Convenio Especial in Spain: How to Pay Into Public Healthcare as a Resident
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 2 October 2026
How Spain's Convenio Especial works: who can join, the monthly cost, what it covers and how to apply.
You don't have to figure this out alone
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If you live in Spain but are not covered by the public health system through work, a pension or another route, the Convenio Especial lets you join it by paying a monthly fee. Here is how it works.
Quick Answer
| Question | Answer |
|---|---|
| What is it? | A paid agreement that gives access to Spain's public health system (SNS). |
| Who can apply? | Residents with at least one year of continuous residence in Spain, registered on the padrón, and with no other public health cover. |
| How much does it cost? | €60 a month if you are under 65, and €157 a month from age 65. Check your region, as rules are set regionally. |
| Who do I apply to? | The health authority of the region where you are registered. |
| Are prescriptions included? | No. The national scheme covers the basic portfolio of care, not pharmacy prescriptions. |
Who the Convenio Especial Is For
It is aimed at people who live in Spain but have no other right to public healthcare, for example early retirees without a state pension, or residents who are not working. It is different from the Social Security "convenio especial" used to keep paying pension contributions.
UK and EU state pensioners usually do not need it: they can register in Spain with an S1 form from their pension country. See our guide to EHIC, GHIC and S1 cover in Spain.
Requirements
- At least one continuous year of residence in Spain before applying.
- Registration on the padrón (empadronamiento) in your region.
- No access to public health cover by any other route.
What It Covers, and What It Doesn't
It covers the basic common portfolio of public care: GP visits, specialists, hospital care and emergencies. It does not include the supplementary portfolio, such as pharmacy prescriptions, orthopaedic products or non-urgent medical transport. You pay prescription medicines in full.
How to Apply
- Get your padrón certificate and proof of residence.
- Contact the health authority of your region (for example SERMAS in Madrid or the Basque Health Department in the Basque Country) and request the convenio especial forms.
- Submit the application and sign the agreement once approved.
- Pay the monthly fee by direct debit.
Is It Valid for a Visa?
For first-time visa applications, consulates usually require private health insurance. The convenio especial is mostly used by people already resident for a year. Check the requirements for your permit.
Frequently Asked Questions
Do I get a health card?
It depends on the region. In some regions you show your signed agreement instead of a card.
What if I need a doctor before I join?
You can use private care, including a same-day online consultation.
Need a doctor in English while you sort out your cover? Book a video consultation with an online doctor in Spain for urgent, non-emergency care. In an emergency, call 112.
Medical Citations & Sources
This content is written and reviewed by a licensed physician with reference to the following official health authorities.
