TL;DR
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr provides expert guidance on private medical insurance for UK citizens moving to Spain. This article explains your options for private health cover, navigating the Spanish system post-Brexit, and securing the comprehensive protection you need for peace of mind. Comprehensive PMI for British expats living in Spain Moving to Spain is a dream for many Britons, offering a sunnier climate, a relaxed lifestyle, and a rich culture.
Key takeaways
- Workers 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 use the SNS.
- State Pensioners: If you receive a UK state pension, you can apply for an S1 form from the NHS Business Services Authority. Once registered with the social security office in Spain, the S1 form entitles you to the same healthcare rights as a Spanish citizen, with the UK government reimbursing Spain for your care.
- *The Convenio Especial: For early retirees or those not working who are not eligible via an S1 form, there is a special pay-in scheme. The Convenio Especial* allows you to access the SNS by paying a monthly fee (currently around €60 for under 65s and €157 for those 65 and over). However, it doesn't cover prescriptions and has limitations. Crucially, you must have been registered as a resident in Spain for at least one year to apply, creating a coverage gap for new arrivals.
- Be provided by an insurer authorised to operate in Spain.
- Offer coverage equivalent to the Spanish public health system.
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr provides expert guidance on private medical insurance for UK citizens moving to Spain. This article explains your options for private health cover, navigating the Spanish system post-Brexit, and securing the comprehensive protection you need for peace of mind.
Comprehensive PMI for British expats living in Spain
Moving to Spain is a dream for many Britons, offering a sunnier climate, a relaxed lifestyle, and a rich culture. However, since the UK's departure from the European Union, navigating healthcare requirements has become more complex. For thousands of British expats, securing the right private medical insurance (PMI) is no longer just a sensible precaution—it's an essential requirement for residency.
This guide provides an exhaustive look at private health insurance for UK expats in Spain. We'll explore the Spanish healthcare system, explain why PMI is crucial, detail what to look for in a policy, and offer practical tips for staying healthy in your new home.
Understanding Spain's Healthcare System for UK Expats
Spain has a world-class healthcare system, the Sistema Nacional de Salud (SNS), which is funded by social security contributions. It provides excellent care, but access for British expats is no longer as straightforward as it once was.
Who is entitled to state healthcare in Spain?
- Workers 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 use the SNS.
- State Pensioners: If you receive a UK state pension, you can apply for an S1 form from the NHS Business Services Authority. Once registered with the social security office in Spain, the S1 form entitles you to the same healthcare rights as a Spanish citizen, with the UK government reimbursing Spain for your care.
- The Convenio Especial: For early retirees or those not working who are not eligible via an S1 form, there is a special pay-in scheme. The Convenio Especial allows you to access the SNS by paying a monthly fee (currently around €60 for under 65s and €157 for those 65 and over). However, it doesn't cover prescriptions and has limitations. Crucially, you must have been registered as a resident in Spain for at least one year to apply, creating a coverage gap for new arrivals.
What about the GHIC?
The UK Global Health Insurance Card (GHIC) has replaced the old European Health Insurance Card (EHIC). It is designed for temporary stays only, such as holidays. It allows you to access state-provided healthcare at the same cost as a Spanish citizen.
A GHIC is not a substitute for comprehensive health insurance and cannot be used if you are a resident in Spain. Relying on a GHIC after becoming a resident is not permitted and will leave you without valid health cover.
Why Do British Expats in Spain Need Private Health Insurance?
While the Spanish public system is excellent, private medical insurance offers several compelling advantages, moving from a "nice-to-have" to a "must-have" for many.
1. A Prerequisite for Residency Visas
This is the most significant change post-Brexit. To apply for most long-term Spanish visas, including the popular Non-Lucrative Visa (NLV) and the Digital Nomad Visa, you must have comprehensive private health insurance in place.
The Spanish authorities specify that this insurance must:
- Be provided by an insurer authorised to operate in Spain.
- Offer coverage equivalent to the Spanish public health system.
- Have no co-payments (sin copagos).
- Have no excess or deductible.
- Cover the full duration of your intended stay.
Failure to meet these strict requirements will result in your visa application being rejected.
2. Immediate Cover on Arrival
As mentioned, there's a one-year residency requirement before you can apply for the Convenio Especial. Private health insurance is the only way to ensure you are fully covered from the day you arrive in Spain, bridging this critical gap.
3. Access to English-Speaking Medical Professionals
While many doctors in tourist areas speak English, this is not guaranteed, especially in more rural locations or for specialist consultations. Private health insurance gives you access to a wide network of private hospitals, clinics, and doctors, many of whom are fluent in English. This can be incredibly reassuring when you're feeling unwell and need to understand your diagnosis and treatment plan clearly.
4. Shorter Waiting Times
Like the NHS, the Spanish SNS can have significant waiting lists for specialist appointments and non-urgent surgery. According to the Spanish Ministry of Health, the average waiting time for non-urgent surgery can be several months. Private medical insurance allows you to bypass these queues, often seeing a specialist within days and scheduling procedures much faster.
5. Choice and Flexibility
With private health cover, you have the freedom to choose your doctor, specialist, and hospital from within the insurer's approved network. This gives you greater control over your healthcare journey, allowing you to select professionals and facilities with the best reputations or those most convenient for you.
6. Enhanced Comfort and Services
Private hospitals in Spain often offer a higher level of comfort, including private rooms with en-suite bathrooms and more flexible visiting hours. They may also provide access to a broader range of treatments and the very latest medical technology.
Critical Information: Pre-existing and Chronic Conditions
This is one of the most important and often misunderstood aspects of private medical insurance. It is vital to be clear on this point.
Standard private medical insurance in the UK and Spain is designed to cover new, acute medical conditions that arise after your policy begins.
- Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include a broken bone, appendicitis, or a cataract.
- Chronic Condition: A disease, illness, or injury that has one or more of the following characteristics: it needs ongoing or long-term monitoring, has no known cure, is likely to recur, or requires palliative care. Examples include diabetes, asthma, hypertension, and arthritis.
- Pre-existing Condition: Any medical condition, symptom, or related issue you had before the start date of your new policy, whether you received a diagnosis or not.
Insurers will not typically cover the treatment of chronic or pre-existing conditions. For expats relying on the S1 form, these conditions will be covered by the state system. For others, they may need to use the Convenio Especial (after one year) or pay for treatment out-of-pocket.
Understanding Underwriting
When you apply for PMI, the insurer assesses your health risk through a process called underwriting. The two main types are:
| Underwriting Type | How It Works | Pros & Cons |
|---|---|---|
| Moratorium | You do not declare your full medical history upfront. Instead, the insurer applies a blanket exclusion for any condition you've had symptoms, treatment, or advice for in a set period (usually the 5 years before the policy starts). These conditions may become eligible for cover after you have held the policy for a continuous period (usually 2 years) without experiencing any symptoms or seeking treatment for them. | Pros: Quicker application process. Cons: Lack of certainty. A claim might be rejected if the insurer traces it back to a pre-existing condition. |
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire, disclosing your entire medical history. The insurer then decides what they will and will not cover. Any pre-existing conditions will be explicitly listed as exclusions on your policy documents. | Pros: Complete clarity from day one. You know exactly what is and isn't covered. Cons: Longer application process. You must provide detailed medical information. |
For a Spanish residency visa, Full Medical Underwriting is often preferred as it provides clear proof to the consulate that you have a comprehensive policy with specific exclusions listed, rather than the ambiguity of a moratorium. An expert PMI broker like WeCovr can guide you on the best approach for your circumstances.
What to Look For in a Health Insurance Policy for Spain
Choosing the right policy is crucial. Here are the key features to scrutinise to ensure your cover is fit for purpose, especially for visa applications.
- ✅ Visa-Compliant: The policy must state that it offers full asistencia sanitaria completa, has no co-payments (sin copagos), and no excess/deductible.
- ✅ Authorised in Spain: The insurer must be legally permitted to operate in Spain. Most major international providers are.
- ✅ Full In-patient and Out-patient Cover: Ensure the policy covers hospital stays (in-patient) as well as specialist consultations, diagnostic tests, and scans (out-patient).
- ✅ Repatriation Cover: This covers the medical cost of returning you to the UK for treatment if necessary. While not always a visa requirement, it provides valuable peace of mind.
- ✅ Geographical Area of Cover: Check if the policy covers you only in Spain, across Europe, or worldwide (often excluding the USA/Canada to manage costs). If you plan to travel frequently, this is an important consideration.
- ✅ Dental and Optical Options: Basic private health plans rarely include dental or optical cover. These are usually available as optional add-ons for an extra premium.
- ✅ English-Language Support: Check for a 24/7 English-speaking helpline and policy documents in English.
Comparing International PMI Providers for Expats in Spain
Navigating the market can be daunting, with numerous providers all offering slightly different products. Using a specialist broker removes the guesswork, but it helps to understand what you're comparing.
Here is an illustrative table showing how to compare key features:
| Feature | Provider A (Example) | Provider B (Example) | What to Look For |
|---|---|---|---|
| Visa Compliance | Yes, offers a specific "Residency" plan | Yes, all comprehensive plans are compliant | Policy must explicitly state "no co-payments" and "no excess". Ask for a certificate for your visa application. |
| Network Size | 40,000 doctors & 1,000 hospitals in Spain | 50,000 doctors & 1,200 hospitals in Spain | A larger network gives you more choice, especially outside the main cities. Check the network in your specific region. |
| Repatriation | Included as standard | Optional add-on | Decide if you'd prefer treatment in Spain or the UK. If the UK, ensure this is included. |
| Dental Cover | Basic check-ups included, further treatment extra | Optional add-on package for €20/month | Compare the cost of the add-on versus the benefits offered. Is it just for emergencies or does it cover routine work? |
| Customer Service | 24/7 English helpline | English support during office hours only | 24/7 support is vital for medical emergencies. |
This comparison process is where a specialist private medical insurance UK broker adds immense value. WeCovr's team are experts in the expat market. We do this analysis for you, presenting you with the best options from leading insurers that match your specific needs and budget, all at no cost to you.
The Cost of Private Medical Insurance for Expats in Spain
The premium you pay for private health cover is influenced by several key factors:
- Age: This is the single biggest determinant of cost. Premiums rise significantly as you get older.
- Level of Cover: A basic plan covering only in-patient treatment will be cheaper than a comprehensive plan with out-patient, dental, and repatriation benefits.
- Area of Cover: A Spain-only policy will be more affordable than a policy providing worldwide cover.
- Excess: Although not an option for visa-compliant plans, on other policies, choosing a higher voluntary excess (the amount you pay towards a claim) will lower your premium.
- Medical History: Under a Full Medical Underwriting policy, your personal medical history can influence the final premium.
Illustrative Monthly Premiums:
To give you a general idea, below are some example price ranges for a comprehensive, visa-compliant policy with no excess or co-payments.
| Age Bracket | Estimated Monthly Premium |
|---|---|
| 30-40 years old | €60 - €100 |
| 45-55 years old | €80 - €150 |
| 60-70 years old | €180 - €350+ |
Please note: These are for illustration only and are not a quote. The actual cost will depend on your individual circumstances and the insurer you choose.
The Role of a Specialist PMI Broker like WeCovr
Choosing health insurance for a new country is a major decision. A specialist broker simplifies the entire process.
- Independent Expertise: As an FCA-authorised broker, WeCovr is not tied to any single insurer. Our advice is impartial, focused solely on finding the best private health cover for you. We have helped thousands of expats navigate the Spanish system.
- Market Comparison: We have access to policies from a wide range of leading Spanish and international insurers. We compare the features, benefits, and costs, saving you hours of research.
- No Cost to You: Our service is free for our clients. We are paid a commission by the insurer you choose, but the price you pay is the same as going direct.
- Application Support: We help you complete the application forms correctly, ensuring all medical information is declared properly and that the policy meets Spain's strict visa requirements.
- Added Value: When you arrange a policy through WeCovr, we provide complimentary access to our AI-powered nutrition app, CalorieHero, to support your health goals. Furthermore, customers who purchase PMI or life insurance may be eligible for discounts on other insurance products, such as home or travel cover. Our high customer satisfaction ratings reflect our commitment to exceptional service.
Health and Wellness Tips for British Expats in Spain
Your health insurance is a safety net, but the best approach is to stay healthy. Embracing the Spanish lifestyle can do wonders for your well-being.
- Embrace the Mediterranean Diet: Focus on fresh fruit and vegetables, lean protein like fish and chicken, healthy fats from olive oil and nuts, and whole grains. Limit processed foods and red meat.
- Stay Active Sensibly: The Spanish climate is perfect for an active outdoor lifestyle. Walking, cycling, and swimming are popular. However, be sensible in the summer heat. Avoid strenuous exercise during the hottest part of the day (typically 1 pm to 5 pm).
- Prioritise Sun Safety: Skin cancer rates are higher in sunny climates. Always wear a high-SPF sunscreen (SPF 30 or above), a wide-brimmed hat, and sunglasses. Seek shade during peak sun hours.
- Stay Hydrated: Dehydration can happen quickly in the heat. Make a habit of drinking plenty of water throughout the day, even if you don't feel thirsty.
- Adapt to the Rhythm: The Spanish day is structured differently. Dinner is eaten late, and the afternoon siesta is still a feature of life in many regions. Adapting to this can improve your sleep and help you integrate into the local culture.
Do I need private health insurance in Spain if I have an S1 form?
Can I use my UK Global Health Insurance Card (GHIC) instead of private insurance?
Does Spanish private health insurance cover pre-existing conditions?
What does 'sin copagos' mean and why is it important for my visa?
Ready to find the right private medical insurance for your new life in Spain? Securing the correct policy is a vital step in your relocation journey.
The expert team at WeCovr is here to provide clarity and support. We'll help you compare leading policies from top insurers, ensure your chosen plan meets all visa requirements, and find the most competitive price.
Sources
- Office for National Statistics (ONS): Mortality, earnings, and household statistics.
- Financial Conduct Authority (FCA): Insurance and consumer protection guidance.
- Association of British Insurers (ABI): Life insurance and protection market publications.
- HMRC: Tax treatment guidance for relevant protection and benefits products.
