Private health insurance for the self-employed (autónomos)

Terms used

• Autónomo — An autónomo is a self-employed person registered with the Spanish social security regime for freelancers.
• Copago — A copago is a small fee you pay each time you use a service under your private policy.
• IRPF — The IRPF is Spain's personal income tax.
• Gestor — A gestor is a professional who handles tax and administrative paperwork for individuals and businesses.

Key rules

• Public cover: Registered autónomos who are up to date with contributions are in the public system, so private insurance is optional.
• Deduction cap: You can deduct premiums up to 500 euros per person a year, or 1,500 euros for a person with a disability.
• Proof: Pay by bank account and keep the invoice or receipt, or you may lose the deduction.
• Age: Premiums rise with age, so compare quotes early.

Do you need private cover?

No. Once you are registered as an autónomo and paying your contributions, you are in the public system. Your dependants are covered too. Private insurance is a choice, not a requirement.

To use public care, get a health card from your region's health service. Keep your payments up to date. If you fall behind, the Seguridad Social can require you to clear the debt before it pays benefits such as sick pay. Check your status with the Seguridad Social if you have missed payments.

Why people add private cover

Typical reasons are shorter waits for specialists, a wider choice of doctors, and English-speaking staff. You can keep the public card and use both.

What it costs

Price depends on your age, province, insurer and plan.

• Younger 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 sign-ups above roughly 65 to 70.
• Policies with a copago (you pay a small fee per visit) cost noticeably less than policies without one from the same insurer.

Get several current quotes before you choose. If you plan to stay long term, sign up while you are younger, because entry gets harder and dearer with age.

Tax deduction

Private health premiums may be partly tax-deductible for you. As an autónomo, you can deduct up to 500 euros per person a year, or 1,500 euros for a person with a disability. This covers you, your spouse and your children under 25 who live with you.

The conditions:

• You pay the premium yourself.
• The policy covers you, and your spouse and children if you are claiming for them.
• You can show the payment with an invoice or receipt.
• You pay through a bank account.

The deduction applies to the income tax (IRPF) calculation of your activity under direct estimation. It does not apply to employees. Ask your gestor, or an accountant, to include it in your return.

How to decide

Stay with public care if it meets your needs and you want to keep costs down. Add private cover if waiting times or choice matter to you. The deduction lowers the real cost, but it does not make the policy free. The questions below cover family members and rising premiums.

Frequently asked questions

Does private insurance cost more as a freelancer gets older?

Yes, premiums rise with age, and people over 60 pay several times the young-adult price. Some insurers limit new entry above about 65 to 70. Policies with copago (a small fee each time you use a service) cost noticeably less than no-copago ones from the same insurer.

Does my family get public healthcare if I pay into the self-employed system?

Yes, your dependants are covered by public healthcare too, as long as you are registered in the RETA (the self-employed social security regime) and up to date with payments. If you fall behind, the Seguridad Social can require the debt to be paid before benefits such as sickness pay are granted. Once registered, you get a health card from your regional health service.

Can I deduct private health insurance for my spouse and children too?

Yes, you can deduct premiums for your spouse and for children under 25 living with you, not only for yourself. This only works if you pay the premium yourself from a bank account, the policy covers you, and you can show the invoice or receipt. It applies to autónomos under direct estimation in their income tax, not to employees.