Health insurance in Spain for US Citizens

Health insurance in Spain for US citizens: how does it work?

The quality of the Spanish public healthcare system has since long been recognized as being of outstanding quality in terms of essential indicators like facilities, equipment and personnel. The financing of this system happens through the social security contributions of working Spanish residents, meaning that most of the people living in Spain have access to it. Still, many people take out a private health insurance in Spain as well, for wider or more specific coverage. Exploring this option can be daunting for US citizens, especially when you don’t speak the language, so in this article we’ll take a more detailed look at what’s important to know for US citizens looking for a private health insurance in Spain.

The Spanish public health care system

In order to understand the role of private health insurance in Spain for US Citizens (la Seguridad Social), it’s useful to take a quick look at the public system and how it works. Basically, anyone who contributes to the social security system has access to public healthcare, so those are mainly employees and self-employed residents. As a consequence, any American citizen with a working visa and a job in Spain has access to the Spanish public healthcare system.

So what about private health insurance for US citizens?

So far, so good, but there is a twist. Citizens of the US, being a non-EU country, who are wishing to obtain residence in Spain (for example, to work or to retire) require to have a private health insurance that is valid in Spain. The exact rules, costs and other details in regard to this regulation differ per region, so be sure to get in touch with the Spanish embassy or consulate in your place of residence, or someone with relevant experience, before taking any decision.

Generally though, for US citizens in Spain who are not working there and not paying into the public healthcare system, a private health insurance is the only option. Of course, much variation exists among providers and types of insurances, but as a general rule you can assume that a Spanish private insurance will cost you less than an insurance with similar coverage in the US. Despite pre-existing conditions usually being excluded from the premium, like with any private insurance, can be found for less than $100 a month.

The advantages of a private health insurance in Spain

Even though the excellent quality of the Spanish public healthcare system is widely known, it does have its downsides. Many Spanish residents complement their public healthcare access with a health insurance in Spain for US Citizens, because:

  • they want to avoid the growing waiting times linked to public healthcare, which can be quite long sometimes.
  • they prefer a doctor who speaks their own language and private insurance enables you to choose your own doctor.
  • they are simply looking for a wider, more varied coverage (dental cover, for example, is often not included in basis private insurance packages in Spain).
  • they are frequent travellers (including outside of the EU) and wish to be fully covered wherever they are.