Private health insurance for expats in Spain — the Generali advantage
Generali customers access BOTH the Generali network AND the Sanitas (Bupa) network — 51,000+ professionals, 240 hospitals and 4,100 medical centres. No other insurer in Spain offers this under one policy.
NEW 2026: EXPAT Medcare — English-language plans, up to age 74
No waiting periods — cover starts day one (Salud Opción Premium)
Visa-compliant cover via Salud Opción Premium — NLV, DNV, NIE & TIE
Dental — 2,000+ dentists, 45+ free services, no waiting period
Choose the right Generali health insurance plan for expats in Spain — from the full EXPAT Medcare range (English-language, up to age 74) to visa-compliant Salud Opción Premium with no waiting periods and no co-payments. Authorised exclusive Generali agents in Javea, serving expats across the Costa Blanca since 2013.
👤By Andrew Turner · In insurance since 2001, exclusive Generali agent since 2007 · DGS Registry C0467B54657010 · Last reviewed May 2026
Best Health Insurance in Spain for Expats
The best health insurance in Spain for expats balances cost, English-language access and acceptability for visa or residency purposes. The best health insurance companies in Spain for English-speaking residents include Generali, Sanitas, Adeslas, DKV and Mapfre. As authorised Generali agents, we arrange the EXPAT Medcare and Salud Opción ranges — widely regarded as among the best private health insurance in Spain for British, Dutch, Norwegian and Irish expats. Free English quote — call 966 461 625.
Cost of Private Health Insurance in Spain
The cost of private health insurance in Spain varies by age and cover level. Average costs: under 40 (€50–€90/month), 40–55 (€80–€130/month), 55–65 (€120–€200/month), 65–75 (€180–€300/month). The cheapest health insurance in Spain for expats starts around €45–€60/month for younger applicants. How much does health insurance cost in Spain for foreigners is the same as for Spanish nationals — no nationality loading applies. Health insurance in Spain for over 75 costs €250–€450/month depending on health status.
Health insurance for foreigners in Spain and health insurance in Spain for non-residents follows the same rules and pricing as for Spanish nationals — there is no nationality premium. Health insurance for residency in Spain (required for all long-stay visa applications) must come from a DGS-registered insurer with no significant coverage gaps. Retiring in Spain health insurance is essential for most expat retirees. Health insurance after Brexit became mandatory for British expats no longer covered by the EHIC. Health insurance in Spain with pre-existing conditions is available — terms vary by insurer and condition. Contact us on 966 461 625 — how to get health insurance in Spain is straightforward with Turner Insurance.
⚡ Quick Answer — Health Insurance in Spain
Mandatory?For visa applicants and pre-residency
Typical premium€30–€155 / month
Visa-compliant?Yes — Salud Opción Premium (no co-payments)
ProviderGenerali (with EXPAT Medcare in English)
CertificateIssued in 24–48 hrs for visa applicants
Max entry age74 (EXPAT Medcare) — highest in Spain
Dental included?Optional from ~€5/month — 45+ free services
The legal framework, specific waiting periods, exclusions and citations every prospective policyholder should know. Sources are linked inline to the BOE (Boletín Oficial del Estado) and Spanish regulators.
Legal framework
Spanish private health insurance contracts are governed by Ley 50/1980 de Contrato de Seguro, with all insurers authorised and supervised by the Dirección General de Seguros (DGS). Public healthcare is provided through the Sistema Nacional de Salud (SNS) under Ley 14/1986 General de Sanidad. The two systems are independent: private cover does not affect entitlement to SNS access for those who qualify, and most expats use the systems in parallel.
When private cover is mandatory
Private health insurance is mandatory for several visa categories. For the Non-Lucrative Visa (NLV), Real Decreto 557/2011 Article 47 requires applicants to demonstrate"seguro público o privado de enfermedad". For the Digital Nomad Visa (DNV) under Ley 28/2022, de 21 de diciembre, de fomento del ecosistema de las empresas emergentes, the same private-cover requirement applies. In both cases the policy must have no co-payments (sin copago), full Spain-wide cover, and be issued by a DGS-registered insurer. Student-visa applicants need a similar policy. UK state pensioners with Form S1 from HMRC Overseas Healthcare Services do not need private cover for visa purposes.
Standard waiting periods (carencias)
Most Spanish health policies apply waiting periods to specific treatments. Typical industry standards (verified against the Generali, Sanitas and Adeslas product literature):
Emergencies and accidents: covered from day one.
General consultations and diagnostics: typically 0–30 days.
Planned surgery (cirugía programada):6 months standard.
Maternity and birth:8–10 months from policy inception.
Assisted reproduction: typically 12 months, where included.
Major prostheses and implants: typically 10 months.
For visa applicants (NLV, DNV, student visa) specific Generali plans waive all waiting periods — this is one reason Salud Opción Premium is the standard recommendation for visa cover.
Standard exclusions
Under Ley 50/1980 Article 3, exclusions must be highlighted in the policy and accepted in writing. The exclusions common to almost every Spanish health policy are: cosmetic surgery not for medical necessity; experimental treatments; injuries from professional sport or non-licensed flying; self-inflicted injury and substance abuse (Article 19); nuclear, war and terrorism (extraordinary risks fall under the Consorcio de Compensación de Seguros); pre-existing conditions not declared on the medical questionnaire; and treatment received outside the cuadro médico network (unless the plan offers reembolso). Always read your condiciones particulares carefully and declare every condition truthfully — non-disclosure can void the policy under Article 10.
Tax treatment for residents
Under Ley 35/2006 IRPF, employers who provide private health cover as an employee benefit can deduct up to €500 per insured employee per year (€1,500 if disabled). Self-employed (autónomo) workers can deduct premiums as a business expense subject to the same limits, applied to themselves, their spouse and children under 25. The Agencia Tributaria (AEAT) treats the cover as a non-cash benefit for IRPF purposes. Always check with your gestor before claiming.
Cancellation rights
Under Ley 50/1980 Article 22, Spanish private health insurance contracts are annual and renew automatically. Either party may cancel at the next renewal by giving at least one month's written notice (some insurers require two months — check your condiciones particulares). Mid-year cancellation is permitted only on prescribed grounds: leaving Spain permanently, change of tax residence, death of the policyholder, or significant change in policy terms. Continuity-of-cover certification is available when switching insurer so already-served waiting periods carry across.
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Important update — Visa & Residency Certificates
Due to a temporary administrative situation, Generali is currently not issuing residency / visa certificates for EXPAT Medcare policies (Standard, Prime or Top). For NLV, DNV, Student visa or residency renewal, the only Generali plan currently providing the certificate is Salud Opción Premium — the Spanish-language no-copayment plan. Certificates take a few days to process. Please contact our team for advice on the best plan for your situation.
The Best Private Health Insurance in Spain for Expats
The best private health insurance in Spain for expats is the policy that covers your specific situation — visa requirements, preferred hospitals, pre-existing conditions and budget — without gaps or hidden co-payments. For the vast majority of expats on the Costa Blanca, that means a Generali plan, for four concrete reasons: the widest medical network in Spain (Generali PLUS Sanitas/Bupa — 51,000+ professionals and 240 hospitals), English-language plans (EXPAT Medcare) with a Spanish-language app, the highest new-applicant age in the market (74 years for EXPAT Medcare), and visa-compliant sin copago cover that satisfies NLV, DNV, NIE and TIE consular requirements.
Private health insurance in Spain replaces — or runs alongside — the Spanish public health system (SNS). For expats, private cover solves three real problems the SNS cannot: immediate access to specialist consultations without referral queues (waiting lists of 3–12 months for specialists in the public system are common), access to English-speaking doctors who understand the expat patient context, and portability across the country and abroad. On the Costa Blanca specifically, our clients have direct access to HCB Hospital de Dénia, HLA Vistahermosa in Alicante, Clínica Benidorm and Quirónsalud facilities — all within the Generali cuadro médico.
Comparing the main Spanish private health insurers — Generali, Sanitas, Adeslas, DKV, Asisa — the differentiating factor for English-speaking expats is almost always the combination of telemedicine in English, an easy-to-use digital app for finding and booking in-network doctors, and a certificate service that issues visa-compliant documentation within 24–48 hours. On all three measures, the Generali EXPAT Medcare range leads the market for expats on the Costa Blanca.
Visa requirement: Spanish residency (NLV, DNV, NIE/TIE) requires a private health insurance policy with sin copago (no co-payments). Generali Salud Opción Premium satisfies this requirement at every Spanish consulate. We issue the required certificate within 24–48 hours. Get your visa health certificate →
How to Get a Quote
Call or email us — ring 966 461 625 or email info@turnerinsurance.es. Our English-speaking team is available Monday to Friday, 09:30–15:00.
Tell us your situation — we will ask a few quick questions about what you need to cover, your age, location, and any existing policies you hold.
We compare options — as authorised Generali agents, we present the plans that match your needs and budget. No pressure, no obligation.
Your policy is set up — once you are happy, we arrange everything and send your certificate and English-language policy documents promptly.
🛂 Visa eligibility keyNLV Non-Lucrative VisaDNV Digital Nomad VisaResidency TIE / Spanish residency renewal
Cover level
What is included
Best for
EXPAT Medcare Standard
✗NLV✗DNV✗Student Visa✗Residency
51,000+ medical professionals, hospitals, 240 hospitals — no waiting periods
Healthy adults under 60 wanting affordable private cover
EXPAT Medcare Prime
✗NLV✗DNV✗Student Visa✗Residency
All Standard benefits plus enhanced specialist access and wider hospital network
Those wanting broader choice of consultants
EXPAT Medcare Top
✗NLV✗DNV✗Student Visa✗Residency
Unlimited private cover, private rooms, worldwide emergency cover, no excess
Full private healthcare with no compromises
Salud Opción Premium
✓NLV✓DNV✓Student Visa✓Residency
Zero co-payments, no waiting periods, NLV and DNV visa compliant
Residency visa applicants and families
✓ Currently only Salud Opción Premium qualifies for residency / visa applications
Salud Opción Premium meets all Spanish consulate requirements: zero co-payments (sin copagos), full territory of Spain coverage, DGS-registered Spanish insurer, annual policy term, and the official certificate accepted by Spanish consulates worldwide. The certificate is issued in a few days from policy purchase.
❌ Plans currently NOT available for Spanish visa or residency certificates
Spanish consulates reject policies with co-payments, reimbursement-only structures, regional limits, or annual maximums. Plus, due to a temporary administrative situation, Generali is currently not issuing residency certificates for EXPAT Medcare policies. The following are not suitable for visa certificates right now:
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
In Spain, private medical insurance — also called private medical insurance for expats — and health insurance are the same product — both refer to a seguro de salud privado giving you immediate access to private clinics and hospitals without public waiting lists. Whether you search for private medical insurance Spain, private health insurance Spain or health insurance Spain for expats, you are looking for the same thing: a policy that lets you see a specialist within days rather than months.
When you compare health insurance in Spain, the key variables are network size, English-language support, entry age limit, co-payment structure and certificate turnaround for visa applications. On all five measures, Generali EXPAT Medcare leads the English-speaking expat market — broader dual network (Generali + Sanitas), English documentation, 74-year entry age, sin copago option and 24-48 hour visa certificates.
The main Spanish private medical insurance providers are Generali, Sanitas, Adeslas, DKV, ASSSA, AXA, Mapfre and Aegon. For English-speaking expats, Generali EXPAT Medcare is the only fully English-language private medical insurance plan in Spain — English app, English documents, English customer service — making it the market leader for British, Irish, Dutch and international residents on the Costa Blanca.
Private Health Insurance Spain — Cost
How much is private medical insurance in Spain? For expats, private medical insurance in Spain costs between €30 and €155 per month depending on age, plan type and co-payment structure. Monthly premiums depend on age, plan type and whether you include co-payments:
With co-payments (copago): from €30/month — most affordable entry point
No co-payments (Salud Opción Premium): from €45/month — visa-compliant, most popular
English-language EXPAT Medcare Standard: from €55/month — up to age 74
Family of two adults: from €85/month combined on most plans
For the cheapest private health insurance in Spain that still satisfies NLV and DNV visa requirements, Salud Opción Premium at €45/month is the most cost-effective option. For those prioritising English-language service, EXPAT Medcare Standard offers the best value at the entry level. Pre-existing conditions are assessed individually — many are accepted, particularly on Salud Opción Premium.
Private health insurance for NIE and TIE: Spanish residency applications require a private health insurance policy without co-payments. Generali Salud Opción Premium satisfies this requirement and we issue the consulate certificate within 24–48 hours. Get your NIE health insurance certificate →
EXPAT Medcare Range — New 2026
Three tiers — all in English
Standard: GP, all specialties, psychology (20 sessions/year), 24/7 telemedicine, travel assistance up to €35,000. English app and documentation. Up to age 74.
Prime (Most Popular): Everything in Standard plus out-of-network reimbursement (80%), optional dental, optional daily hospital benefit up to €60/day.
Top: Maximum freedom — 80% reimbursement at any clinic in Spain, annual cap up to €300,000. Best for complex health needs.
Generali Dental Insurance
2,000+ dental specialists across 600+ locations in Spain. No waiting period — cover from day one. Available standalone or as an add-on.
Annual check-up, professional clean and X-rays — FREE
Simple extractions and provisional fillings — FREE
Children under 14: fillings for permanent teeth — FREE
45+ free dental services as standard
Implants, whitening and major treatments at exclusive rates
From approximately €5/month standalone
Optional Extras
Daily hospital cash benefit: Up to €60/day for illness or accident (€120/day in ICU). Max 120 days.
Maternity cover: Gynaecology, obstetrics, private birth and newborn care.
Out-of-network reimbursement: 80% of costs at any clinic in Spain or worldwide.
Assisted reproduction: IVF, artificial insemination and related procedures.
Psychology & mental health: Up to 20 sessions per year (standard in EXPAT Medcare).
Wellbeing programme: Discounts on gyms, spas, laser eye surgery and aesthetics.
Second medical opinion: International specialist review for serious diagnoses.
Travel assistance: Up to €35,000 medical assistance abroad for trips up to 90 days.
Find a Generali-Approved Clinic Near You
Generali-approved clinics covering Costa Blanca (Javea, Denia, Benidorm, Torrevieja, Alicante), Costa del Sol, Valencia, Barcelona, Murcia, Balearics and Canary Islands. Contact us and we'll find your nearest English-speaking in-network clinic.
🏥 Also available: Hospital Cash & Sick Pay Insurance (Subsidio) Generali Hospitalización Plus pays a daily cash benefit of €15–€300 for every day you spend in hospital — illness or accident. It covers the real costs health insurance does not pay: family travel costs, childcare, home help and lost income. Ideal complement to any health policy. Learn more about Subsidio →
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 Across Spain, the Balearics & the Canary Islands
We arrange Generali health insurance for expats anywhere in Spain — mainland, the Balearic Islands (Mallorca, Menorca, Ibiza, Formentera) and the Canary Islands (Tenerife, Gran Canaria, Lanzarote, Fuerteventura and the rest). The cuadro médico (provider network) covers every Spanish region, with English-speaking GPs and specialists across all major cities. No matter where in Spain you live, we handle your policy, renewals and claims in English from our Jávea office.
Approximate Health Insurance Pricing
Premiums vary by age and area — these are typical starting figures for the Marina Alta and Costa Blanca:
With co-payments
from €30/mo
Lower monthly premium
Small fee per consultation (€3-€8 GP, €6-€15 specialist)
Hospitalisation fully covered
Suitable for occasional users
Not visa-compliant on its own
Most Popular
No co-payments
from €45/mo
No fee at point of use
Full hospitalisation cover
Specialists & diagnostics
Visa-compliant for NLV / DNV
No waiting periods (visa applicants)
No co-pay + foreign reimbursement
from €75/mo
Everything in no-copay
Reimbursement of treatment abroad
Wider international cover
Premium hospital network
For frequent travellers
Prices shown are typical Spanish market starting points and depend on age, area, cover level and your individual circumstances. Contact us for a free personalised quote. Sample 35-year-old, no pre-existing conditions, Marina Alta postcode.
Frequently Asked Questions — Health Insurance in Spain
These are the questions we are asked most often by British, Irish and other expat clients moving to or already living on the Costa Blanca. If your question is not answered here, contact us directly for free English-speaking advice.
Private health insurance is compulsory in Spain only if you cannot access the public Sistema Nacional de Salud (SNS) — most commonly because you are not yet employed or self-employed in Spain, or do not yet hold a UK Form S1 as a state pensioner. For Non-Lucrative Visa, Digital Nomad Visa, Student Visa and certain residencia categories, a fully comprehensive private policy with no co-payments is a legal requirement of the immigration application itself. For everyone else, private cover is optional but practically very useful for avoiding waiting lists in the public system.
The NLV requires a Spanish private health insurance policy with: no co-payments, full Spain-wide cover, no waiting periods (or with all waiting periods waived for visa applicants), and issued by an insurer registered with the Spanish Dirección General de Seguros (DGS). The policy must include hospitalisation, specialist consultations and routine medical treatment equivalent to the Spanish public system. Generali Salud Opción Premium is our standard recommendation. We provide the official certificate the consulate requires, typically within 24-48 hours.
The DNV under Ley 28/2022 (Ley de Startups) has the same private health requirements as the NLV: no co-payments, full Spain coverage, DGS-registered insurer, and waiting periods waived. Many DNV applicants prefer Generali EXPAT Medcare because the entire policy — documentation, app, claims and customer service — operates in English. We can issue the consulate certificate in English and Spanish, ready for your visa application.
Yes. Once you are a Spanish resident and a UK state pensioner, you can apply through HMRC's Overseas Healthcare Services for Form S1 (and the Spanish equivalent paperwork) which entitles you to register with the Spanish public health system on the same basis as a Spanish pensioner. The UK pays Spain a lump sum and you pay nothing further. Many of our older clients combine S1 access to public healthcare with an affordable private top-up policy to skip waiting lists and keep choice of specialist.
No. The GHIC (which replaced the EHIC for UK citizens post-Brexit) is for short visits only — typically tourists or short business trips. Once you become a Spanish resident, your GHIC ceases to be valid for routine care because your healthcare entitlement transfers to Spain. If you are still pre-residency and visiting on a tourist basis, the GHIC will cover state emergency treatment in Spain but never private clinics, repatriation, or planned care.
Premiums depend on age, co-payment choice and area. As a guide: a 35-year-old typically pays around €40–€55/month for a no-copay plan; a 55-year-old around €70–€95/month; a 65-year-old around €110–€155/month. Plans with co-payments can reduce monthly premiums by 25–35%. Family policies usually attract a discount when two or more lives are insured on the same contract. We provide free quotes from multiple insurers — contact us for an exact figure.
With a co-pay plan you pay a small fixed amount per consultation or test (typically €3–€8 for a GP, €6–€15 for a specialist, more for imaging) and the monthly premium is lower. With a no-copay plan the monthly premium is higher but every consultation, test and procedure inside the network is free at point of use. Visa applicants must hold a no-copay plan. Otherwise the right choice depends on how often you expect to use the policy: heavy users save with no-copay; occasional users save with co-pay.
The cuadro médico is the insurer's directory of accredited doctors, specialists, clinics and hospitals in your network. Inside the cuadro médico everything is paid for by the insurer (subject to any copago); outside the cuadro you typically receive nothing back unless you have a reimbursement (reembolso) plan. Before choosing an insurer, check that the cuadro covers the specific clinics and hospitals you want — particularly for the Marina Alta, the Hospital Quirónsalud Torrevieja and HLA San Carlos in Dénia are key facilities to confirm.
Yes. Spanish private health policies cover medical emergencies, accidents and resulting hospitalisation from the first day the policy is in force, regardless of what other waiting periods may apply. Planned hospitalisation (scheduled surgery, scheduled IVF, etc.) is subject to standard waiting periods of typically 6 months on most plans, though Generali Salud Opción Premium and EXPAT Medcare have no waiting periods at all when arranged for visa applicants.
Every applicant completes a confidential medical questionnaire. Insurers may accept the policy as standard, accept it with the pre-existing condition specifically excluded, apply a higher premium, or in rare cases decline. It is critical to declare everything truthfully — non-disclosure discovered later can void the policy. For ongoing chronic conditions (e.g. controlled hypertension, stable diabetes, asthma) a policy is usually still possible. We work through the declaration with you to find the insurer most likely to accept your specific health history.
Maternity is covered on most plans after a waiting period of typically 8–10 months. This means if you suspect or are planning a pregnancy, the policy must be in force well before conception for birth costs to be covered. Antenatal consultations and routine gynaecology are usually available from day one. The newborn is normally covered for the first 30 days under the mother's policy, and must then be added to the policy as a new insured life.
Standard health plans include only the most basic dental cover — typically annual check-ups, cleaning and one X-ray. For fillings, crowns, orthodontics or implants you need a dental add-on or standalone Generali Dental policy, which costs from approximately €5/month. A dental add-on gives you free check-ups and cleans plus heavily discounted rates on all other treatments at network clinics — typically saving 40–60% versus paying as a private patient.
Yes, in significant numbers. The Marina Alta and Costa Blanca have a long-established expat population, and most major private hospitals and clinics in Dénia, Javea, Calpe, Altea and Benidorm have English-speaking GPs, paediatricians and many specialists. The MI GENERALI app lets you filter the cuadro médico by language. For more complex specialties, English-speaking consultants are available in the larger Alicante and Valencia hospitals; many Generali-network facilities offer free transport from the Marina Alta.
Most Spanish private health plans accept new applicants up to age 65 or 70. Generali EXPAT Medcare currently accepts new applicants up to age 74 (subject to medical questionnaire). Once you have a policy in force, it generally renews for life regardless of age, provided premiums are paid. If you are over the new-applicant age limit, options narrow and we will discuss alternative routes including S1 access plus a daily-benefit hospital cash policy.
For straightforward applications with no pre-existing conditions, a policy can be in force within 24-48 hours of receiving the completed application and medical questionnaire. For visa applicants we routinely turn around the consulate certificate the same working day. Applications with significant medical history may take 5–10 working days while the insurer's medical underwriters review the case.
Yes, most Spanish health plans include emergency-only travel cover for trips abroad of typically 60–90 days per trip, with a benefit cap of usually €12,000–€30,000 per claim. This is sufficient for most European emergencies but generally inadequate for the United States, where we strongly recommend a separate travel insurance policy on top. Planned treatment abroad is not covered unless the policy explicitly includes a 'reembolso internacional' option.
No. The Spanish private healthcare system requires Spanish-licensed GPs and specialists, and your insurer's network is the Spanish cuadro médico. UK GPs cannot make referrals in the Spanish system, and consultations conducted in the UK are not reimbursed. The exception is short-term emergency care during a visit to the UK, which most Spanish travel-element cover includes — but as the UK is now non-EU for healthcare purposes, expect to pay upfront and be reimbursed afterwards.
Spanish private health policies are annual contracts that auto-renew on the anniversary date. To cancel, Spanish law (Ley 50/1980) requires written notice at least one month before the renewal date. Cancellation mid-year is generally not permitted except in specific circumstances (leaving Spain permanently, change in tax residence, death). When switching insurers we can carry across continuity-of-cover certification so waiting periods that you have already served do not restart from zero on the new policy.
All are major DGS-registered insurers, but they differ on network, app, English support, regional strength and price. Generali (since acquiring Liberty Seguros) has the broadest Spain-wide network and now shares Sanitas's network, plus a fully English-language proposition in EXPAT Medcare. DKV is strong in central Spain. Sanitas (owned by Bupa) is a long-established premium brand. Adeslas is the largest by market share, with very strong network density. We compare across all of them based on your circumstances and area.
Spanish-resident workers can deduct private health insurance premiums up to €500 per insured person (€1,500 if disabled) on their IRPF return when the policy is paid via their employer's payroll. Self-employed (autónomo) and company directors can deduct premiums in similar amounts as a business expense. Once you are Spanish-resident the insurance does not interact with UK tax. We are not tax advisers; check with a Spanish gestor or accountant before claiming.
These are Generali's two main health insurance products for expats in Spain and they serve different purposes. Salud Opción Premium is the flagship Spanish-market plan — no waiting periods from day one, no co-payments, visa-compliant for NLV/DNV/NIE/TIE, available up to age 65 at entry. All documentation is in Spanish. It is our most popular plan for residency applicants. EXPAT Medcare (Standard, Prime and Top) is Generali's dedicated English-language range — English app, English policy documents, English customer service, and available up to age 74 at entry. It has short waiting periods for some benefits (3 months hospitalisation, 8 months maternity) unless waived. Both use the same broad Generali + Sanitas/Bupa medical network. The right choice depends on your age, visa status, language preference and budget. We always compare both and give you a clear recommendation.
Yes — but the coverage of pre-existing conditions varies significantly between plans. Salud Opción Premium covers many chronic and pre-existing conditions from day one (this is one of its key strengths), though specific exclusions may be applied individually after underwriting review. EXPAT Medcare applies a standard waiting period for some conditions and may exclude or load pre-existing conditions depending on severity. Conditions typically reviewed at underwriting include: diabetes, cardiovascular disease, cancer history, mental health conditions, musculoskeletal disorders and respiratory conditions. The important point is that a declaration of a pre-existing condition does not automatically mean rejection — it means an individual underwriting decision. We handle this process on your behalf and always submit to multiple plans to find the best outcome for your situation.
Yes — 24/7 telemedicine (teleconsulta) is included in all Generali health insurance plans at no extra cost. You can consult a GP or medical specialist by video call or phone from anywhere in Spain, or abroad during travel. The Generali EXPAT Medcare plans offer telemedicine in English — a significant differentiator for expats who are not yet fluent in Spanish. Telemedicine consultations can result in electronic prescriptions, referrals to in-network specialists, and sick notes (baja médica) valid in Spain. It is also useful for minor children's illnesses, repeat prescription renewals, and getting a specialist opinion before deciding whether to attend in person. In practice our clients find telemedicine covers 40–60% of their routine health needs without leaving home.
For expats permanently residing in Spain, a locally-issued Generali plan almost always outperforms international plans (BUPA Global, AXA International, Cigna) on price, network access and visa compliance. International plans are designed for mobile professionals moving between countries — their premiums are typically 30–60% higher than equivalent local Spanish plans for the same treatment access. More practically: BUPA Global and AXA International plans are not inherently visa-compliant for Spanish NLV/DNV purposes without a specific Spain-compliant endorsement; Generali EXPAT Medcare and Salud Opción Premium are purpose-built for Spanish residency requirements. The main reason to consider an international plan is if you split time between Spain and another country, or if you have a specific hospital outside Spain you need covered. For full-time Costa Blanca residents, a Generali local plan with the Sanitas dual-network access gives broader in-Spain coverage at a fraction of the international premium.
Most Spanish private health insurers stop accepting new applicants at age 65. Generali EXPAT Medcare accepts new applicants up to age 74 — the highest entry age of any English-language private health insurance plan in Spain. For those already over 74, options become limited: some insurers offer renewal-only cover for existing policyholders over 75, and there are specialist senior health insurance products available on a case-by-case basis. If you are approaching 74, taking out EXPAT Medcare before your birthday locks in continued cover without an upper renewal limit. Contact us to discuss options for over-75 health insurance in Spain — 966 461 625.
It depends on your nationality and visa type. For non-EU citizens applying for the Non-Lucrative Visa, Digital Nomad Visa or any other Spanish residency permit, private health insurance without co-payments is a legal requirement. For EU/EEA citizens registering as residents in Spain, private health insurance is not legally compulsory — but it is strongly recommended to avoid 3-12 month waiting lists for specialist appointments in the public system. For UK citizens post-Brexit, the position changed: S1 holders (pensioners) can access the public system, but most UK nationals moving to Spain will need private health insurance as part of their residency application. If you are moving to Spain and unsure what health insurance you need, call us on 966 461 625 for free advice.
The European Health Insurance Card (EHIC) — now replaced by the Global Health Insurance Card (GHIC) for UK nationals — is valid for emergency and medically necessary treatment during temporary visits to Spain. It is not accepted as a substitute for private health insurance for Spanish residency applications. Consulates explicitly require a policy from a DGS-registered Spanish private insurer. Furthermore, once you become a Spanish resident, the EHIC/GHIC is no longer valid for you to use in Spain — it only applies to temporary visitors. For Spanish residents, private health insurance covers the waiting list problem that the EHIC never addresses: specialist access, non-emergency diagnostics and elective procedures.
For British expats in Spain post-Brexit, the best health insurance depends on your residency status. If you hold an S1 form (UK state pensioner), you can access the Spanish public system — but most British expats still take out private health insurance to avoid waiting lists and access English-speaking doctors. For British expats applying for Spanish residency (NLV, DNV or non-Brexit residencia), a private policy without co-payments is required. Generali EXPAT Medcare is the most popular choice for British expats on the Costa Blanca — English-language documentation, English customer service, up to age 74, and the widest network of any expat health plan in Spain. Call us on 966 461 625 for a free quote tailored to your specific situation as a British expat in Spain.
Expat health insurance in Spain is private health insurance taken out by foreign nationals living in Spain — as opposed to tourist health insurance for short-term visitors. Expat health insurance covers GP consultations, specialist referrals, diagnostics, hospitalisation and surgery through a private medical network without waiting lists. For expats in Spain, the two main options are Generali EXPAT Medcare (designed specifically for foreign residents, English-language, up to age 74) and Salud Opción Premium (the Spanish-market plan with no co-payments, required for visa applications). Expat medical insurance in Spain differs from tourist travel insurance — it covers ongoing residency, not just emergency visits. Most English-speaking expats on the Costa Blanca choose expat health insurance as soon as they arrive in Spain, regardless of visa requirements, to access English-speaking doctors without waiting months for public system appointments.
Whether you need health insurance in Spain depends on your status. If you are applying for Spanish residency or any long-stay visa — including the Non-Lucrative Visa, Digital Nomad Visa or Golden Visa — private health insurance is mandatory. You cannot obtain the TIE card without it. If you already have residencia and are registered with Spain's public health system, private health insurance is optional but strongly recommended to avoid long waiting times. British expats who lost access to the EHIC after Brexit must have private cover unless they hold an S1 form. In practice, most expats in Spain do need health insurance.
Health insurance is mandatory in Spain for all non-EU nationals and many EU nationals applying for residency visas. The Non-Lucrative Visa, Digital Nomad Visa and Golden Visa all require proof of private health insurance from a DGS-registered insurer. EU citizens with reciprocal rights may qualify for public healthcare without private insurance, but most expats take out private cover regardless. For those already resident and registered with the Spanish public health system (SNS), private health insurance is optional — but highly recommended given waiting times for specialists and hospital procedures.
The best health insurance in Spain for expats depends on age, budget and whether you need the policy for a residency visa. The best health insurance companies in Spain for English-speaking expats are Generali (EXPAT Medcare and Salud Opción), Sanitas, Adeslas, DKV and Mapfre. Generali EXPAT Medcare is specifically designed for international residents and is widely regarded as among the best health insurance in Spain for British, Dutch, Norwegian and Irish expats — with English-language policies, English-speaking claims support and direct billing at major private hospitals across Spain.
The average cost of private health insurance in Spain ranges from €50–€90/month for adults under 40, €80–€130/month for ages 40–55, €120–€200/month for ages 55–65, and €180–€300/month for ages 65–75. The cost of private health insurance in Spain increases with age and varies by cover level and insurer. The cheapest health insurance in Spain for expats starts around €45–€60/month for young adults with basic cover. How much is health insurance in Spain for foreigners is the same as for Spanish nationals — there is no nationality loading. Adding dental cover increases premiums by €10–€20/month.
Health insurance in Spain with pre-existing conditions is available but the terms vary by insurer and condition. Most Spanish health insurance policies exclude pre-existing conditions for an initial 6–12 month waiting period, then cover them after this period. Some conditions may be permanently excluded. Declaring conditions accurately at application is essential — non-disclosure can void claims. Generali EXPAT Medcare is among the most flexible insurers for pre-existing conditions. If you have a specific condition, contact us on 966 461 625 and we can check which policies will cover it and on what terms.
Public healthcare in Spain (the SNS) is free at the point of use for residents registered with Spain's social security system and holding an SIP card. However, to register you must be employed and paying contributions, be self-employed (autónomo), or qualify through an S1 form (mainly UK state pensioners). Tourists and non-resident visitors are not entitled to free healthcare. Private health insurance in Spain is not free — it is a paid product — but it gives access to faster appointments, English-speaking specialists and private hospitals alongside the free public system.
Private health insurance in Spain works on a direct-billing model. You pay a monthly or annual premium. When you need care, you find an approved clinic using the insurer's app or helpline, attend the clinic showing your insurance card, and the insurer pays the clinic directly — no upfront payment on most plans. Some policies have small co-payments of €3–€20 per consultation. Prescriptions are generally not included. Emergency treatment is covered from day one. For planned hospital treatment, pre-authorisation from the insurer is usually required. Specialist referrals typically do not require a GP referral first — you can go directly to a specialist.
To get health insurance in Spain, contact Turner Insurance on 966 461 625 or use our contact form. We will ask for your date of birth, nationality, number of people to insure, and any pre-existing conditions. We provide a comparison of the most suitable Generali policies for your situation, confirm whether the policy meets any visa or residency requirements, and arrange the policy entirely in English. You do not need a Spanish NIE to start — your passport number is sufficient. The policy can be activated within 24–48 hours in most cases, and a certificate of insurance is issued immediately for visa applications.
Health insurance in Spain for over 75 is available but options are more limited and premiums are significantly higher. Most standard policies accept new applicants up to age 70 or 75 at entry. Above 75, specialist older-age policies with modified terms are required, and underwriting is individual — your health history determines the premium and exclusions. The cost of health insurance in Spain for over 75 typically ranges from €250–€450/month. Generali does offer cover for applicants over 75. If you are approaching or over 75 and need health insurance in Spain, call 966 461 625 — we will advise on the best available options for your specific situation.
Yes — health insurance in Spain for non-residents is available. You do not need to be resident in Spain to take out a Spanish private health insurance policy. Non-residents who own property in Spain, spend extended periods there, or are applying for residency can all take out health insurance. The policy can be issued using a passport number if no NIE is yet held. Non-residents who are EU citizens may also use their EHIC or GHIC card for emergency treatment during visits to Spain, but this does not cover routine private care or long stays.
Since Brexit, UK citizens living in Spain no longer have automatic access to public healthcare via the EHIC. UK citizens in Spain now need either: a private health insurance policy (required for residency applications and recommended for all long-term residents), or an S1 form from the UK government if they receive a UK state pension (the S1 funds their Spanish public health treatment). Health insurance for British expats in Spain is now one of the most important costs for UK nationals planning to live in Spain. Turner Insurance arranges Generali health insurance for UK citizens accepted by Spanish immigration authorities for all visa types.
Health insurance in Spain for US citizens must be from a DGS-registered Spanish insurer — US health insurance plans, including employer-sponsored plans with international coverage, do not satisfy Spanish visa or residency requirements. US citizens applying for the Non-Lucrative Visa or Digital Nomad Visa must show proof of a Spanish-registered health insurance policy with no significant gaps in cover. We arrange Generali health insurance policies for US citizens, with all documentation in English and policies accepted by Spanish consulates. Contact us on 966 461 625.
Retiring in Spain without health insurance is not recommended and is generally not possible if you need a residency visa. UK and EU retirees of state pension age who receive the full UK state pension may be entitled to an S1 form, which funds their Spanish public healthcare. Other retirees — including those retiring early, US retirees, or those below state pension age — must have private health insurance to obtain and maintain Spanish residency. Even retirees with S1 cover typically take out supplementary private health insurance for access to English-speaking specialists and shorter waiting times. Most expat retirees on the Costa Blanca have private health insurance regardless of their S1 entitlement.
More questions? Visit our complete FAQ centre with 90+ detailed guides, or contact us for free English-speaking advice.
How This Compares to the Competition
Honest comparisons help you make an informed choice. These figures are typical Spanish-market starting points and depend on age, area, cover level and individual circumstances.
Generali EXPAT Medcare vs International Health Insurance for Expats in Spain
How Generali's English-language expat plan compares to Sanitas Más Salud Plus International and DKV Integral. EXPAT Medcare is built specifically for international residents — full English documentation, claims app and customer service in English.
Feature
Generali EXPAT Medcare (Standard / Prime / Top)
Sanitas Más Salud Plus International
DKV Integral
English-language documentation
Full — policy, app, claims, customer service
Most documents English; calls primarily Spanish
Limited — Spanish primary
Maximum new-applicant age
74
65
70
Co-payments
None
None on Top tier
None on Integral tier
Visa certificate (NLV / DNV)
Currently via Salud Opción Premium only (admin) — we arrange the swap
Yes
Yes
Maternity waiting period
8 months
10 months
8 months
Telemedicine 24/7
Included
Included
Included
Worldwide travel emergency cover
60–90 days/trip, €30,000 cap
Included with international add-on
60 days/trip
Premium 35-year-old (no co-pay)
~€55/month
~€85/month
~€60/month
Premium 65-year-old (no co-pay)
~€140/month
~€220/month
~€175/month
Generali Salud Opción Premium vs Sanitas Más Salud and Adeslas Plena
How Generali's flagship Spanish-language no-copayment plan — the standard recommendation for visa applicants — compares against Sanitas and Adeslas, the two largest Spanish health insurers.
Feature
Generali Salud Opción Premium
Sanitas Más Salud
Adeslas Plena Extra
Visa-compliant (NLV / DNV)
Yes — our standard recommendation
Yes
Yes
Co-payments
None
None
None
Consulate certificate turnaround
24–48 hours
3–5 working days
5–7 working days
Network size (professionals)
51,000+ (shares Sanitas network)
44,000+
47,000+
Hospitals in network
240+
215+
230+
English-speaking GP filter in app
Yes — MI Generali app
Limited
Limited
Maximum new-applicant age
65
65
70
Maternity waiting period
8 months
10 months
10 months
Premium 35-year-old
~€48/month
~€55/month
~€50/month
Premium 65-year-old
~€135/month
~€175/month
~€155/month
Tax deduction for autónomos
Yes — up to €500/insured
Yes
Yes
Comparisons are based on publicly available product literature and our experience placing policies across the Spanish market. Premium estimates assume a healthy applicant on the Costa Blanca with no significant claims history. Contact us for a personalised, like-for-like quote.
Sources & References
This page references the following official Spanish regulatory and legal sources. These are the authoritative bodies and laws governing insurance products in Spain:
Dirección General de Seguros y Fondos de Pensiones (DGS) — Spanish insurance regulator. Confirms registration of insurance brokers (Andrew Turner: Registry C0467B54657010) and authorises all insurance products distributed in Spain.
Ley 50/1980 — Ley de Contrato de Seguro (BOE) — Spanish Insurance Contract Law. The primary legal framework governing all insurance contracts in Spain — defines duties, claims, cancellation rights and disclosure obligations.
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