international health insurance can be complex. Using an independent, specialist broker like WeCovr simplifies the entire process and ensures you get the right cover at a competitive price.
- Expert, Impartial Advice: We are not tied to any single insurer. Our goal is to find the best policy for you. As an FCA-authorised firm, we adhere to the highest standards of professional conduct.
- Market-Wide Comparison: We have access to policies from a wide range of leading international insurers, including those best suited for the Spanish market. We do the shopping around so you don't have to.
- Tailored to Your Needs: Whether you need a simple policy to satisfy visa requirements or a comprehensive family plan, we listen to your needs and find matching options.
- No Cost to You: Our expert advice and support come at no cost to you. We are paid a commission by the insurer you choose, which does not affect the price you pay.
- High Customer Satisfaction: We pride ourselves on our service, and our high customer satisfaction ratings reflect our commitment to helping our clients.
Furthermore, when you arrange your private medical insurance through WeCovr, you also get complimentary access to our AI-powered nutrition app, CalorieHero, to support your wellness journey. Plus, you can benefit from discounts on other insurance products, such as life or travel cover.
Comparing Top International Health Insurance Providers for Spain
Many excellent insurers offer plans for expats in Spain. Below is an illustrative table of some well-known providers. The "best PMI provider" is always the one that best matches your personal circumstances.
| Provider | Key Strengths | Typical Coverage Area | Good For... |
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| Bupa Global | Extensive global network, premium brand, high cover limits. | Regional & Worldwide | Those seeking top-tier comprehensive cover and service. |
| AXA Global Healthcare | Strong reputation, flexible plans, good digital tools. | Regional & Worldwide | Individuals and families wanting customisable plans. |
| Cigna Global | Highly flexible modular plans, large medical network. | Regional & Worldwide | People who want to build their own plan and control costs. |
| Sanitas | A leading Spanish insurer, deep network within Spain. | Primarily Spain | Expats needing a visa-compliant policy with excellent local access. |
Disclaimer: This table is for illustrative purposes only. Features and benefits vary widely between specific plans. A personalised quote from a broker like WeCovr is essential to find the right policy for you.
Understanding the Costs of Expat Health Insurance
The cost of your private health cover will depend on several factors:
- Age: This is the single biggest factor. Premiums increase with age.
- Level of Cover: An in-patient only plan will be cheaper than a comprehensive plan with dental and out-patient cover.
- Area of Cover: A 'Spain only' policy is more affordable than a 'Worldwide' one.
- Excess: A higher excess will lower your premium.
- Your Health: Your medical history can influence the final price.
To give you a general idea, here are some illustrative premium ranges.
| Profile | Illustrative Monthly Premium Range | Notes |
|---|
| Single Person, age 35 | £70 - £150 | Mid-level cover for Europe. |
| Couple, age 55 | £250 - £500 | Comprehensive cover for Europe, zero excess. |
| Family of 4 (Parents 40, Children 8 & 10) | £300 - £650 | Good out-patient and in-patient cover for Europe. |
Important: These are estimates only and not a quote. Prices vary significantly between insurers and are based on individual circumstances. Contact WeCovr for an accurate, personalised quote.
Navigating the Spanish Visa Process with the Right Health Insurance
For many Brits, particularly those applying for a Non-Lucrative Visa (NLV) or Golden Visa, having the correct health insurance is non-negotiable. The Spanish consulate will reject applications that do not meet their strict criteria.
Key Insurance Requirements for a Spanish Visa:
- Full Coverage: The policy must cover all preventative, diagnostic, and treatment services, providing a level of care equivalent to the Spanish National Health System.
- Authorised Insurer: The policy must be from an insurance company authorised to operate in Spain.
- No Co-payments (sin copagos): The policy cannot require you to pay a portion of the cost for each treatment or consultation. It must cover 100% of the costs.
- No Deductibles/Excess (sin franquicias): The policy must not have any excess that you need to pay before the insurance kicks in.
- No Waiting Periods (sin carencias): The policy must be active immediately for all types of care, without waiting periods for certain treatments.
- Fully Paid Upfront: You must pay for the full year of insurance in advance and provide proof of payment with your visa application.
Finding a policy that ticks all these boxes can be tricky, but this is an area where WeCovr excels. We work with insurers who provide visa-compliant certificates, ensuring your application process is as smooth as possible.
Wellness and Healthy Living in Spain: Making the Most of Your New Life
Moving to Spain is also an opportunity to embrace a healthier lifestyle. Your private medical insurance is there for when you're unwell, but the Spanish way of life can help you stay well for longer.
- The Mediterranean Diet: Embrace a diet rich in fresh fruit, vegetables, salads, lean protein like fish, and healthy fats from olive oil and nuts. This diet is consistently linked to better heart health and longevity.
- An Active Lifestyle: The wonderful climate encourages an outdoor life. Join the locals for the daily paseo (a leisurely evening walk), take up hiking in the beautiful national parks, or enjoy swimming and water sports on the coast.
- Sunshine and Vitamin D: Sunshine is great for boosting mood and is the best source of Vitamin D, essential for bone and immune health. Remember to be sun-safe: use high-factor sunscreen, wear a hat, and avoid the intense midday sun.
- A Slower Pace of Life: Spanish culture values social connections and taking time to relax. Embracing a lower-stress lifestyle, including the traditional siesta or afternoon break, can have profound benefits for your mental and physical wellbeing.
Generally, if you are a UK state pensioner, an S1 form gives you access to Spain's state healthcare (SNS) on the same basis as a Spanish citizen. However, many expats with an S1 still choose to take out private medical insurance. The main reasons are to get faster access to specialists and diagnostic tests, to have a choice of doctors and hospitals, and to ensure access to English-speaking medical staff and the comfort of a private room.
Can I use my UK NHS entitlement in Spain after moving?
No. Once you become an official resident in another country like Spain, you are no longer entitled to routine medical treatment on the NHS. Your access to healthcare is governed by the system in your new country of residence. You can still use a GHIC (Global Health Insurance Card) for emergency treatment if you are temporarily visiting the UK, but it is not a substitute for comprehensive health cover in Spain.
What happens if I have a pre-existing medical condition?
Standard international private medical insurance policies are designed for new, acute conditions that arise after your policy begins. They will almost always exclude pre-existing and chronic conditions. When you apply, you will either need to declare your full medical history (Full Medical Underwriting) or opt for a policy with a moratorium. It is vital to be honest, as non-disclosure can invalidate your policy. Some specialist insurers may offer cover for certain pre-existing conditions, often for a higher premium, which a broker can help you explore.
Does my Spanish health insurance cover me when I visit the UK?
It depends entirely on your policy's 'area of cover'. If you choose a plan that covers 'Europe' or 'Worldwide', it will typically provide cover for medical emergencies and eligible treatment during temporary visits back to the UK. If you buy a 'Spain only' policy to keep costs down, you will not be covered for trips outside of Spain.
Ready to Take the Next Step?
Planning your move to Spain is a big undertaking, but arranging your health insurance doesn't have to be complicated. Let WeCovr do the hard work for you. Our expert advisors can provide a free, no-obligation comparison of the best private medical insurance policies for your new life in Spain.
Get Your Free, Personalised PMI Quote from WeCovr Today