Premiums, payments and tax

After reading, you will understand what drives your premium, how to pay it, and how the tax treatment works.

Start with "How much private health insurance costs in Spain and why". It shows what sets your price and helps you build a realistic budget. The other pages then build on it:

• Comparing plans with and without a copayment (copago).
• How premiums rise with age and at each renewal.
• Paying by direct debit or instalments, and avoiding a lapse.
• Tax on cover paid by your employer.
• Deducting premiums if you are self-employed.

Prices of care you pay for out of pocket, and opening a bank account, are covered elsewhere.

Key rules

• Employer cover cap: Employer-paid health insurance is tax-exempt up to 500 euros per person a year for the employee, spouse and descendants, or 1,500 euros for a person with a disability.
• Self-employed deduction: If you are self-employed in direct estimation, you can deduct health premiums for yourself, your spouse and children under 25 living with you, up to 500 euros per person a year, or 1,500 euros for a person with a disability.
• Missed payment: If a renewal premium goes unpaid, cover is suspended one month after the due date, and it resumes 24 hours after you pay.
• Renewal notice: To stop automatic renewal you must notify the insurer in writing at least one month before the period ends, and the insurer must warn you of a premium rise at least two months before renewal.
• Age: Age is the biggest price factor, and prices rise sharply from 65.
• Reembolso: Expect to pay roughly 40-100% more for a reembolso plan than for a comparable cuadro médico plan.

Premiums, payments and tax: the whole process, step by step

• Budget for your premium by age band and compare copago and no-copago plans: before you buy

• Answer the health questionnaire truthfully when you apply: when you apply for a new policy

• Set up payment by direct debit or instalments: when the policy starts

• Expect a warning from the insurer if the premium will rise: at least two months before renewal

• Give written notice if you do not want the policy to renew automatically: at least one month before the period ends

• Pay a late renewal premium to bring cover back: cover is suspended one month after the due date and resumes 24 hours after you pay

• Claim the tax treatment that fits you, as an employee with employer-paid cover or as a self-employed worker: when you file your yearly income tax return

Documents you may need

• Your monthly payslip from your employer — Tax treatment of health insurance paid by your employer

• Your annual certificate of withholdings from your employer — Tax treatment of health insurance paid by your employer

• Your policy wording — Paying your premium by direct debit, instalments and missed payments

• A new health declaration — Paying your premium by direct debit, instalments and missed payments

Premiums, payments and tax: questions that cross several articles

How much does private health insurance cost for someone aged 50?

For ages 45-55, a plan without copago typically costs about 70-120 EUR per month. Premiums climb in age bands, and from about 45 they rise about 20-40% per band. Read "How much private health insurance costs in Spain and why" for the price drivers and "How premiums rise with age and at each renewal" for what to expect later.

How much can a copago plan save me, and what will I pay per visit?

A copago plan typically costs about 15-35% less, often 10-30 EUR per month for an adult. In return you pay per use, for example about 3-6 EUR for a GP or specialist visit and 10-60 EUR for an MRI or CT scan. Read "Copayment (copago) or no copayment: which plan costs less?" to compare the total annual cost.

Will a plan with copagos be accepted for a visa or residence application?

Copagos are generally accepted for visa and residence applications, but some consulates are stricter. What usually matters is full coverage, no waiting periods and no deductible. Read "Copayment (copago) or no copayment: which plan costs less?" and confirm the requirements with your consulate.

Can my health answers raise my price when I apply?

Yes, your health answers can lead to a surcharge on the price, but exclusions of specific conditions and refusal are more common. You must answer truthfully, because hiding a known condition can let the insurer cancel the policy or refuse to pay claims.