Private Spanish healthcare system – how it works

The health of your loved ones

In my last post I talked about the public healthcare system in Spain in general. 

Today I want to expand this topic by talking about the private Spanish healthcare system

Similar to the public system, there are lots and lots of private doctors, hospitals and health centres. 

You can use it in the same way you use the public system:

You have your GP or Peadiatrician who then refers you to a specialist if needed. 

Or you go straight to a specialist.

You go to the health centre, clinic, practice or hospital where that doctor is based and that’s it. 

It works the same, but it has some differences.

Main differences

  1. You can choose your doctors, specialists included;
  2. you can go to a specialist bypassing your GP or peadiatrician;
  3. you choose what health centre or hospital you want to go to;
  4. and sometimes get appointments much quicker than on the public system (not always these days).

In my non-solicited opinion, I believe that the second and fourth points are the most valuable ones. 


Because if you hurt yourself in the gym, for instance, you don’t want to go to your GP to be referred to a traumatologist and wait a few weeks to be seen. 

It’s just an example, but it happens. 

You can easily just book an appointment with the private specialist of your choice (hoping that you do know what specialist is the one you need) and be seen much quicker. 

Why am I emphasizing the fact that it’s not that quick anymore?

From COVID on, many procedures in the public system stopped, like planned (but not urgent) operations, or some regular check ups, for instance.

So people who had a private health insurance started going to the private doctors and hospitals instead than going to the public doctors and hospitals, which clogged that system. 

The result is that the waiting times are now longer than what they used to be. 

(If you don’t think this is true, try book an appointment with a dermatologist and see the waiting time.)

But things are starting to go back to normal, though, so there’s no need to panic.

I mention this, for you to take into account and know what is going on. 

Different insurances

Spain being a country with a market economy, has many private health insurances to choose from. 

The one you end up with, if you come to Spain as an expat because your or your spouse’s company sent you, depends on them. 

Different companies usually have agreements with different insurances. Nothing new here.

To name a few insurances:

  • Asisa
  • DKV
  • Mapfre
  • AXA
  • Cigna
  • Adeslas
  • Generali
  • Caser
  • ASC
  • Agrupación Mutua
  • and Sanitas (BUPA in the UK)


So how do they work?

Well, they have agreements with the doctors. 

So whenever you go to a private clinic, you have to ask if they or a particular physician accepts your insurance, because not all doctors accept all private insurances. 

If they do, then you can be their patient without paying anything extra.

Most big hospital groups, like HM or Quirón, accept all insurances and have clinics and hospitals all over the country and all medical specialisations.

You can of course go to a specialist to one hospital, say OB-GYN, and to another specialist, eg. gastroenterologist, to a different one. 

Problems I see by doing this

These are the problems I see by doing this, which doesn’t mean that I don’t do it. 

I just want you to keep it in mind.

If you…

  • want a second opinion
  • want to change the doctor altogether
  • change your insurance for whatever reason and the new insurance doesn’t cover your actual doctors (been there, so I know)

you have to bring all your medical history to the new physician and hopefully not start from zero, whatever you are doing. 

However, it is doable and it’s not the end of the world. 


And now, let’s talk about Sanitas

Which is the Spanish brand of UK based BUPA.

What is different about them, is that they work like the public system…

… but being private. 

They have their own health centres and hospitals and they only accept their policy takers.

And the rest of the private hospitals and health centres don’t normally take Sanitas clients. (There must be exceptions, but please do ask at your local centre.)

Which is the best?

This is very subjectiv and I’m not here to recommend any insurance. 

My take on it is, if your company gives you private coverage as part of your salary package, you don’t have an option but to go with it. 

You do other options, of course, but but most likely you will have to pay for it yourself. 

I don’t really know.

What I know is that you will find good and bad doctors everywhere. 

We’ve found amazing doctors on Sanitas that also take private patients in other clinics. 

We’ve found amazing public doctors that also see private patients in private clinics.

So, do I go private or public?

As I mentioned on the other post, I go public for most issues. 

When I need to resolve things fast, I go private. 

If I had a serious illness, that I haven’t had, thank God, I’d go public. 

Just this morning I was at my local public health centre because my daughter had a tummy pain. 

The doctor told me to bring her straight to La Paz (one of the best hospitals in the whole country) in case her pain got worse. 

I didn’t question that. 

I’m clear that if my kids or us need an life or death operation, we’d go public. 

But if you need a quick fix, go private. 

And please do take this with a pinch of salt:

this is MY opinion only. 

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