Best health insurance in Spain for expats 2026
Whether you need a visa-compliant policy for your Non-Lucrative Visa or Digital Nomad Visa, or the best value cover once you have your SIP card, we compare every major insurer operating in Spain. Real prices, network quality, and English-language support ratings.
Spanish Health Insurance - Local Plans
Any insurer authorised to operate in Spain can issue a policy that satisfies an NLV or DNV application; these five are the ones Spanish brokers and consulates see most often. Self-employed expats often pair them with autónomo cotización which already covers public care.
Owned by the Bupa group, with its own hospitals and Milenium clinics and the English-language service expats are most often pointed at. The visa-valid policy is the no-copay version of Mas Salud, not the cheaper plan the adverts lead with.
The market leader, and the insurer most Spanish brokers file visa applications with. Dental is bundled into more of its tiers than its rivals. Its cheapest plans carry copays, so ask for the no-copay tier by name.
A cooperative owned by its own doctors, running 18 hospitals and more than 1,000 contracted centres. Asisa Esencial and Asisa Completa are both sold without copays, which is the tier a consulate will accept.
National network + reimbursement plans
Part of Munich Re's ERGO group, with the strongest app and video-consultation setup of the five. Note that Mundisalud is its international reimbursement line, not a cheap local plan - for a visa you want the Spanish network policy without copays.
50,000+ professionals, around 300 hospitals
The only one of the five that publishes its rates instead of quoting privately: Tu e-liges from EUR 18 and Supra from EUR 42 a month, both without copays, against EUR 36 for the copay plan. English-language service is thinner here than at Sanitas or DKV.
Premiums here are not list prices. Mapfre and DKV publish theirs; Sanitas, Adeslas and Asisa quote individually on your age, postcode and plan, so treat any single figure you read online for those three as an order of magnitude rather than a price. What does move predictably is the tier - the no-copay policy a consulate requires costs substantially more than the advertised entry plan, which almost always carries copays. Figures checked September 2026.
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Visa Compliance Comparison
Key features required for NLV and DNV visa applications - check before you buy.
Digital Nomad Visa
RequiredPublic or private cover matching what the Spanish public system provides, from an insurer authorised to operate in Spain, active for the whole permit. Register with Spanish Social Security and that public cover satisfies it. Travel insurance never does.
Non-Lucrative Visa
RequiredFull private cover with no copays and no waiting periods, from an insurer authorised in Spain, for the full visa period. This route gives you no access to the public system, so private is the only realistic option.
Work Visa
OptionalYour employer registers you with Social Security, which covers you from day one. Private cover is an add-on for faster specialist appointments, not a requirement.
Student Visa
RequiredFull cover for the whole stay, shown at application. Travel insurance is not accepted for a stay over 180 days.
EU Registration
Required if not workingEmployees and self-employed residents are covered through Social Security. Students and non-working residents must show a European Health Insurance Card or private cover with no copays, under Real Decreto 240/2007.
International Expat Plans
Global coverage for expats who move between countries. These are issued outside Spain, so a consulate will normally reject them for a residence visa - useful as worldwide cover alongside a Spanish policy, not instead of one.
No rate published
Global cover that follows you between countries, with repatriation built in. It is issued outside Spain, so a consulate will normally reject it for a residence visa unless the policy is underwritten by an entity authorised to operate here.
No rate published
The international arm of the group that owns Sanitas, and strong on chronic and cancer care. The international policy is a different product from the Spanish Sanitas one your visa file needs - buying one does not get you the other.
No rate published
Plans you assemble module by module, which suits people splitting the year across countries. Same caveat as the others: an international policy is not automatically accepted for a Spanish residence visa.
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6 Things to Check Before You Buy
6 Things to Check Before You BuySin copago clause
Your visa application requires a policy without co-payments. Explicitly ask for the 'sin copago' version - it costs slightly more but is the only one consulates will accept.
Get the carta de cobertura in Spanish
Request a coverage letter (carta de cobertura) before submitting your visa dossier, and ask for it in Spanish. That is the version the consulate and Extranjeria want; a document in any other language has to arrive with a sworn translation (traduccion jurada), so an English-only letter creates work rather than saving it. Ask for an English copy alongside it if you want to read it yourself. Sanitas and Adeslas issue these quickly - other insurers may take 1-2 weeks.
No exclusions for pre-existing conditions
Budget plans often exclude pre-existing conditions. For visa purposes you need full cover (cobertura completa sin exclusiones). Confirm this in writing.
Policy duration matches visa duration
Your policy must cover the full visa period - typically 1 year for the initial NLV. Ask for a 12-month policy starting from your expected entry date. US applicants moving via our US-to-Valencia guide should remember Medicare does not cover Spain.
Check Valencia network hospitals
Ask which hospitals are in-network in Valencia specifically. Hospital Quiron and 9 de Octubre are the top private options. Cross-check coverage against our Valencia healthcare guide before signing, and budget premiums via the cost of living guide.
English-speaking GP access
If you do not speak Spanish, ask the insurer for a list of English-speaking doctors in Valencia's city centre or Ruzafa before committing to a policy.
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Health Insurance in Spain: Questions Before You Buy
Do I really need private health insurance?
How much does private insurance cost in Spain?
Is dental included?
Can I keep my home country insurance?
How fast can I get insured?
Official sources
- Digital Nomad Visa health-cover requirement - Ministerio de Asuntos Exteriores
- Non-Lucrative Visa - Reglamento de Extranjeria, Real Decreto 557/2011 (BOE)
- EU citizen registration and health cover - Real Decreto 240/2007, art. 7 (BOE)
- SIP card - Conselleria de Sanitat, Generalitat Valenciana
- Published health premiums - Mapfre
- Published health premiums and no-copay tiers - DKV
- Medical network figures - Asisa