Healthcare and Insurance in Spain: A Comprehensive Guide

Healthcare and insurance in Spain is an important topic for anyone planning to live here or who has already relocated. In this article, I will provide an in-depth look at how the healthcare system operates, the different types of insurance available, and how they differ from one another. We will discuss both private and public healthcare, as well as the specifics of dental and other types of insurance.

Let’s start with private insurance companies. For many foreigners, private healthcare is the most convenient option. Popular companies in Spain include DKV, MAPFRE, SANITAS, ADESLAS, and AXA. Their main advantages are speed and comfort. For instance, you don't need to visit a general practitioner to get a referral; you can book an appointment through an app and arrive at the scheduled time, with the doctor waiting for you. This is incredibly convenient and saves a lot of time.

As for costs, my personal insurance is 62 euros per month and covers almost all medical services. Additionally, I opted for dental insurance at 12 euros per month, which covers teeth cleaning once a year. More complex procedures, like braces, aren’t fully covered but offer discounts of 20-30%. Overall, private insurance covers nearly all essential medical services, while dental insurance includes only basic procedures and provides discounts on more expensive treatments.

The cost of private healthcare varies based on the patient’s age and health condition. For example, insurance for children is generally cheaper, while for pregnant women, it tends to be the most expensive. In some cases, insurance companies may even deny coverage if the risk is deemed too high.

The hospital you attend, whether public or private, also plays a significant role. For instance, my local hospital, K.A.B., which is just a few minutes from home, resembles old Soviet hospitals with simple interiors and paper queues. When you arrive at such a hospital—even for an emergency—you’ll need to go through several stages of waiting. First, an administrator checks if your doctor is available. If they are busy, you’ll have to wait in the reception area until the nurses are ready to see you, and only then will the doctor examine you. This process can sometimes take several hours.

Visiting a public clinic (CAP) can also be time-consuming. Even for a common cough, you might wait several hours. However, it’s worth noting that despite the long wait, doctors and nurses are usually very attentive. For example, during one of my visits, the doctor measured my blood pressure, listened to my lungs, and prescribed three medications. The total cost on the prescription was 13 euros, but at the pharmacy, I only paid 8 euros, which was a pleasant surprise. In other cases, I received antibiotics that lasted only three days and weren’t very effective. Sometimes, public hospitals might recommend simply drinking more water or prescribe ibuprofen, which can be amusing, yet occasionally helpful.

In contrast, private clinics offer a completely different level of service. Here, everything is clean, modern, and equipped with the latest technology. Your number and the corresponding room are displayed on a screen, and the entire process is very organized. Waiting times in private hospitals are usually around 10-15 minutes, though there are exceptions when you may have to wait longer due to a high volume of patients. A significant advantage is the presence of an electronic medical record: all your medical history is stored in the system, ensuring that the doctor is aware of all previous tests and treatments.

I frequently visit my oncologist through private insurance. Each time, I schedule an appointment via the app, and at the designated time, the same doctor is waiting for me at the same hospital. During my last visit, I was diagnosed with anemia, and the doctor recommended an iron injection costing 500 euros, which was fully covered by my insurance. This is a significant benefit of private insurance, especially in situations involving expensive procedures or medications.

Public healthcare in Spain is organized differently depending on the region. To access medical services, you need a SIP card, and the registration process can take some time. Generally, waiting for an appointment in public hospitals is longer than in private clinics. However, for certain groups, the process is simplified. For example, Ukrainian nationals can receive SIP cards even without residency. In Catalonia, all patients are served regardless of their status.

Regarding dental care, this area is not covered by either public or private health insurance in Spain. All dental services are paid for separately unless you have specific dental insurance. I have always visited private dental clinics, where, for instance, teeth cleaning costs around 60 euros, and tooth extraction costs about 100 euros. Now, with my dental insurance at 12 euros a month, while it doesn’t fully cover all services, it does provide discounts.

In addition to medical insurance, there are many other types of insurance available in Spain, such as pet insurance, property insurance, and accident insurance at work. The Seguridad Social system also covers social benefits. For example, if you are pregnant, you will receive paid maternity leave.

When it comes to serious illnesses like cancer, private insurance offers the option to choose your doctor and hospital, which significantly enhances the quality of treatment. However, it’s important to note that not all doctors may be covered by insurance, especially if they are not part of the medical guild.

The cost of medications in Spain depends on your income. For instance, if your income is below 18,000 euros per year, you pay 10% of the medication cost, but no more than 8 euros per month. If your income is between 18,000 and 100,000 euros, you will pay 50% of the cost. If your income exceeds 100,000 euros per year, you will have to cover 60% of the cost of medications. There are benefits for pensioners and the unemployed, and they don’t have to pay for medicines.

As for our doctors, most work legally, but there are exceptions. Some specialists may see patients at home or in offices of licensed doctors, but they cannot prescribe medications. To work as a doctor in Spain, one must validate their diploma, pass exams, and have at least a B2 level of Spanish.

To feel confident in Spain, it's essential to understand the medical insurance and healthcare system.