Is there a couples discount with Sanitas?

Not as such. On Sanitas Mas Salud, Optima, Plus, Family and Top Quantum a person insured alone pays the price plus an 8 per cent single-person loading. Two of you on one policy each pay the price without it, which works out about 7 per cent less each. There is no further reduction for two people. Sanitas' 10 per cent discount starts at four insured on the Mas Salud plans and Top Quantum, and Mas Salud Family gives 14 per cent from the third person. Accede, Avanza and Unico charge the same per person whether one or two of you are insured. The Residents Visa plan is the exception: a couple pays about 6 per cent less per person than one applicant alone.

How much is health insurance in Spain for a couple?

On the 2026 Sanitas prices for mainland Spain, two 35-year-olds pay €167.80 a month together on Sanitas Mas Salud (€83.90 each), with no copayments. Two of you on one policy avoid the single-person loading. Mas Salud Optima, with copayments, costs between a fifth and a third less than Mas Salud. Accede (both under 60) and Unico (both 60 or over) are cheaper outpatient-only plans that charge the same per person whether one or two of you are insured. Each partner is priced at their own age, and the two figures together are what you pay a month.

Do we have to be married?

No. Sanitas insures any two adults on one policy and the application records the second person as "spouse or partner", the same for married and unmarried couples. For a visa the consulates treat a spouse, a registered partner and a duly proven stable partner alike. Under the EU rules a partner registered as a pareja de hecho, Spain's civil partnership register, counts as a family member. So does an unregistered partner who can prove a durable relationship: a year's continuous cohabitation, or stable cohabitation with a child in common.

Do both of us have to be on the same plan?

On one policy, yes: everyone on a Sanitas policy is on the same plan, in the same region, from the same start date. If you want different plans, for example Mas Salud for one partner and Unico for the other because of your ages, that is two policies. On the Mas Salud range two separate policies each carry the single-person loading; on Accede and Unico splitting costs nothing extra.

What if one of us has a pre-existing condition?

Each of you completes the health questionnaire (Unico has none) and is accepted or declined on your own history. Sanitas accepts a declared condition, accepts the person with that condition excluded, or declines that person; a loading on the premium is rare. One partner can be accepted while the other is excluded or declined, and if that happens we quote the alternatives for the second person before anything is signed. A condition that is excluded on one partner never affects the other's cover or price. If Sanitas declines one of you and the other goes ahead alone, that policy carries the single-person loading, and we tell you the new figure first.

Can I add my partner to my policy later?

Yes. Send us a copy of both identity documents and we arrange the addition with Sanitas; your partner completes the health questionnaire and is accepted or declined on their own history. Their pre-existing conditions are judged from the date they join. Ask us for the price and the waiting dates before you choose between adding them now and waiting for renewal.

Do we each need health insurance for a Spanish visa?

Yes. For a non-lucrative visa each family member, including a spouse or partner, files their own application and submits their own health insurance certificate from an insurer authorised in Spain. The consulate asks for cover of all the risks the Spanish public system insures; that means full cover with no copayments and no waiting periods. A UK state pensioner can file the receipt of their S1 registration instead. One Sanitas policy with both of you insured on it does the job. The Residents Visa plan is built for it: no waiting periods, and Sanitas issues the visa certificate naming the insured when the policy activates. The main applicant also shows financial means of 400 per cent of the IPREM income index plus 100 per cent for each family member.

Does a couples policy cover having a baby?

Mas Salud, Optima, Plus, Family and Top Quantum all include antenatal care, childbirth and postnatal care. Childbirth is covered only if you fall pregnant after the policy starts, and it carries an 8-month waiting period from the start date that Sanitas never waives, even when you transfer from another insurer. Residents Visa has no waiting period at all. Accede and Unico do not cover maternity. Fertility investigations are covered up to diagnosis only; IVF and artificial insemination are excluded on every plan. A newborn joins from birth without a health questionnaire when either parent has been insured on the policy for at least 240 days before the birth. You must apply within 30 days.

Which Sanitas plan is best for a couple?

For most couples, Sanitas Mas Salud: full cover, no copayments, accepted for visas and residency, and the cheapest no-copayment price per person for two on the plans anyone can buy. If one of you is a registered autonomo, Sanitas Professional covers you both for less. Apply from abroad for a visa and it is Residents Visa. Already resident and rarely at the doctor: Optima or Plus with copayments. Both over 60 and wanting outpatient cover only: Unico. Both under 60 and wanting the cheapest outpatient cover: Accede. Mas Salud Family only pays off from three people, unless you want its extra psychology and speech therapy cover.

Health Insurance Explained

Couples Health Insurance in Spain: What Two Adults Pay With Sanitas, and the Rules for One Policy

Written by Sean Guy, authorised Sanitas agent (agent code 22395) and DGSFP-registered insurance mediator (C0320X5769518Z), Marbella · Reviewed September 2026

Couple reviewing their Sanitas health insurance together

How does couples health insurance work in Spain with Sanitas?

Couples health insurance in Spain with Sanitas is one policy with two adults on it, each paying their own age price without the 8 per cent that Sanitas adds when one person is insured alone. At 35 in mainland Spain that is €83.90 each on Sanitas Mas Salud against €90.61 alone, about 7 per cent less each.

There is no other couples discount; Sanitas' 10 per cent starts at four insured. Each of you is accepted or declined on your own health answers. For a visa, each of you needs cover matching the public system, and one policy covers you both.

Who arranges it: HealthPlan Spain is an authorised Sanitas agent (agent code 22395) in Marbella that arranges Sanitas policies in English, at the same price as buying direct from Sanitas.

This guide explains what two people pay on the plans couples actually buy, and where the saving comes from. It sets out the rules for two people on one policy, then covers the three questions that decide most couples' choice: different ages, a visa or residency application, and planning a baby.

What a couples policy is with Sanitas

Sanitas does not sell a separate "couples plan". A couples policy is an ordinary Sanitas plan with two insured people on it. One of you signs and pays as the policyholder, normally whoever is entered first on the application, and the other is the second insured person, recorded as "spouse or partner". Married or not makes no difference to Sanitas: the application, the price and the cover are the same. You both share one policy number, one start date on the 1st of a month, one renewal date and one direct debit. Each of you gets your own Sanitas card.

What stays individual is just as important. Each of you completes the health questionnaire (Unico has none) and is accepted or declined on your own medical history. Each of you is priced at your own age band. On Mas Salud Plus, Accede and Avanza the annual copayment cap is per person (Optima has no cap), and the cover limits, from psychology sessions to emergency treatment abroad, are per person. Add-ons such as dental are priced per person too.

What couples health insurance costs in Spain

Two of you on one policy each pay the price for your own age without the single-person loading, on Mas Salud and on Optima alike.

The saving holds at every age and grows in euros as you get older. Optima, which has copayments, costs between a fifth and a third less than Mas Salud, the gap narrowing with age. Enter both dates of birth and compare the plans on our calculator.

Sanitas tariff valid 1 April 2026 to 31 March 2027, mainland rate, monthly payment, no add-ons. Mas Salud has no copayments; Optima has copayments. Islands and some cities price differently. Ages are your ages on the start date.

Two of the same age pay twice the couple rate. Different ages add up in the same way: each of you pays the couple rate for your own age, and the two together are what you pay a month. The other plans a couple might choose:

Mas Salud Family: a little more than Mas Salud for the same medical cover plus its family extras. Its discounts begin at three insured, so it rarely pays for two.
Sanitas Accede (both under 60, outpatient only, copayments): priced by age band, the same per person whether one or two of you are insured.
Sanitas Unico (both 60 or over, outpatient only, no health questionnaire): priced by age band, the same per person alone or together.
Top Quantum: a little more than Mas Salud per person, with the same couple saving.
Residents Visa (applying for a visa from abroad): between a fifth and a quarter more than Mas Salud per person, with a couple's reduction of its own, billed six-monthly or annually.

Our guide to how much health insurance costs in Spain gives every age band for one adult; as a couple you each pay about 7 per cent less than the Mas Salud figure shown there.

Where the saving comes from, and what does not exist

Sanitas prices its Mas Salud range and Top Quantum per person and adds an 8 per cent loading, its "recargo", when only one person is on the policy. Two of you on one policy simply avoid that loading. Because the loading is added on top of the couple price, the saving against the single price is a little over 7 per cent each.

There is no discount beyond that for two people. Sanitas' multi-person discounts start later. It is 10 per cent for four or more insured on Mas Salud, Optima, Plus and Top Quantum. On Mas Salud Family it is 14 per cent from the third person and 19 per cent from the fourth. Two exceptions run the other way. Accede, Avanza and Unico have no single-person loading at all, so a couple pays exactly twice the single price. Residents Visa gives a couple about 6 per cent off the one-applicant rate. Paying annually takes a further 4 per cent off on every plan except Unico and Residents Visa.

The rules for two people on one policy

One plan, one region, one start date. Everyone on one Sanitas policy is on the same plan. If you want different plans, that is two policies, and on the Mas Salud range each of them carries the single-person loading.
One policyholder. The first adult entered signs and pays, and gives notice if the policy is ever cancelled. The policyholder does not have to be insured on the policy, but for a couple they normally are.
Separate health checks. Each of you answers the same five health questions (on every plan except Unico, which has no questionnaire) and is accepted, accepted with a condition excluded, or declined, on your own history. One partner's exclusion never touches the other's cover. Our guide to pre-existing conditions explains how Sanitas decides.
Your own age, your own limits. Each of you is priced at your age on the start date, and every per-person limit, copayment cap and waiting period runs for each of you individually.
Live in Spain. Each insured person must reside in Spain for at least six months a year, and Sanitas can ask for proof. A partner who moves abroad comes off the policy and the other stays insured. From then on that person is priced as one, so the single-person loading applies (on Residents Visa the couple reduction is lost). The same happens if you separate and one of you leaves the policy, so ask us before you split it.
Entry ages. Mas Salud, Family, Top Quantum and Residents Visa take new members up to 75; Accede and Avanza up to 59; Unico from 60; Premium 500 up to 64. There is no age at which cover ends once you are insured.

Different ages: when one plan will not fit you both

The entry ages decide this. A couple of 58 and 62 cannot share Accede, because the 62-year-old is over its limit, and cannot share Unico, because the 58-year-old is under its. Both can join Mas Salud. Or the 58-year-old takes Accede and the 62-year-old Unico on two policies, which costs nothing extra because neither plan has a single-person loading. That only works if you are not applying for a visa or registering EU residency, because neither Accede nor Unico is accepted for those. On a visa route both of you go on Mas Salud or Residents Visa. A couple where one partner is over 75 has fewer options. The older partner can only join Unico, which is outpatient cover, so the younger partner's full cover goes on a policy of their own with the single-person loading. Send us both dates of birth and we will price every combination that fits.

Adding your partner later

You do not have to start together. If one of you is already insured, send us a copy of both identity documents and we arrange the addition with Sanitas by phone. Your partner completes the health questionnaire and is accepted or declined on their own history, and their pre-existing conditions are judged from the date they join. Ask us for the price and the waiting dates before you choose between adding them now and waiting for renewal. Our FAQ on adding a person to your policy has the practical steps.

Visas and residency for a couple

Non-EU couples: the visa

Spain's non-lucrative visa is applied for by the main applicant with family members alongside: a spouse, a registered partner or a duly proven stable partner, and dependent children. Each family member files their own application and submits it in person, and each one must submit their own health insurance. That is a certificate from an insurer authorised in Spain showing cover for all the risks the Spanish public system insures. Consulates read that as full cover with no copayments and no waiting periods. The policy should run for the whole first year, because renewing the permit means having kept the insurance throughout. The London consulate also accepts the receipt of an S1 registration from a UK state pensioner in place of a policy; if only one of you has an S1, the other is insured alone. The main applicant also proves financial means of 400 per cent of the IPREM, Spain's public income index used for these thresholds, plus 100 per cent for each family member. A couple therefore needs 500 per cent.

One Sanitas policy with both of you insured on it covers both applications. Sanitas issues the visa certificate automatically when the policy activates, naming the insured. You will have two appointments, and consulates differ on how recent the certificate must be, so tell us both dates and we time the start date and confirm the paperwork each of you needs. Residents Visa is the plan built for this: no waiting periods on any service, including hospital treatment and childbirth, and priced per person with a couple's reduction. It can be contracted several months before you arrive. It renews for life. If you later move to Sanitas Mas Salud, Sanitas treats the change as a new contract, so the waiting periods and the health questionnaire apply again. The visa health insurance page sets out the consulate requirements in full, and family reunification covers the case where one partner is already resident.

EU couples: residency registration

An EU citizen who lives in Spain without working must show, for themselves and their family members, health insurance covering all risks in Spain, plus sufficient means. The registration offices require cover equivalent to the public system. If one of you works in Spain and pays social security, the other is normally covered by the public system as a dependant and needs no private policy to register. If neither of you pays in, the non-working spouse or partner needs their own cover, and can be the second insured person on one Sanitas policy. A non-EU partner of an EU citizen obtains the family-member residence card on the strength of the EU partner's means and a policy that covers you both. So the non-EU partner goes on the same policy as the second insured. A partner registered as a pareja de hecho in Spain, or in another EU or EEA state's register, counts as a family member like a spouse. An unregistered partner qualifies by proving a durable relationship: a year's continuous cohabitation, or stable cohabitation with a child in common. Both routes need a plan with no copayments: Mas Salud, Family, Top Quantum or the worldwide plans. The residency registration page explains the registration step by step.

Planning a baby

Every full-cover Sanitas plan includes antenatal care, childbirth and postnatal care, with antenatal classes and a pregnancy programme in the app; our guide to maternity care with Sanitas explains the appointments. Three things matter for a couple who may start a family. Childbirth is covered only if you fall pregnant after the policy starts, and it carries an 8-month waiting period from the start of the policy on Mas Salud, Optima, Plus, Family and Top Quantum. It is the one waiting period Sanitas never waives, even when you transfer from another Spanish insurer. Residents Visa has no waiting period at all. Fertility is covered only as far as the diagnosis: hormone tests, ultrasound and the other investigations are included, but IVF and artificial insemination are excluded on every plan. A newborn joins from birth without a health questionnaire when either parent has been insured on the policy for at least 240 days before the birth. So join the policy before you try, not after. You must apply for the baby within 30 days. Accede and Unico do not cover maternity at all. Couples therapy is not part of the psychology cover, which is for individual treatment only (Mas Salud Family's 20 sessions need no prescription). Sanitas does run a relationship programme with a psychologist among its digital health programmes.

Which plan for a couple

Sanitas Mas Salud for most couples: full cover, no copayments, accepted for visas and residency, the cheapest no-copayment price per person for two on the plans anyone can buy. If one of you is a registered autonomo, Sanitas Professional covers you both for less.
Residents Visa when you are applying for a visa from outside Spain and need cover from day one with no waiting periods.
Mas Salud Optima or Mas Salud Plus when you are already resident and rarely see a doctor: full cover for less, with small copayments. Our guide to how copayments work has the schedules.
Sanitas Unico when you are both 60 or over and want outpatient cover with no health questionnaire; it has no hospital cover and is not accepted for a visa.
Sanitas Accede when you are both under 60 and want the cheapest outpatient cover; not for a visa either.
Mas Salud Family once there are three of you, or for its extras: 20 psychology sessions per person without a prescription and cover for articulation and voice-quality problems, for adults as well as children.
Top Quantum for its reimbursement fund: 80 per cent of GP, paediatric and gynaecology consultations outside the Sanitas network, up to €10,000 per person a year.

Whichever you choose, the process is the same. Get a quote with both dates of birth and your province, pick the plan and the start date, and each complete the health questionnaire. Policies always start on the 1st of a month. Apply by the 24th and cover can start on the 1st of that same month; from the 25th the earliest start is the 1st of the following month. Or compare the Sanitas plans side by side first.

Frequently asked questions

Is there a couples discount with Sanitas?: Not as such. On Sanitas Mas Salud, Optima, Plus, Family and Top Quantum a person insured alone pays the price plus an 8 per cent single-person loading. Two of you on one policy each pay the price without it, which works out about 7 per cent less each. There is no further reduction for two people. Sanitas' 10 per cent discount starts at four insured on the Mas Salud plans and Top Quantum, and Mas Salud Family gives 14 per cent from the third person. Accede, Avanza and Unico charge the same per person whether one or two of you are insured. The Residents Visa plan is the exception: a couple pays about 6 per cent less per person than one applicant alone.

How much is health insurance in Spain for a couple?: On the 2026 Sanitas prices for mainland Spain, two 35-year-olds pay €167.80 a month together on Sanitas Mas Salud (€83.90 each), with no copayments. Two of you on one policy avoid the single-person loading. Mas Salud Optima, with copayments, costs between a fifth and a third less than Mas Salud. Accede (both under 60) and Unico (both 60 or over) are cheaper outpatient-only plans that charge the same per person whether one or two of you are insured. Each partner is priced at their own age, and the two figures together are what you pay a month.

Do we have to be married?: No. Sanitas insures any two adults on one policy and the application records the second person as "spouse or partner", the same for married and unmarried couples. For a visa the consulates treat a spouse, a registered partner and a duly proven stable partner alike. Under the EU rules a partner registered as a pareja de hecho, Spain's civil partnership register, counts as a family member. So does an unregistered partner who can prove a durable relationship: a year's continuous cohabitation, or stable cohabitation with a child in common.

Do both of us have to be on the same plan?: On one policy, yes: everyone on a Sanitas policy is on the same plan, in the same region, from the same start date. If you want different plans, for example Mas Salud for one partner and Unico for the other because of your ages, that is two policies. On the Mas Salud range two separate policies each carry the single-person loading; on Accede and Unico splitting costs nothing extra.

What if one of us has a pre-existing condition?: Each of you completes the health questionnaire (Unico has none) and is accepted or declined on your own history. Sanitas accepts a declared condition, accepts the person with that condition excluded, or declines that person; a loading on the premium is rare. One partner can be accepted while the other is excluded or declined, and if that happens we quote the alternatives for the second person before anything is signed. A condition that is excluded on one partner never affects the other's cover or price. If Sanitas declines one of you and the other goes ahead alone, that policy carries the single-person loading, and we tell you the new figure first.

Can I add my partner to my policy later?: Yes. Send us a copy of both identity documents and we arrange the addition with Sanitas; your partner completes the health questionnaire and is accepted or declined on their own history. Their pre-existing conditions are judged from the date they join. Ask us for the price and the waiting dates before you choose between adding them now and waiting for renewal.

Do we each need health insurance for a Spanish visa?: Yes. For a non-lucrative visa each family member, including a spouse or partner, files their own application and submits their own health insurance certificate from an insurer authorised in Spain. The consulate asks for cover of all the risks the Spanish public system insures; that means full cover with no copayments and no waiting periods. A UK state pensioner can file the receipt of their S1 registration instead. One Sanitas policy with both of you insured on it does the job. The Residents Visa plan is built for it: no waiting periods, and Sanitas issues the visa certificate naming the insured when the policy activates. The main applicant also shows financial means of 400 per cent of the IPREM income index plus 100 per cent for each family member.

Does a couples policy cover having a baby?: Mas Salud, Optima, Plus, Family and Top Quantum all include antenatal care, childbirth and postnatal care. Childbirth is covered only if you fall pregnant after the policy starts, and it carries an 8-month waiting period from the start date that Sanitas never waives, even when you transfer from another insurer. Residents Visa has no waiting period at all. Accede and Unico do not cover maternity. Fertility investigations are covered up to diagnosis only; IVF and artificial insemination are excluded on every plan. A newborn joins from birth without a health questionnaire when either parent has been insured on the policy for at least 240 days before the birth. You must apply within 30 days.

Which Sanitas plan is best for a couple?: For most couples, Sanitas Mas Salud: full cover, no copayments, accepted for visas and residency, and the cheapest no-copayment price per person for two on the plans anyone can buy. If one of you is a registered autonomo, Sanitas Professional covers you both for less. Apply from abroad for a visa and it is Residents Visa. Already resident and rarely at the doctor: Optima or Plus with copayments. Both over 60 and wanting outpatient cover only: Unico. Both under 60 and wanting the cheapest outpatient cover: Accede. Mas Salud Family only pays off from three people, unless you want its extra psychology and speech therapy cover.

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