Health insurance for a Spanish residence permit: policy requirements
The wrong insurance gets even flawless applications refused: a policy with co-payments, a waiting period or a foreign licence simply will not be accepted by the consulate. Here is what a seguro medico for a Spanish residence permit must look like, which wording to check in the contract and how the requirements differ by residency type.
- A policy for a residence permit must provide coverage equivalent to Spain's public healthcare system, valid across the whole country.
- Mandatory conditions: no co-payments (sin copagos) and no waiting periods (sin carencias).
- The insurer must be licensed to operate in Spain; travel and reembolso policies do not qualify.
- The requirement mainly concerns no lucrativa, the student permit and some digital nomad applicants; employees and temporary protection holders are covered by the state system.
- Consulates usually ask for an annual policy, often paid for the full year upfront.
Who needs a private policy and who is covered by the state system
The logic behind the Spanish requirements is simple: the state wants to be sure you will not become a burden on public healthcare. Everything therefore depends on whether you pay contributions to Seguridad Social:
- A private policy is mandatory when there are no contributions: residencia no lucrativa, the student permit, the digital nomad visa without Spanish social contributions, and family reunification (for family members without coverage of their own).
- A private policy is not required when coverage already exists: employees and autónomo (contributions to Seguridad Social), temporary protection holders (access to public healthcare), and holders of European social security coordination forms.
The policy requirements are set out in the information sheets (hojas informativas) for each visa and permit type on the Ministry of Inclusion's immigration portal - and consulates interpret them strictly. A cheap policy bought just to tick a box is one of the most frequent reasons a file is returned.
The 5 requirements for a residence permit policy
- A Spanish licence. The insurance company must be authorised to operate in Spain (supervised by the Dirección General de Seguros). Policies from foreign companies without a Spanish licence are not accepted.
- Full coverage equivalent to the public system. Primary care, specialists, hospitalisation, emergency care, surgery - across the whole of Spain. Limited emergency-only plans do not pass.
- Sin copagos. No co-payments for visits, tests or procedures: the policy must cover services at 100%.
- Sin carencias. No waiting periods: every service is covered from the first day the policy is in force.
- Term and payment. A one-year policy (at minimum, for the entire term of the requested visa), and many consulates ask for proof that the annual premium has been paid upfront. Student visas and a number of consulates additionally require repatriation coverage.
The ideal scenario is to ask the insurer for a dedicated residence permit certificate: companies that work with immigration policies issue a statement in which these five points are spelled out word for word.
Requirements by permit type
| Permit / visa type | Private policy | Specifics |
|---|---|---|
| No lucrativa | Mandatory | Full coverage, sin copagos/carencias, paid for a year |
| Student | Mandatory | Plus repatriation; for the entire study period |
| Digital nomad | Depends on the situation | Not needed with Seguridad Social contributions, otherwise a full policy |
| Family reunification | Depends on the sponsor's status | Coverage for every family member |
| Salaried employment / autónomo | Not required | Coverage through Seguridad Social |
| Temporary protection | Not required | Access to public healthcare |
The rule carries over to renewals: if your ground does not give access to the state system, insurance coverage must be continuous for the entire period of residency. A gap in the policy is a typical problem when renewing no lucrativa.
Wording traps: what gets a file returned
Check the policy conditions (condiciones particulares) for these points:
- "Modalidad de reembolso" - a reimbursement policy: you pay yourself and the insurer compensates you later. Usually not accepted for a residence permit - direct coverage (cuadro medico) is required.
- "Copago de X euro por acto" - any co-payment disqualifies the policy.
- "Periodo de carencia: X meses" - a waiting period for hospitalisation or childbirth: formal grounds for refusal.
- "Seguro de viaje" / "asistencia en viaje" - travel insurance does not qualify, even with high coverage amounts.
- Limits and deductibles - annual hospitalisation limits or a contract deductible (franquicia) invite questions from the consulate.
- Coverage territory - it must be the whole of Spain, not a single region.
One separate practical point: the name, surname and passport/NIE number on the policy must match the application exactly. A transliteration mismatch is the kind of small detail that sends a file back for rework.
Cost and the alternative: convenio especial
Benchmarks for 2026 for policies that qualify for a residence permit: from 50-60 euro per month for young applicants and 100-200 euro for older ages; the price depends on age, region and whether repatriation coverage is included. An insurer may exclude chronic conditions from coverage - that is legal, but for a residence permit the fewer exclusions the better.
For those already living in Spain legally with a year of continuous padrón there is an alternative - convenio especial: paid access to the public healthcare system for a fixed monthly fee (benchmark: around 60 euro per month under 65 and about 157 euro after; the exact conditions are set by each autonomous community). It does not work for the initial visa, but over the long run it can be cheaper than a private policy.
How Krepko does it for you
The right policy is not the cheapest one in the search results but the one your specific consulate will accept for your specific permit type. Within our Insurance practice, Krepko:
- selects a policy that matches the requirements of your permit type and your consulate;
- requests a certificate from the insurer with the sin copagos y sin carencias wording;
- checks that your personal details match the file;
- keeps a renewal calendar so coverage is never interrupted, and moves you to convenio especial when needed.
Legally significant steps are performed by licensed specialists - lawyers, gestores, sworn translators. Putting together a residence permit file? Leave a request - the review is free, and we will find a policy that will not get turned away.
Sources
Frequently asked questions
No. Tourist policies, traveller insurance, reimbursement (reembolso) policies and international plans without a Spanish licence are not accepted for a residence permit. You need a policy from a licensed Spanish insurer with full coverage across Spain, with no co-payments and no waiting periods.
A copago is a patient co-payment for each service (a visit, a test, a scan). A carencia is a waiting period during which some services are not yet covered by the policy. For a residence permit the policy must be sin copagos y sin carencias - no co-payments and no waiting periods - so that coverage applies in full from day one.
For student visas repatriation coverage is usually mandatory. For no lucrativa and other types, some consulates also ask for it to be included. The requirement depends on the consulate and the visa type - check your consulate's hoja informativa before buying the policy and add repatriation if in doubt.
The 2026 benchmark is from 50-60 euro per month for young applicants up to 100-200 euro for older ages; the exact price depends on age, region and insurer. Consulates often require the policy to be paid a full year in advance - budget 600-1500 euro per person and confirm rates with the specific company.
Those already covered by the state system: employees and autónomo paying contributions to Seguridad Social, as well as temporary protection holders - they have access to public healthcare. For them a private policy is a matter of choice, not something Extranjería requires.
Yes, if the ground remains the same: when renewing no lucrativa or a student permit, continuous coverage is checked again. A gap in insurance is a frequent cause of renewal problems. After a year of padrón, the alternative to a private policy is convenio especial: paid access to the state system for a monthly fee (conditions depend on the autonomous community).
Need a policy that gets accepted first time?
Leave a request - the review is free. We will match the insurance to your permit type and consulate, obtain a certificate with the right wording and make sure your coverage runs uninterrupted all the way to renewal.
Discuss your caseThis material is for information purposes. Consulate requirements and insurers' terms change; check the hojas informativas on the official immigration portal. Legally significant steps are performed by licensed specialists - lawyers, gestores, sworn translators.
Related articles
Need help with this topic?
We will review your case for free and quote the exact cost and timeline. We reply in your messenger within 15 minutes during working hours.