Health insurance for Spanish residency: what US movers need to know
US health insurance and Medicare don't cover you in Spain. Here's how American movers pick a private Spanish policy the consulate will actually accept.
For most Spanish residency visas — Non-Lucrative and Digital Nomad in particular — Spain requires full private health insurance equivalent to the public system: no copays, no exclusions, no waiting periods, full repatriation.
US health insurance, including most employer plans, ACA marketplace plans and Medicare, does not qualify. Medicare in particular does not travel — it generally does not cover care outside the United States. You need a Spanish-resident-grade policy underwritten by a Spanish insurer with a certificate the consulate recognises.
Common providers include Sanitas, Adeslas, DKV and Asisa. Pricing depends on age and pre-existing conditions; expect roughly $60–$220 per person per month for a residency-grade policy.
The trap most American movers hit is buying a cheaper Spanish policy with a copay structure — perfectly fine for normal use, but rejected by the consulate. The certificate must explicitly say sin copagos, sin carencias, con cobertura de repatriación.
Once you become a Spanish tax-resident and contribute to the system (via the Digital Nomad route or work), you may qualify for the public Spanish system (SNS). Until then, private cover is mandatory.
We work with brokers who specialise in residency-grade policies, run the paperwork in English, and make sure the certificate matches what the Spanish consulate in your US jurisdiction asks for.
Frequently asked questions
Does Medicare cover me in Spain?
No. Original Medicare generally does not cover care outside the United States. A small number of Medicare Advantage and supplemental plans offer limited foreign emergency cover, but none meet the Spanish residency requirement.
How much does residency-grade health insurance cost in Spain?
Roughly $60–$220 per person per month depending on age and pre-existing conditions. Most American movers in their 50s and 60s land in the $100–$180 range.
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