Private Health Insurance in Madrid: Plans, Prices and Visa Rules
Sanitas, Adeslas, DKV, Asisa and Mapfre dominate the market. How the plans differ and what consulates expect from a policy.
Private health insurance in Madrid is sold mainly by Sanitas, Adeslas, DKV, Asisa, Mapfre and a few smaller insurers. As of November 2026, comparison sites quote full no-copay plans for an adult around €60 to €120 a month, with cheaper copay plans from about €20. For a Spanish residence visa you usually need a no-copay, no-waiting-period policy from an insurer authorized in Spain.
Who needs private health insurance in Madrid?
Three groups usually buy it. People applying for residence permits that require insurance, such as the non-lucrative residence or student stays. Residents with no right to public care who have not yet completed the one year needed for the public convenio especial in Madrid. And people who have public cover but want shorter waits for specialists or a private room in hospital.
Private insurance does not replace public emergency care. Any hospital emergency department treats you, and the insurer then decides what it pays depending on where you went.
What is the difference between copay and no-copay plans?
A copago (copayment) plan charges a small fee each time you use a service, such as a GP visit or a test, on top of the monthly premium. A sin copago (no copayment) plan has a higher premium but nothing to pay at the point of use, apart from excluded items.
| Feature | Copay plan | No-copay plan |
|---|---|---|
| Monthly premium | Lower | Higher |
| Fee per visit or test | Yes, set in the policy | No |
| Annual cap on copays | Some insurers set one; check the policy | Not applicable |
| Accepted for a residence visa | Generally no | Yes, if it also has no waiting periods |
| Best for | Occasional users with public cover | Visa applicants and frequent users |
How much do the main insurers charge?
Premiums depend on age, province, plan and any discounts, and insurers only show an exact price after a personalized quote. The figures below are starting prices from Spanish comparison sites, as of November 2026. They are a guide only.
| Insurer and plan | Type | Starting price quoted (as of November 2026) |
|---|---|---|
| Adeslas Plena Plus | No copay | About €62 to €77 a month; one comparison quotes €77 for a 40-year-old in Madrid |
| Sanitas Más Salud | No-copay version | About €65 to €84 a month; some quotes reach €121 |
| DKV Integral range | Copay and no-copay versions | Basic copay versions from under €40 a month |
| Asisa, Mapfre and others | Both types | Request a quote; prices vary widely by age |
Age is the main driver. A 30-year-old usually pays near the bottom of these ranges. Premiums climb steeply after 50, and a 60-year-old can expect to pay well above the starting price, sometimes double or more. Some insurers set a maximum age for new customers, so ask before you plan around a specific company.
What are waiting periods and pre-existing conditions?
A carencia (waiting period) is the time after you sign before certain services are covered. Common examples are childbirth, some surgeries and high-cost tests. Waiting periods for those items often last several months, while GP visits and emergencies are usually covered at once.
Pre-existing conditions (enfermedades preexistentes) are illnesses you had before signing. Insurers ask you to fill in a health questionnaire. They may exclude a condition, add a surcharge or decline the application. If you leave something out of the questionnaire, the insurer can refuse to pay related claims later.
- Read the list of exclusions in the general conditions, not only the summary.
- Ask whether the insurer will waive waiting periods if you switch from another Spanish policy.
- Check whether the insurer can cancel the policy at renewal. Spanish law allows insurers to oppose renewal in some cases.
Which plans meet residence visa requirements?
Consulates and immigration offices generally ask for a policy that:
- Is issued by an insurer authorized to operate in Spain.
- Covers the same range of care as the public system, including hospital stays, specialists and emergencies.
- Has no copayments and no waiting periods.
- Covers at least the length of the permit, often one year, paid up front or monthly depending on the consulate.
Travel insurance and international plans that only cover emergencies normally do not qualify. The exact wording consulates accept varies, so ask the insurer for a certificate that names the policy, states “sin copagos” and “sin carencias”, and gives the coverage dates. Our guide to the non-lucrative residence visa explains how insurance fits into that application. For anything unusual, check with the consulate or the immigration office before you pay.
What does private insurance usually leave out?
Most health plans exclude prescription medicines bought at a pharmacy, cosmetic treatment and most dental work beyond check-ups and cleanings. Dental care is often sold as an add-on. Our guide to dentist costs in Madrid compares those dental plans. Glasses and contact lenses are normally excluded as well.
Bottom line
Get two or three written quotes for your exact age and postcode, and ask each insurer for the visa certificate wording before you sign. Switching later can restart waiting periods, so choose the policy you would keep after the visa is granted.
FAQ
Can I use private insurance in public hospitals?
Only for emergencies, and the insurer may not pay for care in a public hospital. For planned care you use the insurer’s own network of clinics and doctors.
Is a copay plan enough for the digital nomad route?
Requirements differ by permit and change over time. Many applicants buy a no-copay plan to be safe; confirm with the authority handling your application.
Can I cancel at any time?
Most annual policies renew automatically. Under the Spanish Insurance Contract Act, you must give notice before the renewal date, usually one month, so check the deadline in your contract.
Does the premium rise every year?
Yes, usually. Insurers update premiums each year for age and medical costs, and the new price is sent before renewal.
