Healthcare in Spain for retirees
Healthcare in Spain for a retiree on a non-lucrative permit means full private insurance at first; after a year you can join the public system for €60 or €157 a month.
The hospitals retirees use, what insurance does and does not cover. Checked against official and hospital sources on Oct 8, 2026.
- Life expectancy
- 83.9 years US 78.9. World Bank, 2024
- Doctors
- 4.3 per 1,000 US 3.7. World Bank, 2022
- Health spending
- $3,107/person Per year; US $13,473. World Bank, 2023
- Paid out of pocket
- 20.9% Of all health spending; US 10.9%. World Bank, 2023
Hospitals retirees use in Spain
Valencia
Vithas Hospital Valencia 9 de Octubre
- Emergency department open 24 hours, every day of the year
- 258 rooms
Vithas Valencia. Checked Oct 8, 2026.
Benalmádena
Hospital Vithas Xanit Internacional
- Accredited by Joint Commission International
- International patient service in 16 languages
- 141 single rooms, 16 ICU beds, 24-hour emergency department
Vithas Xanit. Checked Oct 8, 2026.
Alicante
Vithas Hospital Alicante
- 94 beds, 7 ICU beds, 9 operating rooms
- Emergency department open 24 hours, every day of the year
Vithas Alicante. Checked Oct 8, 2026.
Madrid
Hospital Universitario HM Sanchinarro
- Home of HM CIOCC, a comprehensive cancer centre
- Robotic surgery
- HM's international team offers multilingual help 24/7
HM Sanchinarro; HM Hospitales. Checked Oct 8, 2026.
A retiree on a non-lucrative permit is not covered by the public health system and keeps private insurance. After at least one continuous year of residence, and while registered on the town's padrón, a resident with no other public cover can join it through a special agreement (convenio especial) with the regional health service: €60 a month under 65 and €157 a month at 65 or over, more where a region adds services. Anyone entitled to public cover another way, such as under EU rules or a bilateral agreement, cannot use it.
Paying for care in Spain
20.9% of health spending in Spain is paid directly by patients, about half again the US share, so plan how you will pay before you move.
Retirees use either an international health plan, which can also cover care at home and in other countries, or a local plan from an insurer in Spain, which costs less but covers care there only. Prices depend on age and on the insurer's terms for existing conditions; compare written quotes.
If you are on Medicare
Medicare usually does not pay for care outside the United States; the exceptions are narrow, such as a foreign hospital closer to your US home than the nearest US hospital.
Medicare.gov. Checked Oct 7, 2026.
Healthcare questions
Does Medicare cover me in Spain?
Medicare usually does not pay for care outside the United States; the exceptions are narrow, such as a foreign hospital closer to your US home than the nearest US hospital. Plan on private insurance or paying directly for care in Spain.
Do I need health insurance for the Non-Lucrative visa?
The consulate asks for public or private health insurance from an insurer authorised in Spain, covering everything the public system covers, with no deductible, copayment or limit, for a year. Travel insurance is refused. You must keep the cover to renew the permit.
How much of the bill do people pay themselves?
In Spain, 20.9% of all health spending is paid out of pocket, against 10.9% in the US (World Bank, 2023).
Can retirees sign up for public healthcare in Madrid or elsewhere in Spain?
Not at first. After a year of continuous residence, registered on the padrón, a resident without other public cover can join through a convenio especial with the regional health service, at €60 a month under 65 or €157 a month at 65 or over.
What health insurance does the visa need?
A policy from an insurer authorised in Spain that covers everything the public system covers, with no deductible, copayment or coverage limit, valid for a year. Travel insurance is not accepted.
Is there an English-speaking hospital on the Costa del Sol?
Hospital Vithas Xanit Internacional in Benalmádena has an international patient service in 16 languages, a 24-hour emergency department and Joint Commission International accreditation.
