Top 6 Health Insurers Compared
These six insurers dominate the Spanish private health insurance market and are the most commonly used by expats. Here's how they compare across key factors.
| Insurer | Network Size | English Support | From (Monthly) | Visa Compliant |
|---|---|---|---|---|
| Sanitas | 44,000+ professionals | Good (coastal/cities) | EUR 55/mo | Yes |
| Adeslas | 40,000+ professionals | Moderate (costas) | EUR 50/mo | Yes |
| DKV | 30,000+ professionals | Excellent | EUR 65/mo | Yes |
| Cigna | International network | Excellent (fully) | EUR 90/mo | Yes |
| Asisa | 35,000+ professionals | Limited | EUR 45/mo | Yes |
| Mapfre Salud | 32,000+ professionals | Limited | EUR 50/mo | Yes |
Prices shown are starting rates for copay plans (con copago) for a healthy 30-35 year old. Copay-free (sin copago) plans cost 20-40% more. Prices increase with age.
Insurer Profiles: Strengths and Weaknesses
Sanitas -- Best Overall Network
Strengths:
- - Largest private healthcare network in Spain
- - Own hospitals and clinics (Sanitas brand)
- - Strong digital app with appointment booking
- - Video consultations available
- - Good English support in major cities
Weaknesses:
- - Limited English outside coastal/urban areas
- - Referral required for some specialists
- - Premium pricing for copay-free plans
- - Age limit: typically 69 for new clients
Best for: Expats in major cities who want the widest choice of doctors and hospitals.
Adeslas -- Best Value Large Network
Strengths:
- - Second-largest network, strong across Spain
- - Competitive family plan pricing
- - Good maternity and pediatric coverage
- - Multiple plan tiers for different budgets
- - Dental add-on available
Weaknesses:
- - English support mainly on costas
- - Bureaucratic claims process
- - Some plans have strict referral pathways
- - Age limit: typically 65 for new clients
Best for: Families and budget-conscious expats who want a big network without paying top prices.
DKV -- Best for International Expats
Strengths:
- - Dedicated international client department
- - Excellent English-language service
- - Flexible reembolso (reimbursement) options
- - Strong mental health coverage
- - Good alternative medicine coverage
Weaknesses:
- - Smaller network than Sanitas/Adeslas
- - Higher premiums for top-tier plans
- - Limited own hospitals (network-based)
- - Age limit: typically 65-70 for new clients
Best for: Expats who prioritize English service and flexibility over the absolute lowest price.
Cigna -- Best Fully International Coverage
Strengths:
- - Fully international company and service
- - Coverage often valid beyond Spain
- - 24/7 English customer service
- - Direct billing at many hospitals
- - Comprehensive wellness programs
Weaknesses:
- - Most expensive option
- - Smaller local Spanish network
- - Some plans require referral for specialists
- - May not satisfy all visa requirements -- check specific plan
Best for: International professionals and expats who travel frequently and want seamless English service.
Best Health Insurance by Situation
Best for Singles (Under 40)
If you're young, healthy, and want basic coverage:
- Top pick: Asisa Integral -- strong coverage from EUR 45/month
- Runner-up: Adeslas Completa -- wider network, EUR 55/month
- Copay plans offer the best value at this age
- Add dental separately for EUR 8-15/month
Best for Families
If you have children and need pediatric/maternity coverage:
- Top pick: Sanitas -- best pediatric network
- Runner-up: Adeslas -- competitive family pricing
- Family of 4: EUR 180-350/month (plan dependent)
- Check maternity waiting periods (usually 8-10 months)
Best for Visa Compliance
If you need copay-free insurance for a non-lucrative or digital nomad visa:
- Top pick: Sanitas sin copago -- widely accepted by consulates
- Runner-up: DKV Integral -- excellent for non-EU applicants
- Must be copay-free (sin copago / sin coparticipacion)
- Ensure policy letter explicitly states "full coverage in Spain"
Best for Retirees (60+)
If you're over 60 and need reliable, long-term coverage:
- Top pick: DKV -- higher age acceptance limit
- Runner-up: Sanitas -- if you can enroll before 69
- Sign up as early as possible -- switching later is hard
- Budget EUR 120-300/month depending on age and plan
How to Choose the Right Insurer
Step 1: Define Your Priorities
Is price most important? English support? Network size? Visa compliance? Rank your top 3 priorities before comparing.
Step 2: Check the Network in Your Area
Use each insurer's online provider finder to check how many doctors and hospitals are near you. The best insurer nationally may have poor coverage in your specific town.
Step 3: Compare Like-for-Like Plans
Compare copay vs copay-free plans separately. Look at the same coverage level across 3-4 insurers. Check waiting periods for pre-existing conditions and maternity.
Step 4: Read the Fine Print on Exclusions
Check what's excluded: mental health limits, physiotherapy session caps, dental, optical, and any age-related restrictions. These vary significantly between insurers.
Step 5: Use a Broker for Free Comparison
A licensed broker can compare all major insurers, explain the differences in plain English, and handle your application -- at no extra cost to you. Brokers are paid by insurers, so the price is the same as going direct.
Common Mistakes When Choosing Health Insurance
Choosing solely on price
The EUR 35/month plan may save money upfront but could have a tiny network, long waits, and poor service
Not checking visa compliance
Plans with copays (con copago) won't satisfy visa requirements -- always confirm before buying
Ignoring age limits
If you're over 55, sign up now -- waiting makes it harder and more expensive to get accepted
Not disclosing pre-existing conditions
Hiding conditions can void your entire policy when you need it most -- always be transparent
Assuming all plans include dental
Most health plans exclude dental care entirely. Budget for separate dental insurance (EUR 8-20/month)
Forgetting to check the local network
A great insurer in Barcelona may have limited options in your Andalusian village -- check before signing