TL;DR
WeCovr's expert guide to PMI for Brits relocating to Spain Moving to Spain is a dream for many Brits, offering sunshine, a relaxed lifestyle, and a rich culture. Here at WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we know that sorting out your healthcare is a top priority. This guide provides everything you need to know about private medical insurance in Spain for UK expats.
Key takeaways
- Visa Requirements: Most Spanish residency visas, including the popular Non-Lucrative Visa (NLV) and the Golden Visa, mandate that applicants hold comprehensive private health insurance. This policy must be with an insurer authorised to operate in Spain and offer coverage equivalent to the SNS, crucially with no co-payments or excess charges.
- Early Access Before State Registration: If you're moving to work, you won't be able to access the state system until you are officially registered and paying social security contributions (seguridad social). Private cover bridges this critical gap, ensuring you're protected from day one.
- Supplementing State Care: Even if you qualify for state healthcare (for example, as a state pensioner with an S1 form), many expats choose PMI for its significant advantages:
- Shorter Waiting Times: The NHS isn't alone in having waiting lists. According to recent data, waiting times for specialists and non-urgent surgery in Spain's public system can be lengthy. PMI offers swift access to consultants and treatment.
- Choice of Doctors and Hospitals: Private insurance gives you the freedom to choose from a wide network of specialists and private hospitals, many of which cater specifically to the international community.
WeCovr's expert guide to PMI for Brits relocating to Spain
Moving to Spain is a dream for many Brits, offering sunshine, a relaxed lifestyle, and a rich culture. Here at WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we know that sorting out your healthcare is a top priority. This guide provides everything you need to know about private medical insurance in Spain for UK expats.
Relocating involves many changes, and navigating a new healthcare system can feel daunting. Whether you're retiring, working, or starting a new life with your family, understanding your options is the first step towards peace of mind. This article will walk you through the Spanish healthcare system, the types of insurance available, and how to choose the perfect cover for your needs.
Why Private Health Insurance is Essential for UK Expats in Spain
Since the UK's departure from the European Union, the rules for accessing state healthcare in Spain have changed for many new arrivals. While the Spanish public healthcare system, the Sistema Nacional de Salud (SNS), is renowned for its high standards, access is no longer automatic for every UK national.
For many, private medical insurance isn't just an option; it's a requirement.
Key Reasons You Need Private Cover:
- Visa Requirements: Most Spanish residency visas, including the popular Non-Lucrative Visa (NLV) and the Golden Visa, mandate that applicants hold comprehensive private health insurance. This policy must be with an insurer authorised to operate in Spain and offer coverage equivalent to the SNS, crucially with no co-payments or excess charges.
- Early Access Before State Registration: If you're moving to work, you won't be able to access the state system until you are officially registered and paying social security contributions (seguridad social). Private cover bridges this critical gap, ensuring you're protected from day one.
- Supplementing State Care: Even if you qualify for state healthcare (for example, as a state pensioner with an S1 form), many expats choose PMI for its significant advantages:
- Shorter Waiting Times: The NHS isn't alone in having waiting lists. According to recent data, waiting times for specialists and non-urgent surgery in Spain's public system can be lengthy. PMI offers swift access to consultants and treatment.
- Choice of Doctors and Hospitals: Private insurance gives you the freedom to choose from a wide network of specialists and private hospitals, many of which cater specifically to the international community.
- English-Speaking Services: A major comfort for many expats is the availability of English-speaking doctors, consultants, and administrative staff, removing any language barriers during a stressful time.
- Comfort and Privacy: Private hospitals typically offer private rooms with en-suite facilities, providing a more comfortable environment for your recovery.
The Spanish Healthcare System (SNS) vs. the UK's NHS
Understanding the local system helps you appreciate what private medical insurance adds. Both the SNS and NHS are excellent, tax-funded systems, but they have key differences.
| Feature | UK National Health Service (NHS) | Spanish Sistema Nacional de Salud (SNS) |
|---|---|---|
| Funding | Primarily from general taxation. | Primarily from social security contributions. |
| Access | Residency-based. Free at the point of use for all UK residents. | Contribution-based. You must be working and paying into the system, or be a state pensioner with an S1 form. |
| GP Access | You register with a local GP surgery. | You register at your local health centre (centro de salud). |
| Prescriptions | A fixed charge per item in England (free in Scotland, Wales, NI). | A co-payment system is used. You pay a percentage of the cost, depending on your income level (typically 10-60%). |
| Dental Care | Limited availability. Subsidised, not free, with set charge bands. | Basic extractions are often covered, but most dental care (fillings, crowns, orthodontics) is private. |
| Choice | Generally limited choice of hospital or specialist. | Limited choice within the state system; you are usually assigned to a specific hospital. |
The main takeaway for a new expat is that you cannot simply walk into a Spanish centro de salud and expect the same automatic access you have to the NHS in the UK. You must either be a legal resident paying into the social security system or hold compliant private medical insurance.
The Most Important Rule: Pre-Existing and Chronic Conditions
This is the single most important concept to understand about private medical insurance in the UK and abroad. It is a fundamental principle that often causes confusion.
Private medical insurance (PMI) is designed to cover acute conditions that arise after you take out your policy.
- An acute condition is 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 the need for a hip replacement due to sudden joint deterioration.
PMI does not cover:
- Chronic Conditions: These are long-term conditions that require ongoing management but cannot be cured, such as diabetes, asthma, hypertension, or heart disease. PMI will not cover the day-to-day monitoring, medication, or management of these conditions.
- Pre-existing Conditions: This refers to any ailment, illness, or injury you had symptoms of, received advice for, or sought treatment for before your policy's start date. These will almost always be excluded from your cover.
When you apply, an insurer will assess your medical history. This is done in two main ways:
- Moratorium Underwriting: You don't declare your full medical history upfront. Instead, the policy automatically excludes any condition you've had in a set period (usually the last 5 years). If you then remain symptom-free and need no treatment or advice for that condition for a continuous period (usually 2 years) after your policy starts, it may become eligible for cover.
- Full Medical Underwriting (FMU): You complete a detailed health questionnaire. The insurer reviews your medical history and explicitly lists any conditions that will be permanently excluded from your policy. This provides certainty from day one about what is and isn't covered.
For expats moving to Spain, Full Medical Underwriting is often the most common and practical approach, as it gives you and your visa application clear proof of your coverage.
What to Look for in a Health Insurance Policy for Spain
When comparing policies, especially for visa purposes, certain features are non-negotiable. An expert PMI broker like WeCovr can help you find a policy that ticks all the right boxes, ensuring your visa application is smooth and you have the right protection.
Here are the key elements to look for:
1. Visa and Residency Compliance
Your policy must state that it:
- Offers cover in Spain.
- Is fully comprehensive, covering hospitalisation, specialists, and diagnostics.
- Has
sin copagos(no co-payments). - Has
sin carencias(no waiting periods for essential services). - Includes repatriation of remains.
2. Sin Copagos (No Co-payments)
Many Spanish health plans operate with a copago system, where you pay a small fee (e.g., €5-€15) each time you see a specialist or have a test. While this lowers the monthly premium, these policies are not suitable for residency visas. You need a policy with zero co-payments.
3. Carencias (Waiting Periods)
Carencias are standard waiting periods before you can access certain benefits. For example, a policy might have an 8-month wait for non-emergency surgery or a 10-month wait for maternity cover. For visa purposes, you need a policy where these waiting periods are waived for most services, ensuring you have immediate, comprehensive cover.
4. Cuadro Médico (Provider Network) vs. Reimbursement
Cuadro Médico: This is the most common type of plan. The insurer has a network of approved doctors, clinics, and hospitals. You use these providers, and the insurer pays them directly. This is simple and requires no upfront payment from you.- Reimbursement (
Reembolso): This gives you the freedom to see any doctor or visit any hospital in the world, even outside the insurer's network. You pay the bill yourself and then claim a percentage (typically 80-90%) back from the insurer. These policies are more flexible but also more expensive.
For most expats, a Cuadro Médico plan with a large, reputable network in their region is the most practical and cost-effective solution.
5. Dental and Optical Cover
Standard private medical insurance in Spain does not usually include comprehensive dental or optical care, much like in the UK. Basic dental check-ups and cleaning might be included, but major treatments like crowns, implants, or orthodontics require a separate dental add-on.
How Much Does Private Health Insurance Cost in Spain for a UK Expat?
The cost of your premium is highly individual and depends on several factors. However, you may be pleasantly surprised to find that comprehensive cover in Spain is often more affordable than equivalent private health cover in the UK.
Main Factors Influencing Your Premium:
- Age: This is the single biggest determinant of cost. Premiums rise significantly as you get older.
- Level of Cover: A basic outpatient plan is cheaper than a fully comprehensive plan with hospital cover.
- Co-payments: A policy with
copagoswill have a lower monthly premium than one that issin copagos. - Add-ons: Including dental, pharmacy, or wellness benefits will increase the cost.
- Underwriting: Your personal medical history can affect the final price.
Sample Monthly Premiums for a Comprehensive Sin Copagos Policy:
| Age of Applicant | Estimated Monthly Premium |
|---|---|
| 30-year-old | €50 – €70 |
| 50-year-old | €70 – €110 |
| 65-year-old | €120 – €180 |
| 75-year-old | €200 – €300+ |
Disclaimer: These are illustrative estimates for 2025. Your actual quote will depend on your specific circumstances and the insurer chosen.
Choosing the Best PMI Provider: Spanish vs. International Insurers
You have two main choices: a Spanish domestic insurer or a global international provider.
Top Spanish Health Insurers
These companies have vast networks and deep knowledge of the local healthcare landscape.
- Sanitas: Part of the Bupa group, Sanitas is one of the most popular choices for expats. They have their own hospitals and clinics and offer excellent English-language support.
- Adeslas: A huge insurer in Spain with a massive network of doctors and centres.
- Asisa: Another leading provider, well-regarded for its comprehensive coverage options.
- DKV: A Spanish subsidiary of the German insurance giant ERGO, known for its focus on wellness and preventative care.
Top International Health Insurers
These providers offer global plans, which are ideal if you travel frequently or may move to another country in the future.
- Bupa Global: The international arm of Bupa, offering premium plans with worldwide coverage.
- Cigna Global: A major US-based insurer with a strong global presence and flexible plan options.
- AXA Global Healthcare: Offers a range of international plans with high levels of cover and excellent support services.
Comparison: Spanish vs. International Plans
| Feature | Spanish Domestic Insurer | International Insurer |
|---|---|---|
| Best For | Expats living full-time in Spain, especially for visa purposes. | Frequent travellers, high-net-worth individuals, those who may relocate again. |
| Cost | Generally more affordable. | Significantly more expensive. |
| Network | Excellent, deep network within Spain. | Global network, but may be less dense in some parts of Spain. |
| Portability | Cover is usually limited to Spain (with some emergency EU travel cover). | Fully portable. You can keep your policy if you move countries. |
| Administration | Increasingly good English support, but core documents may be in Spanish. | English is the primary language for all documents and support. |
| Visa Compliance | Excellent. They specialise in policies that meet Spanish visa rules. | Policies must be carefully checked to ensure they meet specific Spanish requirements. |
For most UK expats moving to Spain, a policy from a major Spanish insurer offers the best combination of comprehensive cover, visa compliance, and value for money.
Your Health and Wellness in Spain: Living the Good Life
Your health isn't just about insurance; it's about your lifestyle. Spain offers an incredible environment for promoting well-being.
- The Mediterranean Diet: Embrace a diet rich in fresh fruit, vegetables, olive oil, fish, and lean protein. It's scientifically proven to reduce the risk of heart disease and other chronic illnesses. Visit the local mercado for the freshest produce.
- Active Lifestyle: With over 300 days of sunshine a year, it's easy to be active. Walk along the paseo marítimo (promenade), go hiking in the stunning national parks, or take up a water sport.
- Managing the Sun: The Spanish sun is glorious but strong. Always wear high-SPF sunscreen, a hat, and stay hydrated, especially during the peak hours of the day (12 pm - 4 pm).
- The Pharmacy (
Farmacia): Spanish pharmacists are highly trained and can provide advice and over-the-counter treatments for many minor ailments. Look for the green cross symbol.
To help you on your wellness journey, all WeCovr clients who purchase a PMI or Life Insurance policy gain complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app. It's the perfect companion for embracing that healthy Mediterranean lifestyle.
How WeCovr Can Help You Find the Best PMI in Spain
Navigating a foreign insurance market can be complex, especially when a visa is on the line. This is where an expert, independent broker is invaluable.
At WeCovr, we specialise in helping UK expats find the right private medical insurance for their new life in Spain.
- Expert, Unbiased Advice: We are not tied to any single insurer. We compare the market to find the best policy for your needs and budget.
- We Understand Visa Rules: We know exactly what the Spanish consulates require and will ensure your chosen policy is fully compliant, providing you with the necessary certificate for your application.
- We Speak Your Language: We break down the complex Spanish insurance terms (
copago,carencia,cuadro médico) into plain English, so you know exactly what you're buying. - Save Time and Money: Let us do the research for you. Our service is completely free to you, as we are paid by the insurer you choose.
- Ongoing Support: Our relationship doesn't end when you buy a policy. We're here to help with any questions you may have in the future. We also offer discounts on other insurance products to our valued clients.
Our high customer satisfaction ratings reflect our commitment to providing clear, friendly, and professional guidance every step of the way.
Do I definitely need private health insurance in Spain after Brexit?
Can I use my existing UK private medical insurance policy in Spain?
Will my Spanish private medical insurance cover my pre-existing conditions?
What does "sin copagos" mean and why is it important for my visa?
Ready to Start Your Spanish Adventure?
Securing the right health cover is one of the most important steps in your relocation plan. It provides not only a safety net for your health but also the key to unlocking your Spanish residency.
Don't navigate the complexities alone. Let the friendly experts at WeCovr guide you. We'll compare leading Spanish and international insurers to find you a policy that's perfect for your needs, compliant with your visa, and fits your budget.
[Contact WeCovr today for your free, no-obligation private medical insurance quote and take the first step towards a secure and happy life in Spain.]
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.











