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Healthcare in Spain for American Retirees: What You Need to Know

Updated: Oct 18


american retiree at dentist in spain

As more Americans look to retire abroad, Spain consistently ranks as one of the top destinations. With its affordable cost of living, beautiful landscapes, and rich culture, it’s easy to see why. Access to healthcare is one of the most crucial factors for American retirees to consider before moving abroad. Fortunately, Spain has one of the best healthcare systems in the world, and it's not only very accessible but also shockingly affordable for retirees.


Here’s what you need to know about healthcare in Spain as an American retiree.


The Spanish Healthcare System: Public vs. Private


Spain is known for their universal healthcare system that provides comprehensive care to residents, including expats with residency permits. The system is split up into two parts: public healthcare (Sistema Nacional de Salud) and private healthcare.


1. Public Healthcare:

The public healthcare system is funded by taxes and provides free or low-cost medical services to residents. If you're a legal resident in Spain, you may be eligible for public healthcare, keeping in mind that certain requirements apply. While public healthcare is generally excellent, it's possible to encounter long wait times for specialist appointments or non-urgent surgeries, which is why many retirees choose to supplement with private healthcare.


2. Private Healthcare:

Spain also has a robust private healthcare sector. In private hospitals and clinics it's usually a lot quicker and easier to get an appointment, and these places tend to be more comfortable. For these reasons, among others, many retirees choose to purchase private health insurance.



Can American Retirees Access Spain’s Public Healthcare?


Yes, American retirees can access public healthcare in Spain, but it depends on your residency status. There are several ways to qualify:


1. Non-Lucrative Visa Holders:

If you retire in Spain on the Non-Lucrative Visa (also known as the Retirement Visa), you are not automatically entitled to public healthcare. You'll need to purchase private health insurance as part of your visa application and prove that it covers you during your stay. With that said, after one year of residency, you can apply for access to the public healthcare system, though most retirees choose to keep their private insurance for better access to services.


2. Pensioners:

If you receive a government pension from the United States or another country within the European Union (EU), and you’ve established legal residency in Spain, you may be eligible for public healthcare under special agreements. However, this typically does not apply to American retirees unless there are certain bilateral agreements in place.


Private Health Insurance for American Retirees


Since most American retirees are already required to have private health insurance as part of their retirement visa status in Spain, it’s essential to choose a policy that fits your needs. Private health insurance is much more affordable in Spain compared to the U.S. The cost will vary depending on your age, health, and the coverage level, but many retirees find policies ranging between €60 to €200 per month.


When choosing private health insurance, consider the following:


  • Coverage: Make sure the policy you choose covers both general care and specialist treatments, hospital stays, as well as prescription medications.

  • Expat-Friendly Insurers: Look for insurance providers that cater specifically to expats, as they often offer bilingual services and policies that meet visa requirements.

  • Direct Payment to Providers: Some policies allow direct payment to healthcare providers, so you don’t have to pay out-of-pocket and wait for reimbursement.


Healthcare Costs in Spain


One of the best parts about Spain’s healthcare system is how affordable it is. Even if you are required to use private health insurance, the costs are significantly lower than what you'd expect in the U.S. Here’s a general overview of costs:


  • Doctor Visits: Visiting a general practitioner may cost between €50 to €100 without insurance.

  • Specialist Visits: Specialist appointments typically range from €80 to €150, depending on the specialist.

  • Prescriptions: Prescription drugs in Spain are heavily subsidized, and most medications are much cheaper than in the United States. Many prescriptions cost only a few euros with insurance.

  • Hospital Stays and Surgeries: If you need surgery or hospitalization, private insurance will cover a large portion of the costs. Without insurance, surgery costs can range from €2,000 to €20,000 depending on the complexity of the procedure, which is still considerably cheaper than in the U.S.


How to Access Healthcare as a Retiree


Once you’ve moved to Spain, getting access to healthcare is fairly simple, whether you’re using the public system or a private provider.


  • Public Healthcare: To use public healthcare services, you’ll need to register with your local healthcare center (Centro de Salud) after you’ve been issued a residency permit. You will then receive a health card (Tarjeta Sanitaria) that allows you to access services.


  • Private Healthcare: If you choose private healthcare, you will need to contact private hospitals or clinics directly.


Overview


Spain offers an excellent healthcare system that is both affordable and accessible, making it a top destination for American retirees. While you will most likely be required to purchase private health insurance as part of your visa application process, you may have the possibility to switch over to the public healthcare system once already living in Spain.


Ultimately, Spain’s healthcare system provides quality care at a fraction of the cost compared to the U.S. This allows Americans to enjoy a stress-free retirement in Spain with the confidence that your medical needs will be well taken care of.


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