What therapy costs in Spain and what insurance covers

Key rules

• Public care: Visits with your GP, psychiatrist and clinical psychologist in the public system are free, but you need a GP referral.
• Private session: Expect to pay 50–80 euros for a private psychology session and 80–150 euros for a first psychiatrist visit.
• Insurance limits: Insurers often cap yearly psychology sessions, may require a referral, and basic plans may exclude therapy.
• Medication: Prescriptions are not free in the public system; your share depends on your income and work or pension status.

The short answer

Public care is free at the point of use. Private therapy is charged per session. Private insurance often covers psychology, but with limits, so read your policy before you count on it.

Public care

If you are covered by the public health system, visits to your GP, a psychiatrist and a clinical psychologist cost nothing. You start with your GP (médico de cabecera). The GP refers you to the community mental health unit. Ask your GP how long the wait for psychology is, because it can be long.

Medication is not free. What you pay depends on your income and status:

• Working people pay 40% of the price if their income is under 18,000 euros, 50% between 18,000 and 100,000 euros, and 60% above 100,000 euros.
• Pensioners pay 10%, with a monthly cap that rises with income. Recent caps were roughly 8.23, 18.52 and 61.76 euros.
• People on minimum-income benefits and some other groups pay nothing.
• Drugs for chronic treatment are paid at a reduced 10%, with a cap.

Private sessions

A private psychology session of about 50 to 60 minutes typically costs around 50–80 euros. A first psychiatrist visit costs roughly 80–150 euros.

Prices move with the place and the therapist:

• Madrid, Barcelona and the Balearics sit at the top, often 60 to 100 euros or more for experienced or English-speaking therapists.
• Smaller cities and other regions can be 40 to 60 euros.
• Online sessions are often a little cheaper.
• Some therapists offer a sliding scale or a bonus pack of sessions. Ask.

Weekly sessions add up fast, so multiply the price by the number of weeks you expect to attend.

What private insurance covers

Large insurers usually cover psychology and psychiatry in their comprehensive plans. Expect these limits:

• A fixed number of psychology sessions per year.
• A referral from your GP or a psychiatrist, or prior authorisation, before you start.
• In some plans, a copayment on each session. Plans labelled copago carry this kind of charge.
• Basic plans may leave out psychotherapy or cover it only with a restricted network of providers.

Caps and copayments differ by insurer and product, and many change every year. Ask for the current figures in writing.

If you are taking out a new policy

Insurers often apply waiting periods (carencias) before some services start. These can run several months, and sometimes apply to psychotherapy and psychiatric care. You will usually fill in a health declaration. A known mental health diagnosis may lead to an exclusion, a higher premium or a refusal, depending on the insurer. Some plans cap psychotherapy for certain conditions, and long psychiatric hospital stays are often limited. Waiting periods can sometimes be waived if you move from another insurer or join a group policy.

Use the checklist below to run through these questions before you book or sign.

Checklist

• Ask each private therapist for their price per session and session length before you book.

• Ask whether the therapist offers online sessions, a sliding scale or a bonus pack of sessions.

• Ask your GP for a referral if you want free public care, and ask how long the wait for psychology is.

• Check what share of your prescription cost you pay, based on your income and work or pension status.

• Read your insurance policy to find the yearly psychology session limit and any per-session copayment.

• Ask your insurer whether you need prior authorisation or a referral before your first session.

• Check whether your plan covers psychotherapy at all, and whether you must use its provider network.

• Check for waiting periods and pre-existing condition exclusions before you take out a new policy.

Frequently asked questions

Do I pay for medication if I see a public psychiatrist?

Yes, you usually pay part of the price of prescribed medication, even though the public consultation itself is free. Active workers pay 40% if they earn under 18,000 euros, 50% between 18,000 and 100,000 euros, and 60% above that. Pensioners pay 10% with a monthly cap, and people on minimum-income benefits pay nothing.

Will private insurance cover my therapy sessions straight away?

Not always, because many insurers apply a waiting period (carencia) of several months to psychotherapy and psychiatric care. Some also ask for a health declaration when you apply, and a known mental health diagnosis can lead to an exclusion, a higher premium or a refusal.

Does a basic insurance plan include psychology?

Often not, because basic plans may exclude psychotherapy or cover it only through a restricted network of providers. Comprehensive plans usually cover it with a yearly session limit. Read the policy conditions before you sign.

Are online therapy sessions cheaper than in-person ones?

Online sessions are often slightly cheaper than in-person ones. Some therapists also offer sliding scales or bonus packs of sessions, so ask before you book.