Private Healthcare in Spain: How to Skip the Lines and Save Money

Spain’s public healthcare system is often praised internationally, including by the WHO. On paper, it looks excellent. However, in practice, the system is overburdened, which is reflected in waiting times: you might wait months for elective surgery or a consultation with a specialist.

If you have tried to book an appointment with a traumatologist through public insurance in Spain and were offered a slot three months away, you probably understand the frustration that led to this guide. Our goal is to help newcomers use Spanish medicine as effectively as possible, minimizing stress and unnecessary expenses.

Public health insurance in Spain

Public healthcare is available to everyone who contributes to the social security fund (employees or autónomos), as well as their family members. The main document here is the SIP card. This is where access to state medicine begins. It entitles you to free doctor visits and significant discounts on medications. Despite the high quality of emergency care, many expats choose additional private insurance for a more comfortable life.

Why pay for private insurance at all?

In Spain, private insurance is rarely about luxury — it’s mostly about time. It allows you to see a specialist directly, bypassing a general practitioner, and to do so within a few days.

Features

• Plans with co-payments (con copago): if you rarely visit doctors, choose this option. It has a low monthly cost, but a small amount (from 2 to 20 euros) is charged for each visit.
• Plans without co-payments (sin copago): ideal for families with children or those who frequently seek medical help. You pay a fixed monthly amount and don't have to worry about anything else.
• Waiting periods (carencia): usually from 3 to 10 months. During this time, certain services—such as surgeries or childbirth—are not yet covered.

What is included in most policies?

• Basic medicine: GP visits, tests, specialists, hospitalization, and emergency care are the core of almost any policy;
• Dentistry: many plans include basic dental services (extractions, cleaning, X-rays, sometimes fillings), or there is an option to add a dental package, which moderately increases the cost;
• Physiotherapy and rehabilitation: often included up to a certain limit of sessions (usually with a doctor's referral);
• Psychiatry: usually included up to a certain limit of visits (10–20), often via telemedicine;
• Other services: coverage may include cosmetology, vision checks/optics, mental health, family planning, etc. If you have a specific request, check for additional service coverage when comparing companies.

Clinics

• Quirónsalud: the largest private network in Spain (50+ hospitals). If you live in Madrid or Barcelona, chances are high that your insurer works with them.
• HM Hospitales: very strong presence in Madrid and Galicia. HM Sanchinarro Hospital is considered one of the best in the country.
• Vithas: a network of 20 hospitals. Their stronghold is the Valencian Community (6 hospitals in Valencia, Alicante, and Castellón), along with a strong presence in Madrid and Malaga.

Key players

• Sanitas (Bupa Group) — leader in service quality and digital solutions.
• Adeslas (SegurCaixa) — the largest network of doctors and clinics.
• DKV Seguros — known for their preventive medicine programs.
• Mapfre — a universal giant with its own centers.
• Asisa — a popular choice with a good balance of price and quality.

How locals actually use the system

Hybrid use of private and public systems

If you have public insurance through work, you might not need a "full" private policy. Consider plans without hospitalization (e.g., Sanitas Accede or DKV Famedic). As of now, such plans usually cost around 25–35 euros per month and allow quick access to consultations, while complex surgeries can be done through the state system.

Discounts from banks

Before buying a policy directly, check with your Spanish bank (BBVA, CaixaBank, Santander). They often offer their clients rates 10–20% cheaper than the market price.

Payment frequency

Almost all insurers provide a 2–8% discount if you pay quarterly, semi-annually, or annually instead of monthly.

Bonuses for autónomos

If you are self-employed, you can deduct up to 500 euros per year from your taxable base for medical insurance for each family member.

Hunting for "slots" in the app

Appointments with a good specialist can be booked a month in advance. Life hack: check the app early in the morning. People often cancel visits at the last moment, allowing you to book "same-day" appointments.

Reverse selection

First, choose a clinic you like or one that is closer to your home, and then see which insurance companies it works with.

Medications via SIP

Remember that the cheapest medications are those prescribed by a state clinic (centro de salud). For this, you need a residence registration (empadronamiento) and registration in the social security system.

Selection algorithm

1. Determine your budget: are you willing to pay for each visit (copago) or do you want fixed expenses?
2. Check the location: see which hospital groups (Quirón, HM, Vithas) dominate your city.
3. Study the carencia: if you are planning a pregnancy or surgery soon, look for a policy with a minimal waiting period.
4. Finally, check bank offers: sometimes that is where you find the most favorable rate.
5. When filling out the questionnaire, always be honest about chronic diseases. If the insurer discovers a concealed diagnosis, they may cancel the policy at the most critical moment.