Medicare in Spain: What Americans Living Here Need to Know
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 5 November 2026
Medicare in Spain pays for almost nothing.
You don't have to figure this out alone
Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
Medicare in Spain pays for almost nothing. Medicare.gov says Medicare usually does not cover health care outside the U.S., and its few exceptions do not apply to Spain. Americans who live here use private insurance, Spanish public care through work or the convenio especial, and private doctors. Plan your cover, and what to do about Part B, before you move.
- Original Medicare does not pay for care in Spain. Medicare drug plans do not cover medicines bought abroad.
- Medigap Plans C, D, F, G, M and N pay 80% of foreign travel emergencies after a $250 deductible, up to $50,000 for life, for trips. Not for living abroad.
- Dropping Part B can mean a lifelong late-enrolment penalty. Talk to your SHIP or Social Security first.
- Veterans with service-connected conditions may use the VA Foreign Medical Program. TRICARE For Life is the main payer overseas.
- In Spain you need private insurance for most visas, and US prescriptions are not valid.
- Emergencies: call 112.
Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).
He is licensed in Spain, not in the US. This guide is general information, not advice on your Medicare choices.
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.
Does Medicare cover me outside the US, in Spain?
No, in practice. Medicare.gov states: "Medicare usually doesn't cover health care while you're traveling outside the U.S." Medicare's fact sheet adds that in most situations Medicare won't pay for care or supplies outside the U.S.
The exceptions are narrow:
- Cruise ships. Part B may pay for needed care on board if the ship is in a U.S. port, or within six hours of one.
- A closer foreign hospital. Medicare may pay if you have an emergency in the U.S. and a foreign hospital is closer than the nearest U.S. hospital that can treat you.
- Travel through Canada between Alaska and another state, by the most direct route, when a Canadian hospital is closer.
- Living near a border. If you live in the U.S. and a foreign hospital is closer to home than the nearest U.S. one.
In those cases, ambulance transport is covered only if you are admitted for a covered hospital stay. None of these applies to living in Spain.
Will my Medicare drug plan pay for medicines in Spain?
No. Medicare.gov says Medicare drug plans don't cover prescription drugs you buy outside the U.S. Plan how you will pay for regular medicines here.
Does Medigap cover emergencies abroad?
Some plans do, for trips. Medicare's fact sheet on care outside the U.S. says Medigap Plans C, D, F, G, M and N cover foreign travel emergencies. After you pay a $250 yearly deductible, the plan pays 80% of the billed charges for some medically necessary emergency care. There is a $50,000 lifetime limit, and the care must begin in the first 60 days of your trip.
Plans C and F are not sold to people new to Medicare on or after 1 January 2020. This benefit is built for travel, not for living in Spain.
Does a Medicare Advantage plan work in Spain?
It depends on the plan. Medicare says these plans follow Medicare's rules on care outside the U.S. and may cover some extra services abroad. Ask your plan in writing what it pays in Spain, and how claims work, before you travel.
Should I keep or drop Part B if I move to Spain?
This guide cannot decide that for you. These are the facts to weigh:
- Medicare stays in the U.S. Social Security says Medicare generally does not cover health services outside the U.S. If you live abroad for a long time, keeping Part B may not help you while you are here.
- A late-enrolment penalty. If you sign up for Part B later, your premium can go up 10% for each full 12-month period you could have had it. Medicare.gov says penalties usually last as long as you have that cover.
- When you can rejoin. The General Enrollment Period runs from 1 January to 31 March each year. Cover starts the month after you sign up.
- Part D has its own penalty if, after your first chance to join, you go 63 days or more in a row without creditable drug cover.
- TRICARE users who live overseas must keep Part B to stay eligible for TRICARE.
Before you change anything, talk to your State Health Insurance Assistance Program (SHIP) or Social Security.
Moving to Spain on regular medicines?
You can book a video visit with a GP licensed in Spain, in English or Spanish. He reviews your US medicine list and explains the Spanish names and what needs a prescription here.
What about VA and TRICARE cover in Spain?
VA Foreign Medical Program (FMP). Veterans living or travelling abroad with a VA-rated service-connected disability may qualify. The VA can pay for care, medicines and medical equipment to treat those conditions. You register with VA Form 10-7959f-1. If your provider does not bill the VA, you pay and then claim. Claims not in English can be translated, but this causes delays.
TRICARE For Life. TRICARE says Medicare only covers care in the U.S. and its territories. Outside them, TRICARE pays first, and you pay its yearly deductible and cost-shares.
How do Americans actually get healthcare in Spain?
- Private insurance. It is the usual route at first. For the non-lucrative visa, the San Francisco consulate asks for insurance from a company operating in Spain. It must cover all risks covered for Spanish nationals, with no copayments, pre-existing-condition gaps or limits. Travel insurance is not accepted. Requirements vary, so check with your consulate.
- Public care through work. If you work in Spain and pay Social Security, you are covered like other workers.
- The convenio especial. After one year of residence and padrón registration, with no other public cover, you can pay to join the public system. The national fee is €60 a month under 65 and €157 from 65. Prescriptions are not included. See our convenio especial guide.
- Private clinics and online GPs for quick, paid visits in English.
Compare every option in health cover in Spain compared. For the full move, see our moving to Spain healthcare checklist.
Can I use my US prescriptions in Spain?
No. US prescriptions are not valid in Spanish pharmacies. Your US doctor cannot send one to a Spanish pharmacy either. You need a prescription from a doctor licensed in Spain.
Bring a letter listing each medicine by generic name, strength and reason. Names differ: acetaminophen is paracetamol here, albuterol is salbutamol and epinephrine is adrenaline. Some medicines sold over the counter in the US need a prescription in Spain. Check the prescription rules table for Spain, the UK and the US, our guide to medicines in Spain and using a UK or US prescription in Spain.
What records and invoices do US or international insurers need?
Keep a dated medical report for each visit, an itemised invoice and your pharmacy receipts. Photograph Spanish pharmacy tickets on the day, as the ink fades. Your insurer decides what it accepts, so ask for its claim rules in writing. Our insurance and invoices page explains what Dr. Yelamo provides.
What should Americans abroad know about healthcare in Spain?
We do not rank countries. For Spain, these points matter most to Americans:
- Spain has a public system for people who work or are covered by Spanish Social Security.
- Newcomers who do not work start with private insurance.
- 112 is the emergency number, free from any phone.
- Pharmacists are a good first stop for minor problems.
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). He is not licensed in the US. In the visit he will:
- Go through your US medicine list and match each one to its Spanish name.
- Check which medicines need a Spanish prescription.
- Give you a written report and an itemised invoice for your insurer.
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
Does Medicare cover me in Spain?
Almost never. Medicare.gov says Medicare usually does not cover health care outside the U.S. The few exceptions involve U.S. ports, Canada or a foreign hospital closer than a U.S. one. None of them fits care in Spain.
Do Medigap plans cover emergencies in Spain?
Medigap Plans C, D, F, G, M and N include a foreign travel emergency benefit. Per Medicare's fact sheet, it pays 80% after a $250 yearly deductible, up to $50,000 for life, if care starts in the first 60 days of a trip. It is not cover for living abroad.
Should I drop Medicare Part B if I move to Spain?
It is a personal decision with long-term costs. If you sign up later, your premium can go up 10% for each full 12-month period you could have had Part B, usually for as long as you have it. Ask your SHIP or Social Security before you decide.
Will my Medicare drug plan pay for medicines in Spain?
No. Medicare.gov says Medicare drug plans do not cover prescription drugs you buy outside the U.S. In Spain you pay at the pharmacy or use Spanish or international cover.
Can I fill a US prescription in Spain?
No. US prescriptions are not valid in Spanish pharmacies. You need a prescription from a doctor licensed in Spain. Bring a letter listing each medicine by its generic name and strength.
What health insurance do Americans need to live in Spain?
For the non-lucrative visa, consulates ask for private insurance from a company operating in Spain, with full cover and no copayments, pre-existing-condition exclusions or limits. Travel insurance is not accepted. Check the exact wording with your consulate.
Is Dr. Yelamo licensed in the US?
No. Dr. Pedro Yelamo Vera is a GP licensed in Spain, not in the US. He sees patients who are in Spain and can prescribe under Spanish law where clinically appropriate. He cannot write US prescriptions.
Related guides
Sources
This content is written and reviewed by a licensed physician with reference to the following sources.
- Medicare.gov: Travel outside the U.S.
- Medicare: Medicare Coverage Outside the United States (fact sheet, April 2026)
- Medicare.gov: Compare Medigap plan benefits
- Medicare: Choosing a Medigap Policy
- Medicare.gov: Avoid late enrollment penalties
- Medicare.gov: When does Medicare coverage start?
- Social Security: Your Payments While You Are Outside the United States
- VA News: Info on the VA Foreign Medical Program
- TRICARE: Using TRICARE For Life overseas
- Consulate General of Spain in San Francisco: Non-lucrative residence visa
- Consulate General of Spain in Los Angeles: Non-working residence visa
- BOE: Royal Decree 576/2013 (convenio especial)
