Copayment (copago) or no copayment: which plan costs less?

Key rules

• Cheaper plan: Which plan costs less depends on how often you use care, so compare premium plus expected copagos over a year.
• Visa: Copago plans may not satisfy visa insurance requirements, so confirm with your consulate before buying.
• Annual cap: Not every copago plan caps your yearly copagos, so find the cap in the policy conditions.
• Waiting periods: For a visa, the plan should have no carencias and no deductible.

The cheaper plan depends on how much care you use

A plan with copagos has a lower monthly premium, but you pay a small charge each time you see a doctor, have a test or start a treatment. If you rarely use care, the copago plan usually costs less over a year. If you go often, the plan without copagos can win.

What you save on the premium

A copago plan typically costs 15-35% less than the equivalent plan without copagos. For an adult this was often 10-30 EUR a month. The saving is smaller for young people and larger for older ones. Over a year, that is roughly 120-360 EUR at those monthly figures.

What you pay each time

Typical charges on copago plans from major insurers:

• GP or specialist visit: about 3-6 EUR.
• Basic diagnostic tests: 3-10 EUR.
• Advanced imaging such as MRI or CT: 10-60 EUR.
• Physiotherapy: about 5-10 EUR per session.
• Hospitalisation: 0 EUR on many plans.
• Surgery or a day-case procedure: 20-60 EUR on some plans.
• Emergencies: often 0-20 EUR.

Each insurer sets its own tariff and changes it over time, so ask for the current copago table before you decide.

Check for a yearly cap

Many copago plans limit your total copagos per person each year, often around 300-700 EUR. Some plans set a lower combined cap for a family. Some plans have no cap at all. The cap is written in the policy conditions, so look for it there. A cap sets the most the plan can cost you above the premium.

A quick comparison

1. Estimate your visits, tests and physiotherapy sessions for a year.
2. Multiply them by the tariff to get your yearly copagos.
3. Subtract the yearly premium saving from that figure.
4. If the result is positive, the plan without copagos is cheaper for you. If it is negative, the copago plan is cheaper.

The checklist below walks through the same steps.

If you need the policy for a visa

Check this before you choose a copago plan. Consulates and the immigration office (Extranjería) generally require a policy from an insurer authorised in Spain, with full coverage, no carencias and no deductible. Copagos are generally accepted, because they are per-use charges and not a deductible. Some consulates are stricter, though, so ask yours whether it accepts a plan with copagos before you buy. Plans with carencias or limited coverage are commonly rejected.

Ask the insurer for a certificate that states the coverage, the period and that premiums are paid.

Checklist

• Estimate how many GP visits, specialist visits, tests and physiotherapy sessions you expect in a year.

• Ask each insurer for its copago tariff, as visit, test, imaging and procedure charges differ between plans.

• Multiply your expected use by those charges to get a yearly copago cost.

• Ask for the monthly premium of the copago plan and of the equivalent plan without copagos, then multiply the difference by 12.

• Compare the premium saving with your expected yearly copagos, and choose the plan with the lower total.

• Find the annual cap on total copagos in the policy conditions, or confirm that the plan has none.

• Check that the plan has no carencias (waiting periods) and no deductible if you need it for a visa or residence application.

• Ask your consulate whether it accepts a plan with copagos.

Frequently asked questions

How much can a copago plan save me on the monthly premium?

A copago plan typically costs about 15-35% less than the equivalent plan without copagos. For an adult this was often about 10-30 EUR per month, lower for young people and higher for older ones.

Is there a yearly limit on what I pay in copagos?

Many copago plans cap total copagos at around 300-700 EUR per insured person per year, but some plans have no cap. Some plans also set a lower combined cap for a family. The cap is written in the policy conditions, so check it before you sign.

What does a single visit or test cost on a copago plan?

A GP or specialist visit typically costs about 3-6 EUR on a copago plan. Basic tests are about 3-10 EUR, and advanced imaging such as MRI or CT is 10-60 EUR. Physiotherapy is about 5-10 EUR per session, and hospitalisation is 0 EUR on many plans.

Will a copago plan be accepted for my visa application?

Usually yes, because copagos are per-use charges and not a deductible, but some consulates are stricter. The policy must come from an insurer authorised in Spain, with full coverage, no carencias (waiting periods) and no deductible. Ask your consulate before buying.