Learn about public, private and employer sponsored health insurance in Spain
SafetyNest Inc. and its affiliates do not provide tax, legal or accounting advice. This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, tax, legal or accounting advice. You should consult your own independent tax, legal and accounting advisors before making any decisions or engaging in any transaction.
How does healthcare work in Spain?
In Spain, the public health insurance system is known as the "Sistema Nacional de Salud" (SNS). The SNS provides universal healthcare to all Spanish residents, including citizens and legal residents. It is funded through general taxation and provides comprehensive medical services, including primary care, specialist care, hospitalization, emergency care, and many medications.
🟢 Services covered by the SNS
Medical consultations with general practitionersÂ
Vaccinations and immunizations
Regular health check-ups for conditions such as hypertension, diabetes, and cancer
Family planning and reproductive health
Health education and counseling on lifestyle choices, disease prevention, and self-care management
Referrals to specialists for further evaluation or treatment
Physical therapy after illness or surgery
Basic dental care for children and emergency dental care for adults
🛑 Services not covered by the SNS
Orthodontics and non-emergency dental care
Some prescription medications including certain expensive or non-essential drugs
Alternative therapies such as acupuncture, chiropractic care, and homeopathy
Non-emergency medical treatments obtained outside of Spain
Private hospital rooms
Treatments or procedures that are not considered medically necessary or are considered experimental
Non-essential cosmetic surgeries and treatments, such as elective plastic surgery or aesthetic procedures
Insurance for expats
Foreign nationals who are legal residents of Spain, including those with work permits, student visas, or long-term residence permits, can access the public health system.
Citizens of EU member states have access to the SNS through the European Health Insurance Card (EHIC) or the new European Health Card (EHC).
Expats may also choose to use private health insurance in Spain which can provide additional health services including comprehensive dental and access to private facilities.
Private health insurance
About 20% of people have private health insurance in Spain. Private health insurance gives members access to faster treatment, private facilities, and more healthcare provider options. Over 90% of dental professionals work in the private sector in Spain and residents can choose to pay out of pocket for their services or use private health insurance to cover the cost of dental care.
Health insurance for employees in Spain
While employer-sponsored private health insurance is not required in Spain, it is an attractive employee benefit. It can offer access to comprehensive dental care as well as expedited medical treatment.
There are several options for private health insurance in Spain. For international companies, a global group health insurance plan may be a good fit because one plan can be used to cover an entire global workforce. This single plan approach to health insurance means minimal administrative work and equitable benefits for a global team.
Employee benefits tax in Spain
According to the Personal Income Tax Act (Law 25/2006), health benefits such as health insurance are considered a benefit in kind in Spain. Since benefits are considered to be income, benefits in kind are subject to the Personal Income Tax Act rules and subject to Personal Income Tax. However, the amount paid as benefits in kind cannot exceed 30% of an employee's salary.
Benefits in kind must meet the following requirements to be considered as such:​
They must be used just for private purpose, not only for professional activity​
They must be the result of a current employment relationship
They cannot exceed 30% of employee's salary
​They must be assessed as per Personal Income Tax Act rules.
Health benefits which cover employees or relatives are assessed as per employer cost. The first €500 a year are tax free and amounts above €500 are taxable as per employee tax brace. The tax free amount can be extended to €1500/year if an employee or any family member has a disability.
Interested in providing global health coverage to your team? Chat with us!
If you’re looking for coverage for yourself and your family, check out Nomad Health.
Laura Scott
Head of Marketing, Remote Health at SafetyWing
As the marketing lead in our Remote Health team, Laura specializes in product marketing, project management and lead generation.
Laura Scott
Head of Marketing, Remote Health at SafetyWing
As the marketing lead in our Remote Health team, Laura specializes in product marketing, project management and lead generation.
