Best Health Insurance in Spain for British Expats

Brexit changed the rules for British expats in Spain more significantly than for any other nationality. Before 2021, British citizens enjoyed the same EU freedom of movement rights as any other EU national. Since then, moving to Spain as a British citizen requires a visa — and health insurance is central to that process.

Whether you're already living in Spain or planning your move, this guide explains what British expats need to know about health insurance in Spain in 2025 and beyond.

The Post-Brexit Picture

Before Brexit, British citizens in Spain could access the Spanish public health system through their EU residency rights. After the Withdrawal Agreement deadline of 31 December 2020, things became more complicated.

If You Were Already in Spain Before 2021

British citizens who were legally resident in Spain before the end of the transition period (31 December 2020) are protected by the Withdrawal Agreement. Most have the right to remain in Spain and should have received a TIE (Tarjeta de Identidad de Extranjero) confirming their residency rights.

In terms of healthcare, those with an S1 form — issued by the UK government and registered with the Spanish health system — may retain access to Sanidad. However, the administration of this varies by region, and many British expats who technically qualify still opt for private health insurance for the reasons we explore below.

If You're Moving to Spain After 2020

If you're a British citizen who has not yet moved to Spain — or who moved after December 2020 without registering under the Withdrawal Agreement — you're now treated as a non-EU third-country national. To live in Spain, you need a visa, and for most of the popular visa routes, private health insurance is a mandatory requirement.

Visa Options for British Expats

The three most popular visa routes for British expats are:

Non-Lucrative Visa (NLV)

The NLV is for people who can support themselves financially without working in Spain — retirees, people living on savings or investment income, or those financially supported by others. It's the most common visa route for retired British expats. Health insurance is a mandatory requirement, and the policy must be comprehensive, from a DGSFP-registered Spanish insurer, and without significant copayments.

Digital Nomad Visa (DNV)

The DNV is for remote workers and freelancers who earn income from companies or clients outside Spain. It's increasingly popular with British professionals. Health insurance requirements are similar to the NLV — comprehensive, DGSFP-registered, and without copayments in most consulates' requirements.

Golden Visa

The Golden Visa is for investors who make a qualifying investment in Spain (typically property worth over €500,000, or a significant financial investment). Health insurance is still required as part of the residency conditions.

Why Most British Expats Choose Private Insurance Even When They Don't Have To

Even among British expats who have rights to Spain's public health system through the Withdrawal Agreement, private health insurance remains extremely popular. The reasons are consistent:

Language

Most public health appointments in Spain are in Spanish. Medical conversations are complex enough in your native language — navigating a diagnosis, treatment options, or a follow-up plan in a language you're not confident in adds real stress. Private hospitals and clinics in expat-heavy areas of Spain — the Costa del Sol, Costa Blanca, Alicante, Marbella, Barcelona — often have English-speaking staff and are designed to serve international patients.

Waiting Times

The Spanish public health system is a good one, but it is under pressure. Waiting times for non-urgent specialist referrals can be weeks or months. For things like a dermatology appointment, an orthopaedic consultation, or a cardiology check-up, private insurance typically means you're seen within a few days.

Choice

With private insurance, you can generally choose your specialist, your hospital, and — to some extent — your timing. In the public system, you go where you're referred and when you're called.

What to Look for in a Policy for British Expats

When choosing health insurance in Spain as a British expat, these are the key factors:

• Hospital network coverage in your area — check that the insurer has good hospitals and clinics in your specific region of Spain, not just in Madrid or Barcelona
• English-speaking customer service — you want to be able to call your insurer and speak to someone in English if something goes wrong
• Copayment structure — if you're applying for a visa, you'll likely need sin copago; if not, consider what works best for your usage patterns
• Pre-existing condition handling — particularly relevant if you have ongoing health conditions
• Dental and optical add-ons — these are often worthwhile, particularly for retirees

The Best Spanish Insurers for British Expats

The major insurers used by British expats in Spain include:

• leading Spanish health insurers — strong network, good English-language service, popular in expat communities
• major health insurance providers (international insurance groups) — extensive hospital network across Spain, competitive premiums
• established health insurers — good value, strong in some regions
• international health insurers — known for digital tools and straightforward claims

The "best" option depends on your region, age, health history, and specific requirements. At 247 Expat Insurance, we compare all of these (and more) and give you a personalised recommendation based on your situation — not a one-size-fits-all answer.

Get Sorted Before You Move

One of the advantages of working with 247 Expat Insurance is that we can arrange your health insurance from the UK — before you move to Spain. If you need a policy in place for your visa application, we can have it sorted well in advance of your consulate appointment.

Contact our English-speaking team today. We're available 7 days a week and understand the specific needs of British expats in Spain.