It depends on how you live in Spain. EU citizens who do not work there need public or private health insurance covering all risks in Spain to register, and non-lucrative and digital nomad visa applicants must show insurance too. If you work for a Spanish employer or hold an S1 form, the public system usually covers you.
It depends on
Employees and the self-employed are covered through Spanish social security, while inactive EU citizens, students and non-lucrative residents must show insurance.
The non-lucrative route requires insurance with an insurer authorised in Spain; the digital nomad route accepts social security or equivalent private cover without co-payments or waiting periods.
After one year of residence on the municipal register (padrón), people without other public cover can join the public system for a monthly fee under the convenio especial.
Who needs it
Private or international health insurance is most relevant for people moving from Germany without a Spanish employment contract: early retirees who do not yet receive a pension, people living on savings or investment income, and remote workers who are self-employed or employed abroad. Non-EU nationals, including non-EU spouses, applying for the non-lucrative residence or the international telework visa must present a qualifying policy. Pensioners with a German statutory pension may be entitled to an S1 form instead, which gives access to the Spanish public system. People employed by a Spanish company are usually covered through social security.
How it works
- 1
Register as an EU citizen
Register on the padrón, then apply for the registration certificate with form EX-18 at the Oficina de Extranjería or police station of your province.
within three months of entry - 2
Choose a policy that meets the rules
For EU registration, cover must be public or private and include all risks in Spain; for the telework visa, travel policies and policies with co-payments (copagos) or waiting periods (carencias) are refused.
- 3
Check the insurer's authorisation
For the non-lucrative route, the policy must be with an insurer authorised to operate in Spain; ask the insurer for a certificate confirming this and the cover.
- 4
Plan your route into the public system
Employment, an S1 form or, after one year of registered residence without other cover, the convenio especial can give access to the national health system (SNS).
- 5
Keep cover continuous
Keep proof of uninterrupted insurance, as authorities may ask for it again in later residence procedures.
What it costs
| Item | Amount | Note |
|---|---|---|
| Convenio especial, under 65 | €60 per month under 65; €157 per month from 659 | Outpatient prescription medicines are paid in full. |
| Convenio especial, 65 and over | €60 per month under 65; €157 per month from 659 | |
| EU registration certificate fee | €123 | |
| Private health insurance premium | [amount] | Depends on age, insurer and level of cover; visa routes may exclude policies with co-payments or waiting periods. |
Key facts
| Fact | Value | Source | Checked |
|---|---|---|---|
| EU citizens: deadline to apply for the registration certificate | Within three months of entering Spain | 12 | checked 15 October 2026 |
| EU registration certificate: fee (tasa 790 código 012) | €12 | 3 | checked 15 October 2026 |
| EU citizens without work in Spain: health insurance | Public or private sickness insurance covering all risks in Spain | 2 | checked 15 October 2026 |
| Digital nomad visa: health insurance | Spanish social security or equivalent private insurance from an insurer authorised in Spain, without co-payments or waiting periods | 45 | checked 15 October 2026 |
| International telework (digital nomad) visa: minimum income | €2,849 per month (€34,188 per year) | 458 | checked 15 October 2026 |
| Non-lucrative residence: health insurance | Public or private sickness insurance with an insurer authorised to operate in Spain | 6 | checked 15 October 2026 |
| Non-lucrative residence: minimum means | €2,400 per month (€28,800 per year); +€600 per month per family member | 67 | checked 15 October 2026 |
| IPREM (reference index for residence permits) | €600 per month (€7,200 per year in 12 payments) | 7 | checked 15 October 2026 |
| Minimum wage (SMI) 2026 | €1,221 per month in 14 payments (€17,094 per year) | 8 | checked 15 October 2026 |
| Public health cover by paid agreement (convenio especial) | €60 per month under 65; €157 per month from 65 | 9 | checked 15 October 2026 |
| EHIC (European Health Insurance Card) after moving to Spain | Temporary stays only; not a substitute for cover after a move | 10 | checked 15 October 2026 |
Common mistakes
- Presenting travel insurance for the digital nomad visa, where it is not accepted.
- Choosing a policy with co-payments or waiting periods when the route requires full cover.
- Using a foreign insurer for the non-lucrative residence without confirming it is authorised to operate in Spain.
- Relying on the European Health Insurance Card (EHIC) after moving, although it only covers temporary stays.
- Cancelling German cover before Spanish cover or an S1 form is confirmed.
FAQ
Is private health insurance required for the non-lucrative residence?
Yes. Applicants need public or private sickness insurance arranged with an insurer authorised to operate in Spain, in addition to means of 400% of IPREM, which is €2,400 per month in 2026. Because this permit does not allow work, most applicants rely on a private policy, so check that the insurer and the cover meet the requirement before applying.
What insurance does the digital nomad visa require?
The international telework visa accepts registration with Spanish social security or private health insurance from an insurer authorised in Spain that offers equivalent cover. Travel insurance and policies that only reimburse medical costs are not accepted, and policies with co-payments or waiting periods are refused. Applicants must also show income of at least €2,849 per month in 2026.
Can I join the Spanish public system without working?
Possibly. If you have lived in Spain for at least one continuous year, are on the municipal register and have no other public cover, you can apply for the convenio especial. It costs €60 per month under 65 and €157 per month from 65, and covers the basic service portfolio without co-payments. Outpatient prescription medicines are paid in full.
Can I use my EHIC after moving to Spain?
No. The European Health Insurance Card only covers medically necessary state treatment during temporary stays. When Spain becomes your habitual residence, you should rely on Spanish social security, an S1 form issued by your previous country if you are entitled to one, or private insurance. The card does not cover private clinics or return transport home.
Sources
- Policía Nacional – Sede electrónica, Certificado de registro de ciudadano de la Unión Europea (opens in a new tab)Authority · checked 15 October 2026
- Punto de Acceso General – administracion.gob.es, Tu espacio europeo: obtener la residencia (updated 1 October 2026) (opens in a new tab)Authority · checked 15 October 2026
- Boletín Oficial del Estado, Orden PJC/617/2025, de 13 de junio (tasas de extranjería) (opens in a new tab)Law · checked 15 October 2026
- Ministerio de Inclusión, Seguridad Social y Migraciones – Unidad de Grandes Empresas, Nómadas digitales: preguntas frecuentes (opens in a new tab)Authority · checked 15 October 2026
- Consulado General de España en Santiago de Chile (Ministerio de Asuntos Exteriores), Requisitos visado de teletrabajo de carácter internacional (opens in a new tab)Authority · checked 15 October 2026
- Ministerio de Inclusión, Seguridad Social y Migraciones, Hoja informativa 6: Autorización inicial de residencia temporal no lucrativa (opens in a new tab)Authority · checked 15 October 2026
- Ayuntamiento de Madrid – Sede electrónica, Indicador público de renta de efectos múltiples (IPREM) (opens in a new tab)Authority · checked 15 October 2026
- Boletín Oficial del Estado, Real Decreto 126/2026, de 18 de febrero, por el que se fija el salario mínimo interprofesional para 2026 (opens in a new tab)Law · checked 15 October 2026
- Ministerio de Sanidad, Convenio especial de prestación de asistencia sanitaria (opens in a new tab)Authority · checked 15 October 2026
- European Commission, European Health Insurance Card (opens in a new tab)Authority · checked 15 October 2026
About the author
[Author name]
[Role]
[Short bio.]
[Personal experience abroad.]
About the reviewer
[Reviewer name, qualification]
Specialist reviewer
[Short bio.]
[Professional background.]