Paying for public cover (convenio especial) and private insurance together

Key rules

• Both at once: You can hold the convenio especial and a private policy together; one does not cancel the other.
• First visa: The convenio does not replace private insurance for your first visa application.
• Renewal: Confirm with your immigration office that public cover is accepted before dropping private insurance.
• Your total: Your monthly cost is the convenio fee plus the private premium.

The short answer

You can hold both at once, and they add up. The convenio especial is a fixed monthly fee for access to public care. A private policy is a separate premium on top. Neither cancels the other. The question is whether the private policy gives you something the public system does not, such as shorter waits or a wider choice of doctors.

What the convenio costs

The convenio especial costs 60 euros a month under age 65 and 157 euros a month from age 65. The fee is fixed, so it does not depend on your health or your income.

You can only join if you have at least one year of registered residence in Spain, and you must have no other route to public care. Apply through the INSS or your provincial Social Security office. Some regions also run their own schemes, so ask what is on offer where you live.

What private cover costs

Private premiums depend on your age, province, insurer and plan. The general pattern:

• Young adults pay the least.
• People in their 40s and 50s pay moderately more.
• People over 60 can pay several times the young-adult price.
• Some insurers limit new entry above about 65 to 70.

Policies with copago (you pay a small fee each time you use a service) cost noticeably less than policies without it from the same insurer. Get quotes with and without copago for your own age and province.

How to work out your real monthly cost

Add the convenio fee to the private premium. For example, if you are under 65, your starting point is 60 euros plus the premium you are quoted. Then ask yourself what the private policy would give you that the public system does not. If the answer is "not much", the convenio alone may be enough. If you want faster appointments or specialists you can pick, the extra cost may be worth it.

Age matters here. Joining a private insurer while you are younger usually costs far less than joining later, and entry can get harder after about 65.

Visas and renewals

The convenio does not replace private insurance for your first visa application. For example, non-lucrative visa applicants must show private full-coverage insurance in Spain at that stage. Keep that policy until the visa is granted.

At renewal, public cover through the convenio is generally accepted as meeting the health requirement. Practice varies by office, so ask the immigration office handling your file before you cancel the private policy.

The checklist and the questions below walk you through the steps.

Checklist

• Check that you have been registered as a resident for one year and have no other route to public care.

• Ask the INSS or your provincial Social Security office for the current convenio especial fee: 60 euros a month under 65, or 157 euros a month from 65.

• Get quotes for private policies for your age, province and plan, with and without copago.

• Add the convenio fee and the private premium together to see your full monthly cost.

• Keep your private policy running if you still need it for the first visa application, which requires private full cover.

Frequently asked questions

Can I hold a convenio especial and a private policy at the same time?

Yes, you can hold both at once, because one does not cancel the other. The convenio gives you access to public care, while the private policy is a separate extra cost. Many people keep both when they want faster access to private doctors.

Does the convenio especial replace private insurance for my visa?

It depends on the stage: a non-lucrative visa application still needs private full-coverage insurance in Spain at the start. At renewal, many offices accept proof of public coverage through the convenio, but practice varies by office.

How much more does private insurance cost as I get older?

Private premiums rise with age, and people over 60 pay several times the young-adult price. Some insurers also limit new entry above about 65 to 70. Policies with copago, where you pay a small fee per visit, cost noticeably less than the same insurer's policies without it.