Health Insurance
with a co-payment


If you are looking to reduce the oevrall cost of the annual insurance premium for your health insurance in Spain then you could consider a policy with a co-payment.

There is a broad range of companies offering health insurance with co-payments in Spain. Some companies offer various co-payment options.

What is a co-payment

A co-payment is an agreed amount the client pays towards a treatment covered under the policy on top of their annual premium. Generally speaking the higher the co-payment you agree to make then the lower the annual premium.

There are a number of things to take into account before accepting a policy with a co-payment.

  1. Accepting a co-payment will reduce the annual premium of your insurance premium.
  2. However, if you become ill and need to use the policy then you will start to incur these extras payments. This might be at a time where you cannot work so could come at a time when your finances are not at their best.
  3. If you want a health policy for a non-lucrative or golden visa or for Spanish residency then a health policy with a copayment will not be accepted.

Is there a limit on the amount of copayments?

Some companies will set a maximum total cost of copayments per year. Once that figure is reached, they will not ask you to make any more co-payments.

Can I change from a co-payment policy to a no co-payment policy or vice versa?

Once you take a health policy with a company then it is a 12-month contract. Usually you cannot chnage the type of cover you have contracting during the year.

At least one month before renewal you can ask the health insurance company if you can improve the cover to a policy without co-payments or vice versa. The amended policy will then be in that new format for the following 12-months.

How are co-payments made?

Co-payments are accrued, processed and then collected from your nominated bank account on a regular basis. You do not pay the co-payments to the doctor, specialist or hospital.

Can I spread the premium by paying in instalments?

Yes. These policies can be paid monthly, quarterly, six-monthly or annually. The contract is for 12-months so even if the company agrees to splitting the annual premium into instalments you are legally contracted to make all of those payments to reach the annual premium.

Whilst splitting the annual premium will make it easier to pay, you should be aware that the annual premium usually increases overall if you pay in instalments.

Can I cancel the policy at any time?

No. All health insurance policies in Spain are 12-month contracts. You can write to cancel the renewal but you cannot cancel during the year. All these policies are 12-month automatically renewable. If you don't want the policy to renew you must cancel it in writing at least one month before the renewal date.

Do I need to take a medical examination?

No. There is no requirement for any of the applicants for the health insurance policy in Spain to take a medical examination.

You will need to complete and application form and complete and sign a health declaration. The health declaration varies from company to company. Common questions that are included in these questionnaires are:

• Height and weight.
• Whether you have undergone an operation or been hospitalised. The reason, what the treatment was and what is the current situation.
• Are you currently on any medication? You should give the name and dosage of the medication and the reason for taking the medication.
• Are you currently suffering from any illness, what it is, any ongoing treatment or medication etcetera?

The companies use this information when considering whether they will underwrite the policy. See the section on pre-existing conditions.

I have some pre-existing conditions

All private health insurance companies will exclude pre-existing conditions. That means that should you have a medical issue that relates to a conditions you had at the time of applying for the policy then it will not be covered by the policy. The cost of any treatment for the pre-existing condition would have to be met by the individual and is not covered or paid for by the insurance company.

When you complete your medical questionnaire (see the section “Do I need to take a medical examination?”) the insurance company may want to contact you either by email or phone to clarify your answers, request a more detailed questionnaire or ask for a medical report from your doctor about something you have entered on the questionnaire. They will use this information to decide if they are willing to issue the health insurance policy.

The completion of the medical questionnaire and your pre-existing conditions will influence whether the insurance company will provide a health insurance policy or not. There are three possible outcomes. 1) you are accepted without any exclusions included in the policy, 2) The company agrees to provide you with a health insurance in Spain but with exclusions. You will be asked whether you accept them or not, 3) Your application is declined. Something in your medical history is outside what the insurance company feels is a comfortable risk to accept. In this scenario, the insurance company decides not to offer any type of health insurance at all.

Please check the FAQs to find the answers to the main questions about medical insurance in Spain. You can also contact us for more information.

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