Health Insurance for Spanish Residency: Rules by Visa Route

Health insurance for Spanish residency depends on your route. Non-lucrative, student and family visas usually need public or private health insurance with an insurer authorised to operate in Spain. Workers are covered by Social Security. EU citizens who do not work need sickness insurance covering all risks in Spain. Travel insurance is not accepted.

Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).

For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.

What health cover do you need to live in Spain?

Almost everyone who moves to Spain must show some health cover. What counts depends on why you are coming:

The new immigration regulation, Royal Decree 1155/2024, came into force on 20 May 2025, says the Spanish consulate in Lima. It changed many visa rules and papers, so use sheets updated since then.

What health insurance does the Spain non-lucrative visa need?

The official information sheet for non-lucrative residence asks for public or private sickness insurance with an insurer authorised to operate in Spain. The permit lasts one year from entry, and you may not work.

Consulates add their own detail. Three examples from official consulate pages:

• Los Angeles: no deductible, copayment, waiting period or cover limit. It must pay 100% of medical, hospital and outpatient costs, be valid for one year and cover everyone on the visa. Travel insurance is not accepted.
• London: the policy must cover all the risks the Spanish public system covers. A receipt of S1 registration on the Spanish Social Security website is also accepted.
• São Paulo: not a travel policy, no waiting periods, no copayment, no cover limit, and cover for every date of the stay.

Requirements vary by consulate. Read the sheet for the one that handles your file before you buy.

What do students and family members need?

Students. The official sheet for long study stays asks for insurance with an insurer authorised in Spain, with benefits similar to the public system's basic services. The London consulate's student checklist also accepts the UK GHIC for all student visas. Our guide to healthcare for international students covers the rest.

Family reunification. The official sheet says the person in Spain must have health insurance for themselves and each family member who joins them.

What health cover do EU and EEA citizens need?

EU, EEA and Swiss citizens do not need a visa. If they stay more than three months, they apply for a registration certificate within three months of arriving. Under Royal Decree 240/2007 and the order that applies it, the health rule depends on what you do:

• Workers and self-employed people. Your job is enough. You show a contract or Social Security registration.
• People not working. You need enough money and sickness insurance that covers all risks in Spain.
• Students. You need full cover in Spain. A European Health Insurance Card valid for your whole stay counts.

The insurance can be public or private, from Spain or another country, if it gives cover equal to the Spanish public system. Pensioners can instead show a certificate that their pension country pays for their care.

The EHIC alone is for visits. The European Commission says people who move should register an S1 instead, if they have one.

What should a Brit moving to Spain know about health cover?

Since Brexit, UK nationals arriving now follow the non-EU routes above. The UK government says you must show proof of healthcare cover before you register as a resident or apply for a visa. It lists work contributions, private insurance or the convenio especial.

A UK state pensioner may get an S1 and must register it with the INSS. People who moved before 1 January 2021 keep rights under the Withdrawal Agreement, says the UK's Living in Spain guide.

What about the digital nomad visa and work visas?

Digital nomad visa. The official FAQ from the large companies unit (UGE) asks for public cover through Social Security registration, or equivalent private health insurance with an insurer authorised in Spain. Travel insurance and policies with waiting periods or copayments are not accepted. Our digital nomad visa health insurance guide has the full checklist.

Work visas. When you work in Spain and are registered with Social Security, you have the right to public healthcare, says the Spanish Social Security. Ask your consulate whether you need private cover before your job starts.

Is health insurance still needed for the golden visa?

You can no longer apply for one. The Spanish government ended residence visas for investors, including property buyers, on 3 April 2025, under Ley Orgánica 1/2025.

For people who already hold one, the large companies unit (UGE) says existing visas and permits keep their validity for the time they were issued. Renewals follow the rules in force when the first permit was granted. Ask the UGE what your renewal needs, including health insurance, before you apply.

What do consulates commonly ask of a private policy?

• An insurer authorised to operate in Spain. Check the DGSFP register.
• Full cover, like the Spanish public system.
• No copayments or deductibles.
• No waiting periods and no cover limit, where the consulate asks.
• Cover from your arrival for the whole period, for every family member on the file.
• A certificate from the insurer stating these terms, in Spanish or with a translation if asked.

To compare plans, see our guide to expat health insurance vs travel insurance.

Once you are resident, how do you get public healthcare?

• Work. A job or self-employment registered with Social Security gives you public cover.
• S1. State pensioners from the UK or the EU register their S1 with the INSS.
• Convenio especial. After one year of residence on the padrón, with no other public cover, you can pay to join. It costs €60 a month under 65 and €157 from 65, under Royal Decree 576/2013.

Our convenio especial guide explains how to apply.

Do you also need a medical certificate?

Often, yes. Many residence and long-stay visas ask for a recent medical certificate. It says you have no disease that could cause a serious public health risk. Each consulate sets its own format and time limit.

See visa and residence certificates and our guide to the medical certificate for a Spanish visa.

Talking it through with a doctor by video

Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:

• Help with urgent, non-emergency problems while your cover is set up.
• Review your usual medicines and any long-term condition.
• Assess whether a medical certificate can be issued. Neither issuance nor acceptance is guaranteed.

He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.

A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.

This guide is general information. It does not replace a consultation with your doctor.

Frequently asked questions

Related guides

• Expat health insurance vs travel insurance
• Moving to Spain: healthcare checklist
• Healthcare for international students in Spain
• Digital nomad visa health insurance
• Convenio especial explained
• Medical certificate for a Spanish visa
• Visa and residence certificates