How much to budget for healthcare and medicines each year in Spain

Terms used

• Convenio Especial — The Convenio Especial is a paid public health scheme for residents without other cover, with a monthly fee set by age.
• Sin copago — Sin copago means a private policy with no charge per visit, in exchange for a higher premium.
• Con copago — Con copago means a private policy with a lower premium and a small charge each time you use it.
• Carencias — Carencias are waiting periods after you buy a private policy before certain care is covered.
• Cuadro médico — The cuadro médico is the insurer's list of doctors and hospitals you may use under your policy.
• Condicionado general — The condicionado general is the full set of conditions and exclusions in a private insurance policy.
• Consejería de sanidad — The consejería de sanidad is your region's health department.

Key rules

• 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.
• No cover: One hospital stay or surgery at private rates can cost thousands of euros.
• Region: Your region sets extras, waiting times and refunds, so costs differ across Spain.

The short answer

Your budget depends mostly on your cover route. The public route is cheapest, but you still pay for dental, glasses and medicines. Private insurance adds a premium you can plan for. No cover is the only route where one event can cost thousands of euros.

The calculator below turns these lines into a figure for your household. The checklist lists every line to include.

Public system

If you are a legal resident with a health card, you use the public system run by your region. Cover can also come through work, a pension, EU rights or the Convenio Especial.

A household using only the public system typically spends several hundred euros up to roughly 1,000 euros a year. These are averages, not an official benchmark. Spending varies with income, age and region.

What drives that figure:

• Dental care. Public care mostly covers extractions and basic treatment. Fillings, crowns and implants are paid by you.
• Glasses and contact lenses. Mostly paid by you.
• Medicines. You pay a copayment on each prescription. Regular medicines for a chronic condition add up over a year.
• Physiotherapy, psychology and hearing aids. Mostly paid privately.

If you join the Convenio Especial, add its monthly fee, which is set by age.

Private insurance

Add the premium, which is priced by age, then the costs the policy does not cover. Policies come in two types:

• Sin copago has no charge per visit and a higher premium.
• Con copago has a lower premium and a charge per use. Expect around 3-15 euros per GP or specialist visit, and more for tests or procedures. Many policies cap the yearly total.

Things that catch people out:

• Medicines are generally not covered outside hospital, so keep a medicines line.
• Dental care beyond the basics is usually excluded, so keep your dental line.
• Pre-existing conditions you did not declare, cosmetic surgery, fertility treatment and experimental treatments are common exclusions.
• Waiting periods (carencias) are common. Expect months for hospitalisation and surgery, and around 8-10 months for childbirth. GP visits sometimes have none. Pay for care yourself during the wait, or use the public system.
• Care is usually limited to the insurer's network (cuadro médico). Out-of-network care is your cost.

Terms differ by insurer, so read the policy conditions (condicionado general) before you sign. If your visa needs private insurance, the policy must have no copays and no waiting periods. That means the sin copago type.

No cover

Going without cover is legal but not advised. Non-residents and irregular migrants get emergency care, plus care for minors and pregnant women. For anything else you pay private rates.

A routine private GP or specialist visit usually costs a few dozen euros. Tests and imaging cost more. A hospital admission or surgery can run to thousands of euros. A healthy adult with occasional visits spends a modest amount. A household with children, a chronic condition or any surgery can spend several times that. One major event can cost more than many years of premiums.

How your region changes the budget

Health is run by the 17 autonomous communities, so costs differ by where you live. The basic pharmacy copayment scheme is national. Regions differ in extra exemptions, added benefits and how they refund excess copayments to pensioners. Some add free or subsidised dental or vaccine programmes. Waiting times and the vaccination calendar also differ.

Check what your region offers with its health department (consejería de sanidad) before you finalise the budget.

Other lines to remember

• Private specialists, diagnostic tests and orthopaedic items.
• Non-urgent ambulance transport.
• Over-the-counter medicines.
• Vaccines outside the official calendar.
• Travel or repatriation cover.

Build it in this order

1. Pick your cover route and enter its monthly cost.
2. Add medicines for everyone in the household.
3. Add dental, glasses and any therapy you expect.
4. Add a cushion for private visits and tests.
5. Check your region's extras and adjust.

The timeline below shows when hospital and childbirth cover start under a private policy.

Timeline and deadlines

• Use GP visits straight away: Often with no waiting period, though this varies by policy

• Plan for hospitalisation and surgery cover to start: After a waiting period (carencia) of often several months

• Plan for childbirth cover to start: After around 8-10 months of waiting period

Health costs to include in your Spanish budget

• Add your monthly cover payment: private insurance premiums, Convenio Especial fees or Social Security contributions.

• Add pharmacy copayments for every regular prescription, and chronic-care supplies.

• Add one or two dental check-ups a year.

• Add dental work, which the public system mostly does not cover beyond extractions and basic care.

• Add glasses and contact lenses, which the public system mostly does not cover.

• Add physiotherapy, psychology and hearing aids, which are mostly paid privately.

• Add private specialist visits and diagnostic tests you expect in a year.

• Add orthopaedic items, non-urgent ambulance transport and private room upgrades.

• Add insurance copayments and bills from private or out-of-network hospital stays.

• Add over-the-counter medicines, which are not prescribed and not covered.

• Add travel or repatriation cover and vaccines outside the official calendar.

• Mark each cost as monthly, quarterly or yearly, and total it by the year.

• Look up prices for the non-covered lines in the other guides on this topic and add them.

Annual health budget calculator for your household

Work it out

What you enter

• Monthly full price of medicines for household members who are working (EUR): Your prescriptions and pharmacy receipts, at the full price before the discount.
• Share of the price a working member pays, as a percentage (%): Use 40 if income is below 18,000 euros, 50 from 18,000 to 100,000 euros, 60 at 100,000 euros or more.
• Monthly cap for pensioner medicine payments (EUR): Ask your regional health service. Roughly 8.23 euros for income below 18,000 euros, 18.52 euros for 18,000 to 100,000 euros, 61.75 euros above.
• Private GP visits per year (visits): Your own estimate from last year's visits.
• Price of one private GP visit (EUR): Clinic price lists. Typically 40 to 80 euros.
• Price of one private specialist visit (EUR): Clinic price lists. Typically 60 to 120 euros.
• Yearly spend on private tests such as blood panels, ultrasounds or MRI (EUR): Quotes from clinics near you.
• Monthly private insurance or Convenio Especial payments for the whole household (EUR): Your insurance policy or your Convenio Especial payment notice.
• Yearly spend on dental, glasses, physiotherapy and other costs (EUR): Quotes from providers or last year's receipts.

Figures used

• Share of the price a pensioner pays: 10 % (as of 2025)
• Months in a year: 12 months

Worked example (with Monthly full price of medicines for household members who are working 40 EUR, Share of the price a working member pays, as a percentage 40 %, Monthly full price of medicines for pensioners in the household 120 EUR, Monthly cap for pensioner medicine payments 8.23 EUR, Private GP visits per year 3 visits, Price of one private GP visit 60 EUR, Private specialist visits per year 2 visits, Price of one private specialist visit 90 EUR, Yearly spend on private tests such as blood panels, ultrasounds or MRI 150 EUR, Monthly private insurance or Convenio Especial payments for the whole household 150 EUR, Yearly spend on dental, glasses, physiotherapy and other costs 400 EUR)

When the sum misleads

• Working members have no monthly cap, so a costly medicine raises your bill in full at your percentage.
• Leave private visits at zero if you use public care only.
• Some chronic-treatment medicines carry a lower payment or are free, so check your prescription before relying on the full percentage.
• Newer branded medicines such as insulin pens or inhalers cost far more than generics, so use the real pharmacy price.

Frequently asked questions

Does private health insurance cover all my medicine costs?

No, private health policies generally do not cover medicines bought outside hospital, so you still pay for them. Budget for pharmacy costs on top of your premium. Policies with copays (con copago) also charge a few euros, around 3-15, per GP or specialist visit.

How much does a household spend on health each year using only the public system?

A typical household using only the public system spends several hundred to roughly 1,000 euros a year. Dental and optical care are the main drivers, followed by medicines and private specialists. These are averages, so your own figure depends on income, age and region.

Do health costs differ between Spanish regions?

Yes, health is run by the 17 autonomous communities, so extra exemptions, supplementary benefits and refund systems can differ. Some regions add free or subsidised items, such as extra dental or vaccine programmes. Ask your regional health service (consejería de sanidad) what applies where you live.

What can a household with no cover at all end up paying?

A household with no cover pays private rates for everything except emergency care, and a hospital stay or surgery can run to thousands of euros.