As a neighboring country, accessible by car, plane and train, Spain is an ideal vacation destination… even when it comes to healthcare! Between health insurance, the EHIC and/or private insurance, there are several solutions to help you leave with a clear conscience. We’ll explain.
All you need to know about the Spanish healthcare system
Spain’s healthcare system is recognized as one of the best in Europe. In fact, a ranking published in September 2024 by Forbes magazine confirms that Spain offers the best healthcare system for expatriates, thanks to the accessibility and quality of care. The system is divided into two sectors: public and private. Although the private sector has modern equipment and qualified staff, it is the public sector that stands out for its efficiency. The healthcare system is universal, accessible free of charge (or at reduced rates) to citizens and long-term residents. It is financed by monthly social security contributions.
On another level, a tourist from any country who needs a visa to visit Spain will also need travel insurance to obtain his or her visa. As a resident of a European country, you don’t necessarily need supplementary health insurance. It is recommended, but not essential.
What health cover is required for vacations in Spain?
For a vacation in Spain or a stay of less than 3 months, there are several ways of obtaining health cover, either on the spot or on your return to France.
- As an insured person or beneficiary of the French health insurance scheme, you can potentially benefit from French social security coverage for healthcare received in Spain. The French social security system will pay for healthcare costs incurred in EU member countries, if they are urgent and unforeseen (in the event of an accident, for example). You’ll need to present proof of payment and other invoices when you return to France (and you’ll need to make an advance payment).
- As a French citizen (or citizen of a European Union or European Economic Area country such as Iceland, Liechtenstein, Norway, Denmark and Switzerland), you can also apply for a European Health Insurance Card, or EHIC, which allows you to be covered by the health insurance system, in accordance with the legislation and formalities in force in your country (in this case, Spain). It gives you access to the same care and coverage as Spanish citizens and residents, as if you were finally registered with the national health system. And benefits are offered under the same conditions as for Spanish policyholders.
- It is advisable to take out private health insurance to supplement the cover provided by the EHIC, particularly for expenses not reimbursed by the public system.
For peace of mind when traveling in Spain, we recommend that you apply for an EHIC before you leave, and supplement your coverage with private insurance.
Apply for EHIC health insurance
The EHIC is free, individual and nominative. It is valid for 2 years. To obtain your EHIC, you can apply to :
- online, via your Ameli account,
- directly to your Caisse d’Assurance Maladie,
- by calling 3646.
It is generally advisable to apply 15 days before departure, or as early as possible. If your departure is urgent, you can apply to your insurance company for a provisional replacement certificate, valid for 3 months.
How do I use my card in Spain?
To benefit from coverage by the Spanish social security system, you must consult a healthcare professional in the public system and present your card, known in Spanish as TSE ( Tarjeta Sanitaria Europea), or your replacement certificate. No advance payment is required, and you don’t have to pay anything in Spain.
It’s important to understand that to obtain reimbursements in Spain, you need to go to a public-sector healthcare professional, or to a public health establishment. Requests for care from private establishments will not be reimbursed. Hospitalisation is also covered by the EHIC if it is carried out in a public establishment under a doctor’s prescription (except in emergencies).
Why take out supplementary insurance?
As we’ve seen, Spain’s healthcare system works very well, but it doesn’t cover all costs. The same is true of the EHIC, which offers coverage similar to that received by residents and citizens of the country. So, to supplement medical expenses (such as dental care or pharmacy costs – between 10% and 60%), we recommend you take out private health insurance.
You should also be aware that, for a simple consultation or specific treatment, waiting lists can be long in the Spanish public system. So, to save time in an emergency, for example, it may be a good idea to turn to the private sector… which, however, has to be paid for. Once again, taking out supplementary insurance can be useful in this situation, as it gives you the same access to, and reimbursement for, care received in both the private and public sectors.
Private health insurers cover medical expenses in public or private establishments at higher rates than those covered by social security (please refer to the contracts of each insurance company for details). They also offer additional options for dental and/or optical care, third-party liability, assistance when traveling in a foreign country… A comprehensive package that’s a welcome addition to your vacation, and to Spain, with a clear conscience.
What’s the best health insurance for travel in Spain?
For a trip to Spain, we recommend that you take out comprehensive travel health insurance. Companies such as Allianz Travel offer insurance that covers emergency medical expenses, medical repatriation and civil liability, as well as specific guarantees linked to COVID-19, such as cancellation or interruption of stay in the event of a positive test. It is also advisable to check that the insurance covers treatment in the Spanish private sector, to avoid waiting times in the public system. Before you leave, don’t forget to apply for the European Health Insurance Card (EHIC), so that you can be covered for any medical care you may need during your stay.
