Best Health Insurance Spain for Expats 2026
Best health insurance in Spain for expats — top carriers ranked by coverage, price, English support, and visa compliance.
- Adeslas ranks #1 overall in 2026 — widest Spanish network and competitive pricing across age bands.
- ASSSA is the best choice if you have pre-existing conditions or need flexible underwriting.
- Sanitas leads for English-speaking support (Bupa-owned) and strong digital tools.
- DKV is the pick for truly zero-copay visa-compliant plans with simple online claims.
Our Top Picks at a Glance
Best overall: Adeslas — lowest prices under 50, largest hospital network
Best for over 50: ASSSA — most competitive rates for older applicants, accepts 75+
Best hospital network: Sanitas — own hospitals, digital-first experience
Best flexibility: DKV — widest age range among mainstream carriers
Adeslas
Adeslas (part of the SegurCaixa group) is Spain’s largest private health insurer and our top pick for expats under 50. They offer the lowest premiums across younger age brackets and have the widest hospital and clinic network in the country — over 44,000+ healthcare professionals and 1,000+ centres.
Monthly from
€50/mo
Max entry age
65
Pros: Cheapest under 50, huge network, fast claims processing, widely recognised by consulates
Cons: Strict age limit (65), less competitive over 50, customer service can be slow
Read full Adeslas review →
ASSSA
ASSSA (Agrupación Sanitaria de Seguros) is the go-to carrier for older expats. Based in the Costa Blanca, they have decades of experience insuring foreign residents and are the only major carrier that accepts new applicants over 75. Their English-language support is among the best in the industry.
Monthly from
€55/mo
Max entry age
75+ (case-by-case)
Pros: Highest max entry age, best rates over 50, excellent English support, expat-specialist
Cons: Smaller network than Adeslas/Sanitas, regional focus (strongest in Levante/Costa Blanca)
Read full ASSSA review →
Sanitas
Sanitas (owned by Bupa) is Spain’s premium private healthcare provider. They operate their own hospitals and clinics, giving them unique quality control. Their digital platform and app are considered the best in the Spanish market — ideal for tech-savvy expats who want easy appointment booking and video consultations.
Monthly from
€55/mo
Max entry age
69
Pros: Own hospitals, excellent digital experience, video consultations, strong in major cities
Cons: More expensive than Adeslas/ASSSA, max entry age 69, weaker in rural areas
Read full Sanitas review →
DKV
DKV (part of the ERGO/Munich Re group) offers solid coverage with a good balance of price and flexibility. They accept applicants up to age 74 and have a reputation for being accommodating with pre-existing conditions. Their network covers all of Spain, though it is somewhat smaller than Adeslas or Sanitas.
Monthly from
€60/mo
Max entry age
74
Pros: Accepts up to 74, good pre-existing condition acceptance, international backing
Cons: Slightly higher base prices, smaller network, less English-language support
Read full DKV review →
Side-by-Side Comparison
| Feature | Adeslas | ASSSA | Sanitas | DKV |
|---|---|---|---|---|
| Price (age 30) | €60–80 | €65–85 | €65–85 | €70–90 |
| Price (age 55) | €110–150 | €110–145 | €120–160 | €115–155 |
| Price (age 70) | — | €250–330 | — | €260–350 |
| Max Entry Age | 65 | 75+ | 69 | 74 |
| Network Size | Largest | Medium | Large (own hospitals) | Medium |
| English Support | Limited | Excellent | Good | Limited |
| Visa Compliant | ✓ | ✓ | ✓ | ✓ |
| Best For | Under 50, budget | Over 50, retirees | Cities, digital-first | 65–74, flexibility |
All prices are monthly, for visa-compliant cuadro médico plans (no copays). 2026 rates. See our full cost breakdown for detailed pricing by age bracket.
How to Choose the Right Carrier
Your ideal carrier depends on three factors: your age, where you will live in Spain, and your budget.
If you are under 50: Start with Adeslas. They offer the lowest prices and the largest network. Unless you specifically want Sanitas’s digital experience or live in a region where ASSSA is dominant (Costa Blanca), Adeslas is hard to beat on value.
If you are 50–64: Compare ASSSA and Adeslas. ASSSA becomes more competitive at this age range and offers better English support. If you live on or near the Costa Blanca, ASSSA is the clear choice.
If you are 65+: ASSSA is your best option in most cases. They offer the widest age acceptance and the most competitive pricing for older applicants. DKV is the main alternative up to age 74. See our Over 65 insurance guide for details.
If you live in a major city (Madrid, Barcelona): Sanitas is worth the premium. Their own hospitals offer shorter wait times and a seamless booking experience. For rural areas, Adeslas’s larger network provides better coverage.
Compare Carriers Side-by-Side
See detailed feature comparisons, pricing tables, and which carrier suits your visa type.
Frequently Asked Questions
What is the best health insurance in Spain for expats in 2026?
Adeslas is the best overall choice for most expats due to its low prices and extensive network. ASSSA is the best option for expats over 50, and Sanitas is ideal for those living in major cities who want a premium digital experience. All four major carriers (Adeslas, ASSSA, Sanitas, DKV) offer visa-compliant plans.
Do I need Spanish health insurance for a visa?
Yes. All Spanish residence visas (Non-Lucrative, Digital Nomad, Student, and formerly Golden Visa (ended April 2025)) require private health insurance from a carrier authorised to operate in Spain. The policy must be a cuadro médico plan with no copays and no waiting periods. International or travel insurance is not accepted.
Can I switch insurance carriers after arriving in Spain?
Yes, you can switch carriers at any time. Most policies are annual, so it is best to switch at renewal to avoid losing prepaid months. When switching, ensure there is no gap in coverage, as this could affect your visa status. Your new carrier cannot impose waiting periods if you transfer from another Spanish private insurer.
Nationality-specific guides: US citizens · UK citizens · EU citizens · All foreigners · Private insurance guide · Travel insurance
Related Guides
How Much Is Health Insurance in Spain?
Full cost breakdown by age, carrier, and plan type
Health Insurance Over 65
Guide for older applicants including S1 form info
Adeslas vs Sanitas vs DKV
Head-to-head feature and pricing comparison
Caser Health Insurance Review
Full review of Caser plans, pricing, and coverage for expats in Spain
All carriers listed are authorised by Spain’s DGS. Prices updated April 2026.
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