Convenio especial or another way to cover a gap in your healthcare?

Terms used

• Convenio especial — The convenio especial is a paid scheme that gives residents without other cover access to Spain's public healthcare.
• S1 — The S1 is a form from an EU, EEA, UK or Swiss pension country, which pays Spain for your healthcare.
• INSS — The INSS is Spain's national social security institute, where you register an S1 or ask about the convenio.
• Carencia — The carencia is the waiting period before a private policy covers certain treatments.

Key rules

• S1 holders: If you are entitled to an S1, you cannot use the convenio.
• Convenio fee: The fee is 60 euros a month under 65 and 157 euros from 65, the same in every region.
• Private policies: Pre-existing conditions are often excluded or delayed, and a false health declaration can void the policy.
• Residence permit: Immigration offices differ on accepting the convenio as health cover, so ask yours before relying on it.

The short answer

If you have an S1, use it: it blocks the convenio anyway. If another public route is coming soon, such as a job or a benefit, a short private policy may bridge the wait. If you have no other route and need broad cover soon, the convenio is usually the stronger choice.

If you have an S1

An S1 comes from the EU, EEA, UK or Swiss country that pays your pension. It has no monthly premium in Spain. It covers you and usually your dependants. You register it with the INSS, then with your regional health service, and you get a health card and a GP.

You cannot use the convenio if you are entitled to an S1, because other public cover rules it out. A pension from outside the EU does not give you an S1. In that case the convenio is open to you, whatever your nationality. UK pensioners should check their own position under the Withdrawal Agreement with the INSS.

If another public route is coming

Several routes give you public cover without paying a premium:

• Registering with Social Security as an employee or self-employed worker. This covers you and your dependants.
• Receiving unemployment benefit or another Social Security benefit.
• Being the dependant of an insured spouse, partner or child.
• Residence-based entitlement, if you have no other cover and low income. Some regions also have their own access rules for registered residents. Requirements vary by region, so ask the INSS and your regional health service.

While you wait, emergency care is available to everyone until discharge. Pregnant women and minors get full care. EU citizens can use the EHIC for medically necessary care during temporary stays.

The convenio especial

It is a paid scheme for residents with no other cover. You need a period of registered residence, at least one year. The fee is set by law and is the same in every region. The monthly fee is 60 euros if you are under 65 and 157 euros if you are 65 or over. Benefits are broadly those of the public system, though pharmacy co-payments apply. Ask the INSS to confirm the current fee before you sign.

For a non-lucrative residence renewal, many immigration offices have accepted the convenio as proof of health cover, but not all do. Ask your immigration office before relying on it. For a first visa from abroad, you will usually need a private policy, because the convenio is not available before you arrive and register as a resident.

Short-term private cover

Private cover can start quickly, but it is narrower than the convenio. Expect these limits:

• Pre-existing conditions are often excluded or covered only after a waiting period (carencia). The insurer asks for a health declaration. A false declaration can void the policy.
• Other common exclusions include cosmetic surgery, infertility treatment, dental work beyond the basics, experimental treatment, self-inflicted injury and extreme sports. Some plans exclude chronic or congenital conditions.
• Age: premiums rise as you get older, and some insurers limit entry above 65 to 70.
• Copago: some policies charge a small payment per visit.

Some insurers waive waiting periods if you come from another insurer with continuous cover. Read the policy conditions (condiciones generales) before you pay. The timeline below shows the usual waiting periods.

How to choose

• Short gap, healthy, and a public route is close: private cover, or wait with emergency care only if you accept the risk.
• Long gap, a health condition, or you are 65 or over: the convenio, once you meet the residence period. Private insurers may exclude your condition or refuse you.

The decision, timeline and questions below go through these cases.

Choosing between options

How do you cover a gap in your healthcare: convenio, another public route, S1 or private cover?

• Wait for another public route: You are about to start a job or self-employment, receive unemployment benefit, or can join an insured spouse, partner or parent as a dependant.

• Use your S1: You get a pension from an EU, EEA, UK or Swiss country. The pension country pays for your care, there is no monthly premium in Spain, and you cannot use the convenio at the same time.

• Sign the convenio especial: You have lived registered in Spain for at least one year, have no other cover, and no S1 or work route is coming. It costs 60 euros a month under 65 and 157 euros a month at 65 or over, and gives broadly the same care as the public system.

• Take short-term private cover: You need cover now, or you do not yet meet the residence period. Expect exclusions for pre-existing conditions and waits of about 6 months for surgery and up to 12 months for high-cost treatment. Premiums rise with age.

Use an S1 or a work or dependant route if you qualify. Otherwise, if you have a year of registered residence, take the convenio. If you do not, take private cover until you do.

Timeline and deadlines

• Emergencies and accidents are covered, and basic consultations and primary care often are too: from the start of the policy

• Hospitalisation and surgery become covered: after about 6 months

• Childbirth becomes covered: after about 8–10 months

• Transplants, high-cost tests and some specialist treatments become covered: after up to 12 months

Frequently asked questions

Can I use the convenio if I already have an S1 from my pension country?

No, you cannot use the convenio if you hold an eligible S1, because other public cover rules it out. The S1 carries no monthly premium in Spain and usually covers your dependants too.

Can I use the convenio if my pension comes from outside the EU?

Yes, the convenio is open to any nationality, including people with a non-EU pension, as long as you have no other cover. A non-EU pension does not give you an S1, so the convenio is the paid public route for you.

Which waiting periods should I expect on a private policy?

Expect about 6 months for hospitalisation and surgery, about 8–10 months for childbirth, and up to 12 months for transplants or high-cost tests. Emergencies and accidents usually have no wait, and basic consultations often have none either.

Will the convenio count as health cover when I renew my residence permit?

Many immigration offices have accepted the convenio as proof of cover for renewals such as the non-lucrative permit, but not all do. Ask your immigration office before you rely on it. For a first visa from abroad, you will usually need a private policy without co-payments or waiting periods.