Healthcare: US vs. Spain. What Healthcare Really Looks Like on Each Side

Moving to Spain compares US and Spanish healthcare on outcomes and cost, and explains the private insurance a Spain visa requires.

  • Members only
  • Recorded webinar

Already a member? Sign in to watch

About this session

Moving to Spain, Expatsi's partner for Spain, compares healthcare in the US and Spain using its own independent research. Price is only part of it. The session also looks at how each system works and what care feels like day to day. Stephanie, Expatsi's chief revenue officer, hosts and moderates.

Spain has about half the US rate of treatable deaths and spends about a third as much per person. The talk covers the public system's GP gatekeeper, regional wait times and why most expats keep private cover. It also sets out the visa rule: insurance must cover pre-existing conditions, with no copays. US policies don't qualify. In the Q&A, the host asks about public wait times and alternative medicine.

Key takeaways

  • A private policy used for a Spanish visa cannot exclude pre-existing conditions and must have no copayments. Of the more than 6,000 healthcare quotes Moving to Spain has issued, 60% were for people with pre-existing conditions.
  • US coverage generally won't pay for care in Spain and won't be accepted for a visa. Tricare and VA care can work in some places overseas, but they aren't registered in Spain, so you still need a Spanish compliant policy.
  • Recent quotes for a single applicant aged 65 to 69 averaged 1,600 to 2,500 a year, covering primary, specialist and hospital care with zero copayments. Dental care, some mental health care and prescriptions are generally excluded.
  • Age and pre-existing conditions drive the price. A 68-year-old client with a severe condition paid €5,000 a year, and the highest seen was €8,000 for a single person over 80, so get cover sorted before you turn 80 if you can.
  • Find out whether you can get qualifying health insurance right after you identify your visa or residency pathway. Some people have sold houses and got 90% of the way through a move before discovering healthcare was a problem.
  • Public wait times depend on which of Spain's 17 autonomous communities you live in, while private cover is countrywide. Still ask the insurer whether it will cover the town you want; one insurer would not cover a client in a small rural town in Galicia.
  • Bring as many medical records as you can and up to 3 months of prescriptions. You may have to change the type of medication you're on in Spain.

Chapters

  1. 0:03Welcome, and why Americans ask about healthcare in Spain
  2. 4:19Preventable deaths and per-person spending: Spain vs. the US
  3. 5:55Primary care, the GP gatekeeper and Spain's public and private systems
  4. 11:57Unmet medical need and what private insurance costs in Spain
  5. 15:00Public wait times, emergency care and the 17 autonomous communities
  6. 17:59Why expats with public access still keep private cover
  7. 19:38Where the US is ahead: research, drug trials and tertiary care
  8. 20:43Real cases: a suspect mole, a retina bleed and a $750-style ER bill
  9. 27:10Pre-existing conditions, age and visa-compliant insurance
  10. 30:42Why US cover, Tricare and VA care won't work for a Spanish visa
  11. 32:41Records, prescriptions, dental, vision, mental health and policy checks
  12. 38:12Q&A: public wait times, alternative medicine and Spanish pharmacists

Questions from the session

Are wait times in Spain's public healthcare system really long?

Wait times apply to the public system; in the private system they don't happen. In the public system, primary care has no real wait, but elective surgery and specialist care can take much longer, and waits vary by town, hospital and autonomous community. Public wait times are published. Public emergency rooms can also be slow, especially on a Saturday night.

Is alternative medicine like chiropractic or acupuncture available in Spain?

Yes, there are plenty of alternative options, including chiropractors, osteopaths and homeopathy. It is not covered in the public system and is seldom covered by private insurance. You'll tend to find more practitioners in areas with larger expat communities than in small, traditional towns. Pharmacies also carry a large range of wellness and alternative products alongside prescription drugs.

Will Medicare or my US health insurance work for a Spanish visa?

No. US coverage generally won't pay for care in Spain and won't be accepted for a visa application. You need health insurance written by a Spanish health care company or a company registered with the Spanish immigration department. Tricare and VA care can be used in some places overseas, but they aren't registered in Spain, so they won't satisfy the visa requirement.

Can I get health insurance for a Spain visa with a pre-existing condition?

Usually, yes. Visa-compliant policies must cover pre-existing conditions, so declare them. Minor ones like glaucoma, allergies or asthma often don't change the price. Controlled type 2 diabetes or hypertension can raise the premium, and conditions like autoimmune disease, cancer history or stroke are assessed individually. Serious or ongoing issues can be declined. Cover gets quite hard after 75, and after 80 it can be really difficult if you have severe conditions.

Transcript

Auto-generated from the session’s captions and lightly corrected; it may contain errors.

0:03Hello everybody. Welcome, welcome, welcome. I just noticed that I have got my little light spots bleeding in from my electric shutters. I love the effects. It always makes me feel like I'm living in a disco ball. We're going to fix that. Um, I want to welcome everybody to today's session. My name is Stephanie Stone Rob. I am the chief revenue officer here at Expatsi. Oh, that's even worse. Um, again, welcome everybody to today's session. Thankfully, you don't have to look at my weird lighting for too long because we'll be handing it over to our partner over at Moving to Spain. Today,

0:37we're going to be talking not about how do I move to Spain, what is a visa, what do I need to qualify, but we're going to focus on a topic that we get a lot of questions about, and that is okay, how do I navigate health care? You know, as Americans, we are so in tune to uh the American health care system. Um the good, the bad, and the ugly. uh you know as as an American who now lives abroad that was something that was very much forefront of my mind you know just just remembering the challenges and the cost

1:07of American health care and then going okay but when I move what's going to is it going to be different is it going to be easier are there things that I need to know before I make this move so we're going to be doing a deep dive into the health care system in Spain and how it compares to the US and what you need to know as you navigate this move abroad Before I turn things over to Alistister, just a couple quick pieces of housekeeping. Number one, we are recording this session. I will make sure that everybody has a copy of this

1:38recording. It'll be in your inbox first thing tomorrow morning. Number two, we always encourage questions during any of our webinars, and this one, of course, is no different. Down at the bottom of your Zoom window, you're going to see a little box says Q&A. Has a little question mark right in the center. You can click on that Q&A box at any point in time and type in any questions that you have about today's topic or even questions about general questions about moving to Spain. Um Alistar and his team at Moving to Spain handle everything when it comes to Spain relocation stem

2:11to Stern. So we want to make sure that we get your questions answered. So if you have any questions, click on that Q&A box, type your question in. Please do not feel like you have to wait until the end of the presentation or you have to wait for me to go, "Oh, it's okay to ask questions now." If two minutes from now mentioned something and you go, "Oh, that reminds me. I need to get clarification on XYZ." Click on that box, type your question in. I think that's enough from me. I'm going to go ahead and turn things over to

2:40Alistister. Thank you so much for joining us today here at Expatsi. Thanks very much for having us. And again, Stephanie and the Expat team, we we're so happy to be in this partnership with with the air and really hope we can shed some light on this topic tonight. So, this um is a question that gets raised heaps is what's the difference in healthare between the US and Spain. Not just what it cost, but what does it actually feel like? What does it if you do move to Spain? What's the experience of health care beyond just paying for it? And we'll look at definitely what it

Which country fits you best?

Take the free 5-minute test.

400,000 people have taken it

Take the test