Health insurance for retirees and non-lucrative visa holders

Key rules

• Policy features: The insurer must be authorised in Spain, and the policy must have no copago and no waiting periods.
• First-year payment: Paying the first year in full is the safest choice for visa proof.
• Consulate checklist: Each consulate sets its own requirements, so confirm them before you buy.
• Renewal: Private insurance is required for visa renewal, so do not cancel it.

What the policy must have

Pick a policy from an insurer authorised in Spain that gives full cover with no copago and no waiting periods. It should also have no deductibles. It must run for at least your first year of residence.

It should match the range of the public system: hospital stays, specialists and emergency care. Add repatriation if your consulate asks for it. Emergency-only and travel policies are normally refused.

Each consulate sets its own checklist. Get the list from the consulate that will handle your application before you buy. The documents you need to hand in are in the document list below.

How to pay for the first year

Pay the first year in full. Some consulates do not accept monthly instalments. Others accept them if the insurer states the policy is in force for the whole year and shows the payments made. Ask your consulate, or avoid the question by paying annually.

What it costs

For a couple aged 60 to 70, a visa-compliant policy is commonly a few thousand euros a year in total. That is well above what a younger couple pays. The price rises with age and with the size of the insurer's hospital network. Quotes differ by insurer, province and age, so get several for your exact ages and town.

How premiums rise as you age

Expect an increase at each annual renewal, usually a few percent for inflation and rising claims costs. There are larger jumps when you move into a higher age band, especially after 60 and 65. Insurers can also revise premiums for an individual policyholder.

Before you sign, read the renewal terms in the contract. Ask how the price changes by age band. Budget for cover to cost more each year.

Joining the public system later

Most non-lucrative visa holders keep private insurance, and the visa renewal rules require it. Public access is possible in some cases:

• Convenio especial: a paid agreement with the Seguridad Social. You must be registered at your address (empadronado) and legally resident, in general for at least a year. The monthly fee depends on your age, lower under 65 and higher from 65.
• Other routes: contributing through work, or cover through a pension or an EU or bilateral healthcare agreement.

Fees and conditions change and vary by region. Check the current rules with the Seguridad Social or your regional health authority before you plan to drop private cover. The common questions are answered in the FAQ below.

Documents you need

• Private health policy certificate from an insurer authorised in Spain, showing full cover in Spain with no copago, no deductibles and no waiting periods, valid for at least the first year of residence

• Proof that the first year is paid, such as an insurer statement that the policy is in force for the full year and shows payments made; paying the full year upfront is the safest choice

• Policy terms showing the range of cover matches the public system, including hospitalisation, specialists and emergency care, and repatriation where the consulate asks for it

Frequently asked questions

How much does a visa-compliant policy cost for a couple aged 60 to 70?

For a couple aged 60 to 70, a visa-compliant policy is commonly a few thousand euros a year in total. That is well above the cost for a younger couple.

How much will my premium go up as I get older?

Your premium usually rises a few percent at each yearly renewal, with bigger jumps when you move into a higher age band. The biggest jumps tend to come after 60 and 65. Insurers can also change the price of an individual policy, so read the renewal terms in your contract.

Can I join the Spanish public health system later as a retiree?

Yes, if you are a legal resident with no Social Security cover, you can join through the convenio especial, a paid agreement with the Seguridad Social. You must be registered at your town hall (empadronado) and have been resident, in general, for at least a year.

Can I drop my private insurance once I have residence?

Not usually, because non-lucrative visa holders normally keep private insurance and the renewal rules require it. Public access through the convenio especial is a separate route to look at only if your situation changes. Ask your regional health authority before cancelling anything.