Health Insurance for Children in Spain: A Practical Guide for Expat Families

If your family is entitled to use Spain's national health system (SNS), care is generally delivered in the public sector and is described as free at the point of delivery. That said, 'free' doesn't always mean 'no costs ever.' Some areas (like medicines or certain items) can involve cost-sharing depending on your status. The most important step is confirming entitlement in your region and understanding how your local primary care centre works, because primary care is the usual first point of contact for children.

Often yes—but 'cover' depends on the plan structure. Some policies are network-based (you choose from a list of doctors/clinics). Others are reimbursement-based (you pay first, then claim back). The key is to confirm how paediatric appointments are booked, whether specialists need approvals, and what counts as in-network care. Also check waiting periods for certain services; many private policies include 'carencias' for higher-cost care.

Spain has a common recommended vaccination calendar coordinated through the national health system, and the Ministry of Health publishes the framework and updates. Coverage and delivery can still vary by autonomous community in terms of logistics, but the national calendar gives you a clear baseline. Even if you prefer private paediatric clinics, many families follow the public vaccination schedule because it's the standard reference.

Sometimes, but it depends on underwriting. Private insurers may exclude pre-existing conditions, apply restrictions, or request medical history before acceptance. This is exactly why families should avoid buying a policy 'last minute' when a problem already exists. Waiting periods can also apply for specific services in private health insurance. If you already know your child needs ongoing care, the best step is to compare policies carefully (and get the exclusions in writing) before you decide.

No—there's significant variation. Some plans include children at reduced rates on family policies, while others charge per child. Coverage details also differ: paediatric specialist access, therapy services, and dental add-ons vary between insurers. Network size matters too; a plan with excellent adult coverage may have limited paediatric specialists in your area. Always check the specific children's coverage section of any policy before committing.

Most private insurance policies include 24/7 emergency coverage, but the key is knowing which hospitals are in your network. In a genuine emergency, you can typically go to any hospital and the insurer will cover it. For urgent but non-life-threatening situations, check your policy's rules—some require pre-authorization or direct you to specific urgent care centres. Keep the insurer's 24h helpline number saved in your phone for guidance during emergencies.

Usually yes, but timing and conditions vary. Many insurers require you to add a newborn within 30-60 days of birth to avoid new underwriting. Some policies automatically cover newborns for the first month. The key is to notify your insurer promptly and understand whether the baby inherits your policy's waiting periods or starts fresh. Ask your insurer specifically about newborn addition procedures before the birth if possible.

Private insurance typically covers the medical examinations required for school certificates and sports participation. Many families use their private paediatrician for these routine checkups because appointments are faster to schedule. Check whether your plan requires using specific clinics for certificate issuance or if any paediatrician in the network can provide them. Schools may have specific form requirements, so ask beforehand.

Coverage varies significantly. Some comprehensive family plans include speech therapy, occupational therapy, and physiotherapy for children, while basic plans may exclude or limit these services. If your child needs ongoing therapy, this should be a key comparison point when selecting insurance. Check session limits (some plans cap at 20-30 sessions per year), whether pre-authorization is needed, and if the plan's network includes qualified paediatric therapists in your area.

Orthodontics is usually not included in standard health insurance—it's typically a dental add-on or separate dental policy. Some family plans offer basic orthodontic coverage with significant co-payments. If braces or orthodontic treatment is likely for your child, ask specifically about dental coverage options when comparing plans. Be prepared for waiting periods of 6-12 months before orthodontic benefits become available.

Copay plans charge a small fee (€3-15) per visit or service, but have lower monthly premiums. No-copay plans have higher premiums but nothing to pay at the point of care. For families with children who visit the doctor frequently (colds, ear infections, routine checkups), a no-copay plan often works out cheaper overall. For families who rarely need care beyond annual checkups, a copay plan might save money. Calculate based on your family's typical usage patterns.

Start by requesting official copies of records from your previous healthcare providers—vaccination records are especially important. Have documents translated into Spanish by a certified translator if needed. Your new paediatrician in Spain can review these records and integrate relevant information into your child's Spanish medical file. The vaccination record is critical to ensure your child's schedule is properly continued or adjusted according to Spain's calendar.