Buying real estate in Spain often becomes the first step towards a new life by the sea. But along with choosing an apartment or villa, practical questions arise: how does healthcare work, is private insurance needed, and how much does it cost?

Let's understand how the medical insurance system in Spain is organized in 2026.

Public or Private Healthcare?

Spain has a public healthcare system — Sistema Nacional de Salud. Access to it depends on a person's status and their right to medical care. The individual medical card TSI confirms the user's status in the public healthcare system.

In the Valencian Community, the SIP card is used. It confirms the patient's registration in the regional public system and is used when visiting public medical institutions.

However, many foreigners moving to Spain additionally obtain private medical insurance.

The reason is simple: the possibility to see a specialist faster, choose a doctor or clinic, and use the private medical network.

Is Medical Insurance Required for Residency?

In some immigration procedures, having medical insurance is a mandatory requirement.

Requirements depend on the type of visa or residence permit. For certain national visas, Spanish consulates require a policy without co-payments by the patient, waiting periods, or coverage limits. Insurance must cover medical, hospital, and outpatient expenses.

This is where it is important not to confuse ordinary travel insurance with a full medical policy for staying in Spain.

Before applying, always check the requirements for your specific type of residence.

What is copago?

One of the key terms when choosing insurance is copago (co-payment).

It is an additional payment for using medical services.

For example, insurance may be cheaper per month, but the patient pays a small amount additionally for doctor consultations, tests, or examinations.

Policies sin copago work without such additional payments.

If insurance is arranged for certain visa or migration procedures, a no-copago option may be required. Official consular requirements for several national visas explicitly state the absence of copago.

For ordinary life, the choice depends on how often you plan to visit doctors.

How Much Does Medical Insurance Cost in Spain?

The price depends on age, region of residence, selected coverage, and specific contract conditions.

In 2026, the approximate cost of private medical insurance often starts at around €50 per month. More comprehensive programs and policies for older people can cost significantly more.

Costs are also influenced by:

• insured person’s age;

• presence of copago;

• hospitalization;

• dental services;

• medical network;

• additional programs;

• individual insurance conditions.

Therefore, comparing insurance only by monthly price is not the best strategy.

What to Pay Attention to Before Signing a Contract?

First — the medical network.

Check which clinics, hospitals, and specialists are available in your city. For residents of Alicante, Torrevieja, Orihuela-Costa, or Benidorm, real access to doctors may be more important than the insurance company's reputation.

Second — waiting period, or carencia.

Some services may not be available immediately after signing the contract. Pay special attention to hospitalization, surgical treatment, and certain complex procedures.

Third — existing illnesses.

The insurance company may request a medical questionnaire. Coverage conditions for previously diagnosed diseases must be clarified before signing the policy.

And finally — language.

For foreigners, the ability to get consultation in English or another understandable language is often an important factor when choosing a clinic and doctor.

Can You Have Both Public and Private Healthcare?

Yes.

For many residents of Spain, this is a convenient combination. The public system remains the basis of medical care, while private insurance is used for faster access to certain specialists and examinations.

Interest in medical insurance in the country continues to grow. According to ICEA, by mid-2025 the medical insurance sector in Spain had about 14.3 million insured. And industry statistics for the first quarter of 2026 have already been published as a current sector market snapshot.

Healthcare — Part of a Comfortable Life in Spain

When moving, we often think about the climate, the sea, schools, and real estate prices. But access to healthcare is no less important part of daily life.

Especially if you are moving with children, planning permanent residence, or applying for residency.

When choosing a home on the Costa Blanca, it is worth studying not only the area and infrastructure in advance but also the location of medical centers, hospitals, and private clinics.

Alicante Real Estate helps you look at real estate more broadly — as part of your future life in Spain.

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