Doing Healthcare the Spanish Way
What we've learned living in a country with universal healthcare
One of the questions I often get about living abroad is about healthcare. After all, healthcare in the United States is anything but straightforward. As an adult, you have to learn how to navigate a maze of deductibles, copays, out-of-pocket maxes, denials, appeals, and much, much more.
I’ve had a pre-existing eye condition since I was in my 20s, requiring injections and frequent doctor visits. I’ve had fights with health insurance companies about coverage, been denied, and made appeals–the works. I feel like I’m fairly well informed on this topic, whether I want to be or not.
As a shiny new adult, my mom advised me to “always buy the best health insurance you can afford.”
So I did. Always. And year after year, it was painfully expensive, increasing in cost despite generous employer subsidies.
When I decided to become a stay-at-home mom for a while a year after our daughter was born, I became completely dependent on my husband’s employer coverage. This meant that if he ever lost his job, we’d be on the hook for thousands of dollars every month for COBRA or an ACA plan, which we did not have the extra funds for then.
In 2024, as we gathered our paperwork and prepped for the move to Valencia, Spain, part of our visa process included proof of an annual health insurance policy with no deductibles or copays. We shopped it around, hoping it wouldn’t be completely ridiculous. My research told me it wouldn’t, but you never know until it’s in your hands.
Ultimately, we landed on a policy covering everything except my eye injections. The injections are more expensive here, out-of-pocket, than I paid in the U.S. However, the policy itself for our family of four was about $3,000. We were used to paying $17,000/year, which sounds insane as I type it out now. I would need to receive a lot of treatments to cover that difference.
Walking into a doctor’s office in Spain is not much different than in the U.S. There are waiting rooms, exam rooms, etc. The offices I’ve been to are very modern and up-to-date. If you aren’t going to a practice with its own building, you will likely go to a hospital, where the subspecialties are divided into their own spaces.
We have private insurance, which was required for our visas, and we cannot yet use public healthcare. Once we’ve been here for a year, we will have access to the public system if we choose. Because we are not Spanish or EU citizens paying taxes into that system, we will have to pay a monthly fee for each family member. I believe it’s around €60 each (if you’re under 65), and you pay €0 for most treatments. With private insurance, we also pay €0 for most treatments (unless it is excluded from coverage). Most people I talk to say it’s worth having options in both systems, and we may also opt for that.
Prescriptions are generally far more affordable here in Spain than in the U.S. For example, my husband takes a medication that was about $40 for a 90-day supply. Here in Spain, it’s €1.50 for the same prescription. The pharmacist laughed at him when he had to ask her to repeat the price because surely that couldn’t be correct! I won’t pretend to understand how this works, but I believe it has to do with the public healthcare system and how taxes subsidize public healthcare and prescription drugs.
Of course, a post on a giant topic like this could go on for days. But so far, we are incredibly happy with the quality and cost of healthcare in Spain. We haven’t had to wait months to be seen, and we haven’t been rushed out the door at every appointment. We are also provided with full explanations of care.
While there are flaws–no system is perfect, after all–healthcare here is as modern and efficient as it is in the U.S. without the tremendous price tag.