This guide explains how Spanish healthcare works for British people moving to Spain. It covers access to public healthcare, when private health insurance is required, how registration works, and the key differences compared with the NHS, helping you plan cover before and after relocation.
While Spanish healthcare is high quality and widely accessible, it operates on different principles and administrative requirements compared with the NHS. This guide explains how public healthcare works, when you need private health insurance, and how to register once you arrive.
Spain’s public healthcare system, the Sistema Nacional de Salud (SNS), provides comprehensive medical care to residents, including primary care, specialist treatment, hospital care and emergency services.
There are several key differences from the NHS that British people moving to Spain should understand.
Unlike the NHS, access to Spain’s public healthcare is not automatic based on residence alone. Eligibility depends on your legal residency status and, in many cases, whether you contribute to the Spanish social security system.
Registration is required before you can use public healthcare services. Until this process is complete, you may not be able to access routine care.
Some services, including dental care, optical services and certain prescriptions, are not fully covered and often require private insurance or out-of-pocket payment.
Healthcare is administered at a regional level, meaning processes and access can vary slightly depending on where you live.
Eligibility for public healthcare depends on your circumstances.
If you work in Spain and make social security contributions, you and your dependants are generally entitled to public healthcare coverage.
If you receive a UK State Pension and live in Spain, you may be able to register an S1 certificate. This allows access to Spanish public healthcare without paying into the Spanish social security system.
If you are not working or paying social security contributions, you may still be able to access public healthcare through a special agreement by paying a monthly fee. This provides access to the public system but does not cover all services.
Access to public healthcare involves several administrative steps, which usually need to be completed in order.
Your foreigner identity number is required for almost all official processes in Spain, including healthcare registration.
You must register with your local town hall. This confirms your habitual residence and is often required for healthcare and social security registration.
If you are working, this is usually done through your employer or your self-employment registration. If you are using an S1 certificate or joining through a special agreement, registration is handled directly with the social security office.
Once registered, you can apply for a health card at your local health centre. This card allows you to access public healthcare services.
Private health insurance plays an important role for many British people moving to Spain.
In some cases, it is a legal requirement. Certain visas, such as non-lucrative or digital nomad visas, require comprehensive private health insurance with full coverage and no co-payments.
Even where public healthcare is available, many residents choose private insurance for faster access to specialists, shorter waiting times and greater choice of doctors and hospitals. Private cover can also make healthcare easier to navigate if Spanish is not your first language.
Costs vary depending on age, medical history and level of cover, but basic policies are often affordable, particularly for younger and healthier applicants.
For short stays or during the initial period before full registration, British citizens may be able to access emergency healthcare using a UK-issued health card. However, this does not replace full healthcare cover and is not suitable for long-term residence.
While many residents in Spain will eventually qualify for public healthcare, private health insurance is essential during the early stages of relocation, particularly for visa applications (such as non-lucrative, student, digital nomad or other residence permits) and before you are fully enrolled in the Spanish system.
Feather offers expat-focused health insurance plans designed specifically for people who are moving to Spain and need straightforward, compliant coverage right away. Plans are available for retirees, students, digital nomads, freelancers, and people not immediately working in Spain, with monthly premiums starting from around €45–€60 depending on age, visa type and coverage level.
The policies are structured to cover key medical needs such as accidents, emergencies, sudden illness, prescribed medication, ambulance transport and repatriation, and they can be tailored for visa-compliant documentation that meets Spanish embassy and residency requirements.
One practical benefit is that everything is managed online and in English, from getting a quote to downloading the official insurance documents you need for consulate appointments.
Get a quote for expat health insurance in Spain — a quick, online process with plan options suited to your situation
Please note that Feather are a partner of Experts for Expats and if you proceed with health insurance, we may receive a small fee.
