If you’re living in Spain or planning to move, one of the first questions that may come to mind is: is public healthcare enough, or should you get private health insurance?
Spain’s public healthcare system is among the best in the world. However, it’s also known for long waiting times, limited flexibility, and restricted schedules. That’s why many people, especially freelancers, international students, or foreign residents on a visa, choose to get private insurance as well.
At Legal Allies, we explain the differences between public and private health insurance in Spain, what each one covers, their pros and cons, and when it’s worth getting additional coverage.
What Is Spain’s Public Healthcare System?
Spain’s public healthcare is state-funded through taxes and managed by the National Health System (SNS). It includes:
- Free medical care in health centers and hospitals.
- 24/7 emergency services.
- Specialist consultations (with referral).
- Surgeries.
- Pediatric and gynecological care.
- Chronic illness treatment.
Who qualifies?
- Spanish citizens.
- Legal residents with NIE and registration (“empadronamiento”).
- Employees under contract.
- Freelancers registered with Social Security.
- Unemployed individuals who have contributed to the system.
- International students with a European Health Card or a bilateral agreement.
Newcomers without coverage can apply for public healthcare through a special agreement.
What Is Private Health Insurance?
This is insurance provided by a private company that gives access to medical care outside the public system. It typically includes:
- Medical appointments with no waiting time.
- Fast diagnostic tests (ultrasounds, MRIs, etc.).
- Scheduled surgeries.
- Private hospital rooms.
- International care if you travel frequently.
There are co-pay plans (cheaper) and full coverage plans (more comprehensive).
Key Differences Between Public and Private Health Insurance
| Aspect | Public | Private |
| Cost | Free (tax-funded) | Monthly fee (€30 to €100/month) |
| Specialists | Referral required | Direct access |
| Waiting Time | Long (weeks or months) | Short (a few days) |
| Doctor Choice | Limited | Wide selection within network |
| Hospitalization | Shared rooms | Private rooms |
| Emergency | Excellent 24/7 coverage | Included in some plans |
| Dental Coverage | Very limited or none | Optional, available with supplements |
| International Care | Not included | Included in some plans |
When Should You Get Private Insurance?
If you’re a foreign student or applying for a visa
Many visa applications require private insurance with no waiting periods or co-payments, since you don’t automatically qualify for public care.
If you’re self-employed
Even if you have public coverage, quick access to medical services can be essential to keep your business running without interruptions.
If you want to avoid long wait times
Some tests or surgeries may take months in the public system, but only a week in private clinics.
If you value comfort and personalized care
Private clinics often provide more flexible schedules, better patient experience, and service in your preferred language.
Can You Use Both Systems?
Yes! In fact, many people in Spain use both public and private systems.
Example:
- Use public healthcare for blood pressure check-ups.
- Get an MRI through private insurance for faster results.
- Visit the public hospital emergency room for a serious situation.
- Add dental or mental health coverage through your private plan.
Which Private Insurance Is Right for You?
That depends on your situation:
- Young and healthy? Choose a basic plan with co-payments.
- Have children? Look for family coverage with pediatric care.
- Travel often? Get a plan with international coverage.
- Older or with chronic conditions? Check policy exclusions carefully.
At Legal Allies, we help you compare plans, review the fine print, and avoid clauses that could leave you without coverage when you need it most.
Real Stories
Sophie, a Canadian student, needed to renew her visa. She bought a private plan with all the features required by Immigration and we helped her submit the correct certificate to avoid rejection.
Ramón, a freelancer with hypertension, didn’t check his policy carefully and found his medications weren’t covered. We helped him switch insurers and now he’s fully covered for only €45/month.
The difference between public and private health insurance in Spain isn’t just about cost—it’s about speed, flexibility, international coverage, and service quality. Both systems can work together, but it’s crucial to understand what fits your personal or professional needs.
At Legal Allies, we help you choose the best option for you, your family, or your visa application. We review contracts, compare policies, and answer your legal questions about healthcare coverage.
Because your health can’t wait—and neither should you.
