Who sells private health insurance in Spain and how they differ

Key rules

• Largest networks: Large Spanish insurers have the widest networks of doctors and hospitals across the country.
• Price: Digital insurers are usually cheaper, with simpler plans and often a copago.
• English: Expat brands offer English throughout, while large Spanish insurers often keep the contract in Spanish.
• Shortlist: Compare at least one insurer from two different types before you choose.

The market has three types of seller

Private health cover in Spain comes from three kinds of company. Each suits a different buyer. The choice block below helps you pick which type to shortlist first.

Large Spanish insurers have the biggest networks of doctors and hospitals across the country. The main names are Sanitas, Adeslas, Asisa, DKV, Mapfre, AXA, Cigna (through its Spanish arm), Caser and Generali.

Digital insurers sell mainly online. Their plans are simpler, premiums are often lower, and they often use copago (you pay a small fee per visit). They compete on price and app-based access. Alan is one example. Some large insurers, such as Sanitas, Adeslas and Asisa, also sell online-only products.

Expat-focused brands sell international plans or plans for people living in Spain. Examples are Cigna, Bupa Global, Allianz Care, April International, Cegos and Aetna International. They stress English support and worldwide cover. Premiums are often higher.

Who sells across Spain

The large Spanish insurers are your safest starting point for national cover. Their networks reach most regions. Digital and expat brands also sell nationally, but check that doctors and hospitals near your town are in the network before you buy. Brand ownership changes, so confirm who is behind a product when you request a quote.

Who works in English

The level of English differs a lot:

• Expat brands (Cigna, Bupa Global, Allianz Care, April International) usually offer English on the website, phone, app and policy documents.
• Large Spanish insurers with English sales or phone help include Sanitas (English web pages and a phone line for foreigners), Adeslas, Asisa (international desk), DKV and AXA. They usually keep the contract and policy conditions mainly in Spanish.
• English-speaking brokers are widely used to compare insurers. See the questions below.

If you do not read Spanish, ask for the policy conditions in English before you sign. Check which language you will get for claims and customer service too.

Build your shortlist

1. Pick one or two from the type that fits your priorities: network size, price or English.
2. Add one from another type to compare.
3. Ask each for a quote for your age and town, and ask which language the contract is in.

Choosing between options

Which type of insurer should you shortlist first?

• Large Spanish insurer: You want the biggest network of doctors and hospitals across Spain.

• Digital insurer: You want a lower premium and app-based access, and accept simpler plans, often with copago. Alan and the online products of the big insurers fit here.

• Expat-focused brand: You want English service and possibly worldwide cover, and accept a higher premium.

Pick the type that matches your top priority: network size, price or English support. Then compare two or three insurers within that type.

Frequently asked questions

Will my policy documents be in English?

Usually only with expat-focused brands, which offer English across their website, phone, app and policy documents. The large Spanish insurers usually offer English sales and phone help, but keep the contract and policy conditions mainly in Spanish. Ask for a sample contract before you commit.

Can an English-speaking broker help me compare insurers?

Yes, many buyers use English-speaking brokers to compare several insurers in one conversation. Ask the broker which insurers they cover, so you know whether the comparison includes both Spanish incumbents and expat brands.

Why are digital insurers cheaper than the big incumbents?

Digital insurers sell mainly online with simpler plans, often with copago (a small fee you pay per visit) and lower premiums. The trade-off is a smaller choice of plans, and incumbents have the largest networks of doctors and hospitals, so check that your nearby doctors are included.