Private Health Insurance in Spain for Britons: What Each Visa Asks

Private health insurance for a Briton moving to Spain is not one rule but several, because each visa and permit asks something different of the policy. Take a breath: the pattern is simpler than the paperwork suggests. A non-lucrative visa wants an insurer authorized in Spain, a student visa adds limits on copayments, and a worker enrolled in Spanish Social Security needs no policy. The GHIC, the UK’s free health card, is not a replacement for insurance, and the London consulate accepts it only as insurance for student visas. This article is for informational purposes only and is not legal advice; verify current requirements with the relevant Spanish authority or a licensed professional.

Does your visa require private insurance?

Start with which group you belong to, because the pages split Britons in two. This guide addresses Britons arriving now, who are third-country nationals. The ministry’s initial permit sheet excludes citizens of the EU, the EEA and Switzerland, and, for investors, entrepreneurs, highly qualified workers, researchers, intra-company transferees and teleworkers, Ley 14/2013 asks for public insurance or private cover from an insurer authorized to operate in Spain. Britons covered by the Withdrawal Agreement, meaning those already living in Spain before 2021, are treated in a separate ministry guide and in our Withdrawal Agreement card guide.

For most newcomers the answer depends on the visa. The non-lucrative visa, the student visa and the telework visa all ask for health cover. Employee and self-employed permits list none, because the work itself leads to Social Security enrolment. Our guide to the visa options shows which route fits you.

The pages do disagree on the telework visa. The London consulate’s page (May 17, 2024) asks only that the policy cover all the risks of the public system; the ministry’s telework documents also refuse copayments and waiting periods. The London non-lucrative page says nothing on copayments either way, so ask the consulate before you pay for a policy that has them.

What each visa or route asks of the insurance

In the table, the last column links the page behind each row.

The Spanish regulation also lists a health insurance among the conditions for EU long-term residence, without saying more. Which wording will the consulate apply to your file? The certificate in your hands is what it will read, so ask the insurer for a certificate that names the cover in the terms of your route’s page.

Who counts as an authorized insurer?

At the counter, the word that matters is “authorized”. Every route that names insurance says the insurer must be authorized to operate in Spain, and Ley 20/2015 explains what that means. Insurers based in Spain need prior administrative authorization, and the authorization leads to an entry in an official register. The law also covers branches in Spain of insurers from third countries and EU insurers acting in Spain.

You can check this yourself. The DGSFP, the Spanish regulator of insurers and pension funds, runs a public register where you can search by status, by type of entity (including EEA entities working through a branch or by free provision of services) and by branch of business, such as 2 for illness.

Here is the part the official pages leave open. None of the official pages says whether an insurer based in the UK is acceptable or not; they ask only for an insurer authorized to operate in Spain. If a UK company offers you a policy for your visa, ask it to show where it appears in the register, and ask the consulate if in doubt.

What the GHIC does, and where it stops

Your GHIC, the UK Global Health Insurance Card, is free and lasts up to 5 years, according to the NHS. It gives necessary state healthcare in the EEA to people ordinarily and legally resident in the UK. The same page says it is not a replacement for travel and medical insurance, and that it does not cover treatment in a private medical facility, a flight home for medical reasons, or costs a local resident would have to pay. The FCDO travel advice adds that private hospitals will not accept it.

The Ministry of Health’s Brexit page says that the trade agreement’s social security protocol gives UK visitors cover with a GHIC or EHIC. That covers visits, not residents, and the page shows no date and still carries parts written before 2021.

GOV.UK’s healthcare page for Britons in Spain is dated July 27, 2022, so treat its details as stale until you confirm them. It says Britons living in Spain who work and pay social security in Gibraltar, if not covered by the Withdrawal Agreement, have had no reciprocal state healthcare in Spain since July 1, 2022, and that someone living in Spain under one year who cannot get cover must buy private insurance. The public convenio especial, at 60 euros a month under 65 and 157 euros from 65, asks for a year of continuous residence, which the ministry says residence in the UK or the EU can count toward, and a padrón registration in Spain.

No Spanish page says whether the convenio especial counts as the insurance for a non-lucrative visa or its renewal; GOV.UK (2022) names it among the usual proofs of cover, without naming routes. The public route and the S1 are covered in our healthcare guide and our S1 guide.

What Spanish law says about your policy, and where to complain

Spanish law gives you some protection once you hold a policy. The Insurance Contract Law sets these points:

• General conditions must be clear, and clauses that limit your rights must be highlighted and accepted specifically in writing.
• You must declare the risk circumstances you know about, following the insurer’s questionnaire. If the insurer sends none, you are released from that duty, and the insurer can cancel within one month of learning that an answer was wrong.
• For health care, the insurer pays the costs the policy expressly covers, but its conditions cannot exclude necessary urgent care.
• Insurers must guarantee free choice of provider within the contract limits, with an accessible provider list, unless the policy names a single provider.
• The insurer must announce any change at least two months ahead. You can oppose renewal with one month’s notice, and the insurer with two.

On price, the DGSFP’s criterion on health premiums says tariffs are not approved by the regulator. A rise for the new period must be notified two months before the end of the current one, otherwise the old premium applies.

Two things the official pages do not say. The Insurance Contract Law article on the questionnaire does not mention pre-existing conditions, and no official page says insurers must accept them or may exclude them. No page gives a price range for private insurance either.

If the insurer lets you down, the DGSFP complaints procedure is written and can be filed on paper or with an electronic signature. The practical guide says you must first complain to the insurer’s customer service or ombudsman and wait one month as a consumer, or receive its reply. The regulator’s final report is not binding and cannot be appealed.

Your next step: read your route’s page, then buy the policy

You can do the first three steps alone, in an afternoon. Read the page for your route in the table, open the DGSFP register to check the insurer, and ask for a policy certificate that states the cover in the words of that page. No official page says the policy must be bought before you leave the UK. For students the regulation wants it valid for the planned stay, and for a renewal it must cover the renewal period, so confirm the dates with the consulate that takes your application. Our visa application guide shows where the certificate sits among your other documents.

Ask for help when your case is unusual: a family reunification with several members, a Withdrawal Agreement file, or a long illness history that raises the questionnaire. A licensed professional can read your file, and the consulate can answer what the pages leave open. Once you hold your card, our TIE guide covers the next stage. The Spain Navigator puts every step of your move to Spain in order, from the visa to settling in.