Moving to Spain: Essential Expat Health and Insurance Checklist

Health care is one of those subjects most people don’t think about until they suddenly need it. But for anyone relocating to Spain, it becomes one of the most important decisions you’ll make long before stepping off the plane. The way Spain handles healthcare access isn’t complicated, but it is very different from the systems many expats know. Your visa route, employment status, and even the timing of your arrival can determine how quickly you’re able to see a doctor, get medication, or register with local services.

For thousands of newcomers each year, the first few months in Spain are a blend of excitement, unfamiliar bureaucracy, and the occasional surprise. Some arrive assuming they can walk straight into the public system. Others expect everything to function like their home country. A few underestimate how crucial private insurance is until an immigration officer politely asks for it. Understanding how Spain’s healthcare landscape really works can make the difference between a smooth transition and a stressful one.

The Role Private Insurance Plays When You First Arrive

One of the biggest misconceptions newcomers face is the assumption that Spain, known for its excellent public system, automatically grants access to everyone who moves here. The reality is far more conditional. For anyone arriving on a Non-Lucrative Visa, Student Visa, Retirement route, or many Digital Nomad applications, private health insurance is a legal requirement — not a suggestion. Consulates expect to see fully comprehensive cover with no co-payments, and immigration offices won’t process residency without it.

Even for those planning to work, there is often a gap between arrival and official enrolment in Social Security. Until that activation is confirmed, private insurance remains the only guaranteed way to access care. Many expats treat it as a bridge; others end up keeping it because the service and speed prove invaluable.

A Public System You Must Qualify For

Spain’s public healthcare system is superb, but it isn’t something you simply “sign up for” as soon as you land. Access depends on meeting specific criteria, whether through employment, self-employment, EU agreements, or the convenio especial. That process can take weeks or months, depending on your region and paperwork.

And even when access arrives, many expats don’t drop their private cover. Public care handles the essentials brilliantly, but private insurance often provides faster diagnostics, English-speaking doctors, shorter waiting lists, and direct specialist access without gatekeeping. In the long run, combining the two systems becomes a comfortable way of life for many foreign residents.

Prescriptions, Records, and Ongoing Treatment

Anyone arriving with long-term medication or existing medical conditions quickly discovers that Spain does things its own way. Medication names differ, brands change, and the referral system isn’t always intuitive. Bringing printed or digital copies of your medical history helps smooth the transition, but having private insurance often makes the biggest difference — especially when you need referrals, specialist input, or continuity of care without waiting weeks.

Finding Your Place in the System

Once eligible for public healthcare, you’ll register at your local centro de salud. This becomes your administrative home for primary care, referrals, and routine appointments. Private insurance works differently: instead of being tied to a single centre, you choose from a countrywide network of clinics and hospitals. For many newcomers living between cities, travelling often, or dividing life between regions, that flexibility is invaluable.

What Happens in an Emergency

Spain’s approach to emergencies is refreshingly simple: in a true emergency, you can go to any hospital. Nobody will ask to see proof of employment, residency status, or insurance before stabilising you. For ongoing or non-urgent matters, though, the rules differ. Your insurer provides a specific network, and staying within it keeps care seamless and covered. Providers such as Sanitas have extensive networks ranging from the Milenium clinics to major private hospitals across Spain’s largest cities.

Families, Children, and the Realities of Moving

Spain is one of Europe’s most welcoming countries for families, but the administrative steps can still be slow. Children gain access to public healthcare through a parent who has a recognised right to it, yet the registration process isn’t instant. Private cover ensures children can see paediatricians, access vaccinations, and receive urgent attention without navigating long waiting lists. This is especially important for families settling in larger cities where demand can overwhelm public services.

It’s also worth recognising what the public system doesn’t prioritise. Routine dental care, physiotherapy, broader mental health support, and fertility treatment often fall outside its scope. Private insurance fills many of these gaps, which is why a large proportion of expats keep it permanently, not just during the relocation phase.

Life Between Countries

Spain is increasingly home to a globally mobile generation — remote workers, digital nomads, dual-country families, and retirees who split their year between nations. Public healthcare stops at Spain’s borders, but many private plans include worldwide emergency cover. For people with international lifestyles, this becomes one of the most useful (and most overlooked) benefits of private cover.

Renewals, Bureaucracy, and the Importance of Continuity

Residency renewals come with their own rules, and maintaining uninterrupted health insurance is one of them. A single lapse, even just a few days, can complicate your renewal. Keeping a stable policy — and renewing early — avoids unnecessary friction with immigration authorities. Many long-term expats choose to stay with providers who understand the documentation requirements and issue renewal certificates quickly.

Why Starting Early Makes Everything Easier

Whether you're applying for a visa, booking NIE appointments, or preparing residency paperwork, your health insurance certificate is often required at the very beginning. Securing a compliant policy before you move means your documentation is ready when you need it, not weeks later. The smoother your paperwork, the smoother your relocation.

Choosing a Provider That Understands Expats

Not every insurer is accepted by Spanish consulates, and not every policy meets Spain’s residency standards. Sanitas is widely recognised across Spain for offering immigration-compliant cover, English-language support, fast documentation, and access to an extensive private network. For expats beginning their new life here, it’s often the safest and simplest route.

Our dedicated visa and residency policies provide fully compliant cover with no co-payments, immediate documentation, and a streamlined onboarding process tailored for newcomers.

Start your relocation on the right foot:

Get Visa & Residency Health Insurance

If you already have a policy with another provider and want better service, more flexible access, or smoother renewals, switching is simple — and with January renewals around the corner, now is the perfect moment.

Switch to Sanitas Health Insurance