Your annual health budget

It is for anyone thinking about, planning or carrying out a move to Spain. You will leave with a realistic yearly health budget for your household and cover route.

Start with "How much to budget for healthcare and medicines each year in Spain". It gives you the base budget that the other pages build on.

Then pick the page that fits your situation:

• "Health budget for retirees and long-term conditions" if you expect higher medicine and care spending.
• "Paying out of pocket while waiting for your health card" if you are about to arrive and cover is not yet working.
• "What a serious health event costs with nothing covering you" if you want to size a safety buffer.

Premiums and tax treatment, prices for dental, vision and therapy, and your whole first-year cash runway are covered elsewhere.

Key rules

• Pensioner copay: Pensioners with public cover pay 10% of a medicine's price, up to a monthly cap that depends on income.
• Worker copay: Active workers pay 40% of a medicine's price below 18,000 euros of income, 50% from 18,000 to 100,000 euros, and 60% at 100,000 euros or more, with no monthly cap.
• Emergency care: Emergency care in public hospitals is guaranteed to everyone until discharge, but the hospital may still bill you when no insurer or agreement pays.
• Public route: Expect to pay for dental, glasses and prescription copayments even if you use the public system.
• Visa policy: A private policy for a non-lucrative visa must have no copays and no waiting periods.
• S1 holders: A retiree with an S1 or a Spanish pension is treated as a pensioner; one with neither usually pays 40% to 60%.

Documents you may need

• Padrón certificate — Paying out of pocket while waiting for your health card

• NIE: your foreigner identification number — Paying out of pocket while waiting for your health card

• Proof of Social Security registration — Paying out of pocket while waiting for your health card

Your annual health budget: questions that cross several articles

Which health cover routes can my household choose between in Spain?

Your household can choose public cover, private insurance or no cover at all. Public cover is open to legal residents registered in a municipality with a health card, while private insurance is open to anyone the insurer accepts. Going without cover is legal but not advised, and non-EU visa applicants for non-lucrative residence must hold a private policy with no copays and no waiting periods.

How much does a household using only the public system spend a year out of pocket?

A typical household figure is several hundred euros to roughly 1,000 euros a year. Most of it goes on dental care, optical items, medicines and private specialists, not on public care. Read "How much to budget for healthcare and medicines each year in Spain" to build your own figure.

What should I expect to pay while I wait for my health card?

Until your card works, you may have to pay private rates for care other than emergencies. Prices are usually a few dozen euros for a routine GP or specialist visit, and more for tests and imaging. Read "Paying out of pocket while waiting for your health card" to plan that gap.

Does private insurance mean I pay nothing more for care?

No, a policy without copays has higher premiums but no charge per visit, while a policy with copays typically charges around 3-15 euros per GP or specialist visit. Waiting periods, exclusions such as pre-existing conditions and most dental care, and medicines outside hospital can still cost you.

Do retirees pay less for medicines than people who work?

Yes, pensioners with public cover pay 10% of a medicine's price, up to a monthly cap that depends on income. Medicines that are not publicly financed, such as most over-the-counter products and many vitamins, are still paid in full. Read "Health budget for retirees and long-term conditions" for the caps and exemptions.

What happens if I have a serious health event with no cover?

Emergency care in public hospitals is guaranteed to everyone until discharge, but the hospital may still bill you when no insurer or agreement pays. See How much to budget for healthcare and medicines each year in Spain.