Health Cover in Spain Compared: EHIC, GHIC, S1, Convenio Especial, Private and Travel Insurance
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 2 October 2026
A side-by-side comparison of every way to be covered for healthcare in Spain, and the gaps most people miss.
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Which health cover do you actually have in Spain, and what does it pay for? This side-by-side comparison covers the EHIC, the UK GHIC, the S1 form, the Spanish public system, the Convenio Especial, private health insurance and travel insurance, so you can see at a glance who each option is for and where the gaps are.
Health cover in Spain compared
| Option | Who it is for | Cost | Public GP and hospital | Prescriptions | Private clinics | Repatriation | Valid for a visa? |
|---|---|---|---|---|---|---|---|
| EHIC | Visitors insured in another EU/EEA country or Switzerland | Free | Yes, necessary care during a temporary stay | Yes, paying the same share as residents | No | No | No |
| UK GHIC (or valid UK EHIC) | UK residents visiting Spain | Free | Yes, necessary care during a temporary stay | Yes, paying the same share as residents | No | No | No |
| S1 form | State pensioners (and some posted workers) whose pension country pays for their care | Free (paid by the pension country) | Yes, full cover once registered in Spain | Yes, at reduced pensioner rates | No | No | Can support residence; check your permit |
| Spanish public system (Social Security) | People working, self-employed or receiving a Spanish pension or benefit | Through contributions | Yes, full cover | Yes, with an income-based share | No | No | Yes, once registered |
| Convenio Especial | Residents of 1+ year with no other public cover | €60/month under 65; €157/month from 65 (national rates) | Yes, basic common portfolio | No: you pay full price | No | No | Rarely: consulates usually want private insurance |
| Private health insurance | Anyone | Monthly premium | Private network (public system only by your own right) | Depends on the policy | Yes | Depends on the policy | Usually required for non-lucrative, digital nomad and student visas (no copayments, no waiting periods) |
| Travel insurance | Short-term visitors | Per trip or annual | Reimburses costs as per policy | Usually reimbursed | Yes | Usually yes | No, not for long-stay residence visas |
Which one do I need?
| Your situation | What usually fits |
|---|---|
| Tourist from an EU country | EHIC plus travel insurance. |
| Tourist from the UK | GHIC plus travel insurance. |
| Second-home owner (stays under 90 days) | GHIC or EHIC plus annual travel insurance; a private or online doctor for quick care in English. |
| UK or EU state pensioner moving to Spain | Register an S1 with the Spanish Social Security (INSS) to get a Spanish health card. |
| Early retiree below state pension age | Private health insurance for the visa; after a year of residence the Convenio Especial is an option. |
| Digital nomad or remote worker | Private health insurance that meets visa rules: authorised in Spain, full cover, no copayments, no waiting periods. |
| Non-EU student | Private health insurance for the student visa; EU students use their EHIC. |
| Employee or self-employed in Spain | You are covered by the Spanish public system once registered with Social Security. |
The gaps most people miss
- The EHIC and GHIC only work in the public system. A private clinic or private doctor will ask you to pay.
- No public scheme pays to fly you home. Only travel insurance or some private policies cover repatriation.
- The Convenio Especial does not include prescriptions. You pay the full price at the pharmacy.
- Travel insurance is not accepted for long-stay residence visas. Consulates ask for private health insurance with no copayments.
More detail in our guides to the EHIC, GHIC and S1 in Spain, the Convenio Especial and digital nomad visa health insurance.
Sources and updates
Based on EU rules on the European Health Insurance Card, the UK–EU healthcare arrangements, the Spanish Social Security (INSS) and the national Convenio Especial rules. Regions can apply their own variations. Checked October 2026. You can cite or link to this page as a source.
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.
