Note

Healthcare in Spain for foreign residents

§ 1It depends on your status

Spain’s public health system is run by the regions, and access depends on who you are. A worker who pays social security is covered. A pensioner covered by another state may be covered through that state. An economically inactive resident with no other cover may be able to sign a special agreement. A person without legal residence has a separate procedure. This page belongs to the chapter on the rules on daily life, and it describes the routes we could read in official pages.

§ 2The special agreement

The ministry of health explains that the special agreement is aimed at foreign citizens who are economically inactive and need health insurance to reside. Its requirements are effective residence in Spain for a continuous minimum of one year immediately before applying, with residence in other EU, EEA, Swiss or UK territory counting, registration on the municipal register when applying, and no access to public health protection by any other route. You apply to the regional health service where you are registered.

§ 3Fees and benefits

The page lists monthly fees of sixty euros a month under sixty-five and one hundred and fifty-seven euros a month from sixty-five. The agreement gives affiliation to the common basic portfolio of the national health system, covering primary and specialist care, outpatient and hospital care and urgent medical transport, with no copayments or waiting periods, and an individual health card. Outpatient medicines and some products, and non-urgent transport, are paid by the patient in full. Check the current page, because fees can change.

§ 4No legal residence

A royal decree of March 2026 sets the procedure for recognising the right to public healthcare for foreigners who are in Spain without legal residence. It uses a sworn statement of the conditions, proof of identity, and habitual residence shown mainly by registration on the municipal register. It is in force from 13 March 2026, and it gives a provisional document on filing. It is not a route for a buyer with a residence permit, but it explains the system.

§ 5Pensioners from other states

Pensioners whose pension comes from another EU or EEA state, or from a country with an agreement, may be covered by a form issued by that state. We found the title of the social security portal’s page on this form but could not read its text, so ask your pension authority. Registering the form with the Spanish social security gives access in practice.

§ 6Private cover

Private insurance is an alternative or a supplement. Compare cover, limits, age bands and renewal terms. Visa routes for non-working residents can require private cover, and the residency section explains the routes we read.

§ 7Where you live

Services differ by region and by distance. Check the nearest health centre, hospital and pharmacy, and the language that staff speak. More on cost of living for retirees covers how to put health cover into the budget.

§ 8What we could not verify

We did not read the special agreement’s legal text, the S1 procedure or any regional waiting-time data.

§ 9More on this topic

Schools explained explains how school admission works and what to ask when moving with children and living near an airport explained explains how to check airport noise before buying.

Neighbours and the community explained explains how to learn about neighbours and the community of owners before buying.

General information only. This is not legal, tax or financial advice. Check your own situation with a qualified adviser.