Generali EXPAT Medcare Prime — Health Insurance Spain
↓ Jump to Frequently Asked QuestionsGenerali's most popular tier — everything in Standard plus 80% out-of-network reimbursement, optional dental, and daily hospital benefit.
Who Is EXPAT Medcare Prime For?
About 55% of our new EXPAT Medcare clients choose Prime — the balance of broad specialist access and reasonable premium suits the majority of expat profiles.
The 80% out-of-network reimbursement extends to clinics outside the Generali network across the EU/EEA — useful for snowbirds and second-home owners.
Optional dental add-on integrates seamlessly — same membership card, same app, same renewal date as your health policy.
The daily hospital benefit add-on (up to €60/day) helps cover incidental costs during recovery — childcare, family travel, lost income.
Often chosen by clients who want a step up from baseline cover with optional dental and hospital benefit add-ons. Note: residency / visa certificates are currently unavailable for EXPAT plans — see advisory above.
What's Included
EXPAT Medcare Prime includes everything in Standard, plus three significant upgrades that explain why it is our most-recommended tier.
- 80% out-of-network reimbursement — if you choose to use a clinic outside the Generali network, Prime pays back 80% of the cost up to the annual limit. This applies in Spain and across the EU/EEA. Standard does not include this.
- Up to 20 psychology sessions per year — double the Standard allocation, plus video psychology and access to a wider network of bilingual therapists.
- Wider specialist network — Prime adds about 8,000 additional consultants beyond the Standard network, including more boutique private clinics on the Costa Blanca and Madrid/Barcelona.
- Optional dental cover — Generali Dental Premium can be added for around €12/month, including 2 free annual cleanings, free X-rays, free check-ups, fillings at preferential rates, and discounts on implants and orthodontics.
- Optional daily hospital cash benefit — Subsidio Hospitalización Plus pays €15–€60/day for every day spent in hospital, on top of the medical cover. Particularly valuable for self-employed expats who lose income during recovery.
- Optional maternity cover — full antenatal, childbirth and post-natal cover available as add-on (8-month waiting period from policy start).
- All Standard tier benefits — full Spain hospital network, 24/7 emergency, telemedicine, travel assistance up to €35,000.
What's Not Included
Prime delivers strong value but a few situations call for the Top tier instead:
- Worldwide private cover outside the EU — Prime's 80% reimbursement applies in Spain and the EU/EEA. For full worldwide cover (US, Canada, Asia, Africa), Top tier is required.
- Higher annual reimbursement caps — Prime's out-of-network reimbursement is subject to annual limits that can be reached by complex chronic-condition treatment. Top has substantially higher caps.
- Pre-existing conditions — same medical underwriting applies. Conditions disclosed at application may be excluded or loaded.
- Routine cosmetic procedures — not covered unless medically necessary.
- Long-term care or nursing-home stays — not covered (no Spanish health plan covers this).
- UK private treatment — UK is not in the EU/EEA, so Prime's 80% reimbursement does not apply. Emergency UK travel cover up to €35,000 is included; planned UK treatment requires Top tier.
Indicative Premium Ranges (2026)
| Profile | Indicative monthly premium |
|---|---|
| Adult age 25-30 | €55–€78 |
| Adult age 31-40 | €65–€95 |
| Adult age 41-50 | €80–€120 |
| Adult age 51-60 | €100–€150 |
| Adult age 61-70 | €135–€200 |
| Adult age 71-74 | €185–€275 |
| Child (under 18) | €35–€55 (each child) |
| Optional dental add-on | +€10–€18/month |
| Optional hospital cash benefit | +€8–€25/month |
Disclaimer: Premium ranges are indicative for 2026 and depend on age, postcode, sex, health declaration and Generali underwriting at the time of application. Contact us for a written quote in a few days.
Visa Compliance
EXPAT Medcare Prime is fully compliant with all Spanish residency and visa requirements:
- EXPAT Medcare Standard, Prime and Top — temporarily unavailable for residency / visa certificates (administrative issue, expected to resolve)
- Salud Opción Plus / Salud Plus con copagos — Spanish co-payment plans (cheaper, but not visa-compliant)
- UK private health insurance (Bupa UK, Vitality, AXA UK) — wrong jurisdiction; not DGS-registered in Spain
- EHIC / GHIC card — public emergency cover only, never sufficient for a visa
- Travel insurance — short-term emergency cover, not full residency cover
- "Reimbursement only" international plans — the consulate requires direct-billing in Spain
- EXPAT Medcare Standard, Prime and Top — temporarily unavailable for residency / visa certificates (administrative issue, expected to resolve)
- Salud Opción Plus / Salud Plus con copagos — Spanish co-payment plans (cheaper, but not visa-compliant)
- UK private health insurance (Bupa UK, Vitality, AXA UK) — wrong jurisdiction; not DGS-registered in Spain
- EHIC / GHIC card — public emergency cover only, never sufficient for a visa
- Travel insurance — short-term emergency cover, not full residency cover
- "Reimbursement only" international plans — the consulate requires direct-billing in Spain
Compare EXPAT Medcare Tiers — Standard, Prime & Top
EXPAT Medcare is Generali's English-language private health range for international residents in Spain (available up to age 74). It comes in three tiers — all are visa-compliant and have no co-payments, with the bigger plans adding worldwide cover, dental and faster access.
| Cover & benefit | StandardEssentials | PrimeMost popular | TopFull cover |
|---|---|---|---|
| All medical specialties (Spain) | ✓ | ✓ | ✓ |
| Hospitalisation & surgery | ✓ | ✓ | ✓ |
| 24/7 emergency care | ✓ | ✓ | ✓ |
| Private room during hospitalisation | ✓ | ✓ | ✓ |
| No co-payments (sin copagos) | ✓ | ✓ | ✓ |
| DGS visa-compliant certificate (English) | ✓ | ✓ | ✓ |
| English-language app, docs & support | ✓ | ✓ | ✓ |
| Specialist access without GP referral | ✓ | ✓ | ✓ |
| Telemedicine / video consultations | ✓ | ✓ | ✓ |
| Mental health & psychology sessions | ✓ | ✓ | ✓ |
| Maternity & childbirth (after qualifying period) | ✓ | ✓ | ✓ |
| Annual preventive health check | ✓ | ✓ | ✓ |
| Vaccines & immunisations | ✓ | ✓ | ✓ |
| Physiotherapy & rehabilitation | ✓ | ✓ | ✓ |
| Worldwide emergency cover | ✓ | ✓ | ✓ |
| Basic dental (cleanings, x-rays) | — | ✓ | ✓ |
| Advanced dental (treatments, extractions) | — | ADD-ON | ✓ |
| Optical reimbursement (glasses / lenses) | — | ADD-ON | ✓ |
| Worldwide planned treatment | — | — | ✓ |
| Alternative medicine (acupuncture, etc.) | — | ADD-ON | ✓ |
| Pharmacy reimbursement | — | ADD-ON | ✓ |
| Repatriation cover | ADD-ON | ADD-ON | ✓ |
| No waiting periods on basic services | ✓ | ✓ | ✓ |
Frequently Asked Questions — EXPAT Medcare Prime
EXPAT Medcare Prime sits between Standard and Top in Generali's English-language range. The most popular tier for residents settling long-term who want broader hospital choice and higher annual cover limits.
Prime adds three main upgrades over Standard: a wider hospital network (including the most premium private hospitals like HCB Group, Quirónsalud premium centres, and IMED Hospitales); higher annual cover limits across most benefit categories; and broader specialist access without referral requirements. Standard meets the everyday needs of most expat residents; Prime upgrades the experience for those wanting broader choice and higher limits.
Yes, often — Standard is sufficient for visa compliance. Prime is the right choice when you're settling long-term in Spain and want the broader network and higher cover limits as part of your everyday healthcare. Many clients start on Standard for the visa application, then upgrade to Prime at the first renewal once they confirm they're settling for the long term.
Prime gives full access to: HCB Group's flagship hospitals (HCB Hospital Dénia, Clínica Benidorm flagship facilities, HCB Calpe consultations); the premium private wings of IMED Levante and IMED Elche; full Quirónsalud Alicante; and selected Madrid and Barcelona referral hospitals if specialised treatment is required outside the Costa Blanca region. Standard already includes the everyday-use private hospitals; Prime adds the premium-tier and referral options.
Same waiting period structure as Standard: GP/specialist/emergency from day one, hospitalisation and non-emergency surgery 6 months, childbirth 8 months. Visa applicants typically have waiting periods waived. Switching from Standard to Prime preserves the waiting periods you've already served — you don't restart them on the new tier.
Prime is typically 35-50% more than Standard at the same age. For example, an adult at age 50 might pay around €80-€100/month for Standard and €120-€150/month for Prime. The exact difference depends on age, area, and any pre-existing conditions. We always quote both side-by-side so you can see the trade-off transparently.
Prime includes enhanced emergency travel cover — up to €30,000-€50,000 for trips abroad up to 60-90 days. This is more comprehensive than Standard's basic travel cover. For routine treatment abroad or trips longer than 90 days, the Top tier (which has worldwide reimbursement) is more appropriate. Many UK-Spain split-resident clients sit on Top rather than Prime.
Practical access times are similar — Generali's network response is fast on both tiers (typically 3-7 days for an MRI versus 4-12 weeks on Spanish public healthcare). Prime can give access to additional premium imaging centres if your local network is busy. The difference is more about choice (more centres available) than urgency (both tiers respond quickly).
Yes — within a single family policy, individual lives can be on different tiers. For example, the main earner on Prime, partner on Standard. The administrative simplification (single renewal, single contact) is preserved. Most families choose to align tiers but the option exists for cases where one family member has greater healthcare needs.
Prime's basic dental cover is similar to Standard (check-ups and cleaning included; treatment at member rates). Optical cover is more comprehensive on Prime — annual eye test and a contribution towards glasses/contact lenses. For full dental treatment cover, the optional dental add-on (€10-€20/month) is typically taken alongside Prime by clients who want comprehensive dental.
Generally yes — older clients tend to use the broader hospital network more frequently and benefit from the higher cover limits. The premium difference between Prime and Standard becomes proportionally smaller at older ages (Standard premiums increase with age too). Many of our clients at age 65+ either start on Prime or upgrade from Standard at this stage.
Yes — Prime gives you the right to choose your hospital and surgeon within the Generali network for any planned surgery. This is one of the practical Prime advantages: you can choose to have hip replacement at HCB Dénia rather than be allocated to whichever network hospital has space. The choice option matters for routine planned procedures where comfort and language matter.
Identical to Standard — Generali bills the hospital directly and you pay nothing at point of treatment (no co-payments). The difference with Prime is simply that more hospitals are within the network. The user experience is the same: present your card, receive treatment, no out-of-pocket payment, no claim form to file.