Private health insurance in Spain costs an average of €46 a month for a basic policy without co-payments and €74 for a complete one. For people over 55, a complete policy averages about €125 a month. These figures come from the December 2025 health insurance price index by Rastreator, a Spanish comparison site, which also shows premiums rising by around 19% during 2025.
That cost matters beyond budgeting. Private cover is a requirement for some residence visas and often the only option before you qualify for public healthcare. It is also a popular way to see specialists sooner, and more than 12 million people in Spain hold a private health policy, according to the insurance research body ICEA. Here, we cover what you can expect to pay, what drives the price and how to choose a policy.
Review a private health insurance policy with an adviser before signing. Photo: Freepik
What is the average cost of private health insurance in Spain?
The answer depends on what is measured. Rastreator's index, built from quotes made through its site in 2025, puts the average at €46 a month for a basic policy without co-payments and €74 for a complete one.
ICEA measures something different. Across every individual policy in force, the average premium was €975 a year per insured person in 2024, about €81 a month, and €1,477 a year for reimbursement policies. That figure is higher than most advertised prices because it includes older policyholders, whose premiums are far above those quoted to new, younger customers.
| Average monthly cost of a complete private health policy by age, 2025 |
| Age |
Average monthly cost |
| Under 25 |
€59 |
| 25 to 34 |
€70 |
| 35 to 44 |
€77 |
| 45 to 54 |
€91 |
| 55 and over |
€125 |
Source: Rastreator price index, December 2025, based on quotes made through its comparison site. Individual quotes vary by insurer, location and health.
Treat the over-55 average with caution. Quotes for people in their 60s and 70s are often much higher, particularly for policies without co-payments. One 2026 expat guide from WaypointSur puts comprehensive cover without co-payments for people aged 60 to 70 at roughly €250 to €400 a month. Getting several quotes is worth the effort, and Rastreator estimates that comparing policies can save up to €122 a year.
What affects the price of private health insurance?
Four factors explain most of the difference between one quote and another.
Age and health
Age is the biggest factor, and Rastreator found that prices can vary by up to 72% between age groups. Insurers also ask you to complete a health questionnaire when you apply. Conditions you declare may be excluded or priced in. A known condition you do not declare can lead to an exclusion or a refused claim, so answer honestly.
Co-payments
Policies with co-payments (copago) charge a fixed fee each time you use a service, in exchange for a lower premium. The fee is often a few euros for a GP visit and more for a specialist. Policies without co-payments (sin copago) cost more each month but nothing per visit, and some consulates ask for them when you apply for a visa.
Type of cover
Most policies give access to a network of doctors and hospitals (cuadro médico). Reimbursement policies let you choose any provider and claim back a share of the cost. They are noticeably more expensive: the ICEA average is €1,477 a year, against €975 for individual policies as a whole. Dental treatment is often excluded or sold as an add-on, so check what is included.
Where you live
Prices vary by region because insurers price in local healthcare costs. Rastreator's index found the Balearic Islands the most expensive, at an average of €57 a month for a basic policy, followed by Catalonia at €51. Extremadura (€39), Asturias (€42) and Murcia (€43) were the most affordable. If you are still deciding where to settle, Find Your Place lets you compare areas against your own priorities.
Can I have private health insurance in Spain?
Read more at thinkSPAIN.com