Sanitas vs Adeslas vs DKV vs Asisa: Spain Health Insurers
The best local Spanish health insurance providers are Sanitas, Adeslas, DKV, and Asisa. Each meets the visa requirements for expats living in Spain, and they each offer their own benefits, strengths, and add-ons. Deciding which one is best for you depends on your individual needs.
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Do you have an expat who has decided to purchase private health insurance through a local Spanish insurer? Need help comparing the features of each provider as you decide who to partner with?
This article is ready to do just that. We’ll compare the network size, coverage tiers, pricing, and pros and cons of each of these local insurance companies, and we’ll tell you which company is strongest for different patient needs. By the end, you should be ready to secure your coverage.
You also won’t want to miss our list of the top 10 health insurance providers for expats in Spain, in case you’d like to consider an international provider as well. You can also learn more about your public, private, and international health insurance Spain options on our post about them.
The Best Spanish Health Insurers for Expats Compared
Sanitas, Adeslas, DKV, and Asisa are the four most commonly chosen Spanish health insurers among expats who have decided on local coverage. All four offer visa-compliant private medical insurance, nationwide provider networks, and plans designed for long-term residents.
While these insurers overlap in core benefits, they differ meaningfully in hospital access, pricing structure, underwriting strictness, English-language support, and suitability for different expat lifestyles.
Review the following table with high-yield indicators for comparison.
Best Local Spanish Insurers Compared |
|||||
| Insurer | Network Size | Typical Monthly Cost* | Copay Options | English Support | Best For |
| Sanitas | 57,000+ providers | $70–$210
€60–€180 |
Yes / No | Strong | Expats wanting premium private hospitals |
| Adeslas | 43,000+ providers | $60–$190
€50–€160 |
Yes / No | Moderate | Broad access and competitive pricing |
| DKV | 51,000+ providers | $65–$200
€55–€170 |
Mostly Yes | Strong | Expats valuing flexibility and sustainability |
| Asisa | 40,000+ providers | $53–$170
€45–€150 |
Yes / No | Moderate | Budget-conscious long-term residents |
*Indicative pricing for adults aged 30–50; actual premiums vary by age, location, and underwriting.
If you’re not sure if local coverage is the right option for your needs, consider getting an international health insurance plan designed specifically for expats living in Spain.
Sanitas
Sanitas is often considered the most “premium” Spanish health insurer for expats, largely due to its strong hospital ownership model and extensive English-speaking services. Sanitas is part of the international Bupa Group.
This contributes to its international standards, digital infrastructure, and appeal to foreign residents.
Network and Hospital Access
Sanitas operates a mixed provider model combining owned hospitals with a large external medical network.
- Owned Hospitals: Sanitas manages over 20 proprietary hospitals and medical centers, particularly concentrated in Madrid, Barcelona, and major cities.
- Total Network Size: Access to more than 57,000 doctors and specialists across Spain.
- Hospital Quality: Sanitas-owned facilities are consistently ranked among Spain’s most modern private hospitals.
For expats, this model provides predictable quality and strong continuity of care, especially in urban areas.
Plan Coverage Tiers
Sanitas offers a wide range of plans that scale in coverage and cost, including their Sanitas Mas Salud, Sanitas Premium 500, and Sanitas Health Plan Classic.
- Basic Plans: Outpatient care, GP visits, diagnostics, and specialist consultations.
- Comprehensive Plans: Full inpatient coverage, surgeries, hospitalization, and advanced diagnostics.
- No-Copay Options: Visa-compliant plans with no cost-sharing, commonly required for residency applications.
Most plans include maternity, mental health, and preventive care, subject to waiting periods.
Pricing Structure
Sanitas pricing tends to sit at the higher end of the Spanish market.
- Typical Monthly Premiums: USD $70–$210 (€60–€180) depending on age and plan type.
- Age Sensitivity: Premiums increase steadily with age, particularly after 55.
- Copay Discounts: Copay plans reduce monthly premiums but increase out-of-pocket costs.
Pros and Cons for Expats
- Pros: Excellent hospitals, strong English support, robust digital tools, international reputation.
- Cons: Higher premiums, stricter underwriting for older applicants, urban-centric hospital footprint.
Sanitas is often best for expats prioritizing premium facilities and smooth communication over price.
Adeslas (SegurCaixa)
Adeslas, formally SegurCaixa Adeslas, is Spain’s largest private health insurer by membership and network reach. It is jointly backed by CaixaBank and Mutua Madrileña, giving it deep financial stability and nationwide penetration.
Network and Hospital Access
Adeslas offers the broadest geographic coverage of any Spanish insurer.
- Network Size: Over 43,000 medical professionals and 1,200+ medical centers.
- Regional Strength: Particularly strong outside major metropolitan areas.
- Public-Private Integration: Good access to smaller regional hospitals and clinics.
This makes Adeslas appealing to expats living in secondary cities or rural regions.
Plan Coverage Tiers
Adeslas’ plans are clearly structured around copay and coverage depth.
- Adeslas GO / Plena: Entry-level plans with outpatient and diagnostics.
- Plena Plus: Comprehensive inpatient and specialist coverage.
- Plena Total: No-copay, fully comprehensive plans suitable for visas.
Dental, wellness, and preventive services are often available as add-ons.
Pricing Structure
Adeslas is known for competitive pricing relative to network size.
- Typical Monthly Premiums: $60–$190 (€50–€160) depending on coverage level.
- Copay Flexibility: Multiple copay tiers allow cost customization.
- Family Discounts: Reduced rates for couples and dependents.
Pros and Cons for Expats
- Pros: Massive network, strong regional access, competitive pricing, stable insurer.
- Cons: Less premium hospital ownership, English support varies by location.
Adeslas suits expats who value coverage breadth and affordability over luxury facilities.
DKV
DKV positions itself as a flexible, sustainability-focused insurer with a strong appeal to younger and internationally minded expats. DKV is part of the ERGO Group and Munich Re, giving it solid European backing.
Network and Hospital Access
DKV’s network emphasizes flexibility and partial reimbursement.
- Network Size: Over 51,000 providers nationwide.
- Reimbursement Options: Some plans allow partial reimbursement for out-of-network care.
- Cross-Border Appeal: Easier coordination for care outside Spain on select plans.
This structure benefits expats who travel frequently or want provider choice beyond closed networks.
Plan Coverage Tiers
DKV offers modular plans with customization options.
- Integral Plans: Traditional network-based coverage with copays.
- Élite Plans: Higher reimbursement limits and broader provider choice.
- Visa-Compliant Plans: Available with no-copay inpatient coverage.
Mental health, alternative therapies, and preventive services are often emphasized.
Pricing Structure
DKV pricing is mid-range but variable based on flexibility.
- Typical Monthly Premiums: $65–$200 (€55–€170).
- Reimbursement Plans: Higher premiums offset by provider freedom.
- Copay Structures: Generally required but capped annually.
Pros and Cons for Expats
- Pros: Flexibility, reimbursement options, strong digital tools, sustainability focus.
- Cons: Copays are common, fewer owned hospitals, and reimbursement complexity.
DKV works well for expats who dislike rigid networks and value choice.
Asisa
Asisa is one of Spain’s oldest medical cooperatives and is widely recognized for value-driven healthcare access. It is physician-owned, which influences pricing and provider relationships.
Network and Hospital Access
Asisa maintains a solid but more traditional network.
- Network Size: Approximately 40,000 providers nationwide.
- Hospital Access: Strong in Madrid, Valencia, Andalusia, and Murcia.
- Doctor Relationships: High physician participation due to cooperative structure.
Facilities may be less modern than Sanitas but remain clinically reliable.
Plan Coverage Tiers
Asisa focuses on straightforward, no-frills plans.
- Basic Plans: Primary care, specialists, and diagnostics.
- Comprehensive Plans: Full hospitalization and surgery.
- No-Copay Visa Plans: Available and competitively priced.
Coverage is generally conservative, with fewer premium extras.
Pricing Structure
Asisa is one of the most affordable options.
- Typical Monthly Premiums: $53–$170 (€45–€150).
- Lower Age Loading: Often more accommodating for older applicants.
- Simple Pricing: Fewer complex add-ons.
Pros and Cons for Expats
- Pros: Affordable premiums, straightforward plans, strong doctor participation.
- Cons: Fewer premium hospitals, basic digital tools.
Asisa is best for budget-conscious, English-speaking expats prioritizing cost over luxury.
Mapfre Salud: Another Local Spanish Health Provider
Mapfre Salud operates slightly differently from the four insurers above, functioning more as a hybrid insurer with reimbursement-heavy structures. Mapfre appeals to expats who want insurer stability paired with partial provider freedom.
- Network Size: Approximately 40,000 providers.
- Reimbursement Focus: Many plans emphasize cost-sharing and refunds.
- Global Presence: Strong brand recognition outside Spain.
Mapfre Salud is less commonly chosen for visa compliance, but it can work well as supplemental or flexible coverage.
How to Know Which Spanish Insurer is Right For You
Choosing the right Spanish insurer depends on aligning personal priorities with each company’s strengths rather than assuming one provider is objectively superior. Different expat profiles naturally fit different insurers.
- Choose Sanitas If: You want premium hospitals, English-speaking support, and a polished private healthcare experience.
- Choose Adeslas If: You value the largest network, strong regional access, and balanced pricing.
- Choose DKV If: You want flexibility, reimbursement options, and international-style coverage.
- Choose Asisa If: You prioritize affordability, simplicity, and long-term cost control.
- Consider Mapfre If: You want partial freedom outside closed networks with a major global insurer.
For many expats, working with an independent broker allows side-by-side plan comparisons and ensures visa compliance while optimizing price and coverage.
Understanding your age, health profile, location, language needs, and long-term residency plans is the most reliable way to select the right Spanish health insurer with confidence.
Frequently Asked Questions
Are Sanitas, Adeslas, DKV, and Asisa accepted for Spanish visas?
All four insurers offer visa-compliant health insurance plans that meet Spanish residency requirements when purchased without copayments. Applicants must ensure the policy includes full inpatient coverage, no exclusions, and continuous validity for the visa duration.
Do Spanish health insurers cover pre-existing conditions?
Spanish health insurers typically underwrite pre-existing conditions and may exclude them, apply waiting periods, or decline coverage. Acceptance depends on medical history, age, and insurer policy, making disclosure essential during the application process.
Conclusion: Get Quotes from Multiple Insurers Today
To begin comparing plans from multiple insurers at once, we recommend consulting with an insurance broker. You can use a brokerage like Pacific Prime by contacting our team online, calling at +852-3113-1331, or by using our free online comparison tools.
We are an international health insurance brokerage with over 20 years of experience helping over a million and a half expatriates just like you secure healthcare coverage globally.
Utilize our exceptional online database that features over 50,000 expat-focused health insurance plans to begin comparing benefits, plans, quotes, and more! It’s a free resource anyone can use, and you won’t want to miss it!
We recommend expats and foreign citizens living in Spain reference the following links:
- Health Insurance for Latin American Expats in Spain
- Health Insurance by Region: Madrid vs Barcelona vs Costa del Sol
- Spain Digital Nomad Visa Guide
- Spain Healthcare for Expats
Serena earned her Bachelor’s Degree in Psychology from the University of British Columbia, Canada. As such, she is an avid advocate of mental health and is fascinated by all things psychology (especially if it’s cognitive psychology!).
Her previous work experience includes teaching toddlers to read, writing for a travel/wellness online magazine, and then a business news blog. These combined experiences give her the skills and insights she needs to explain complex ideas in a succinct way. Being the daughter of an immigrant and a traveler herself, she is passionate about educating expats and digital nomads on travel and international health insurance.
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