Top 10 Insurance Companies for Expats in Spain in 2026
Private international medical insurance is essential for non-EU citizens living in Spain. The top 10 health insurance companies for expats in Spain include Blue Cross Blue Shield, AXA, Cigna, NOW Health, April International, Allianz, Bupa Global, IMG, Generali, and Aviva. Choosing the right health insurance in Spain depends on coverage limits, premiums, and benefits like dental or maternity care. In this article, we highlight the top 10 providers for expats, along with other options, to help you compare plans and select the best coverage for you and your family.
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Best Health Insurance Options for Expats in Spain in 2026: Top Providers
The 10 best health insurance companies for expats in Spain are
- Blue Cross Blue Shield
- NOW Health International
- April International
- AXA
- Cigna
- Allianz Care
- Bupa
- Generali
- Aviva
- IMG
Some additional insurance companies for expats in Spain to consider include the following:
If you would like more information about how the healthcare system works in Spain, consult this blog post.
Blue Cross Blue Shield for Expats in Spain
Blue Cross Blue Shield is an outstanding insurance provider for American expats living in Spain and worldwide. This insurance company has one of the largest global direct billing networks, an unlimited annual benefit limit, and provides covered telemedicine services to policyholders.
Blue Cross Blue Shield’s comprehensive plans start at USD $412 monthly for a 30-year-old female expat in Spain, with a deductible of up to USD $10,000. This affordable plan even covers annual health checks and vaccines.
The following table illustrates how comprehensive Blue Cross Blue Shield’s benefits are for American expats in Spain.
| Blue Cross Blue Shield Insurance Coverage Availability for Expats in Spain | |
| Benefit | Availability through Blue Cross Blue Shield |
| Inpatient & Outpatient Coverage | Available |
| Emergency Evacuation and Repatriation | Available |
| Dental Coverage | Available with a 3-month waiting period |
| Maternity Coverage | Available at renewal after 12 months |
| Coverage for Annual Health Checks | Available |
| Vaccination Coverage | Routine vaccines are covered, and there is a USD $500 limit for travel vaccinations. |
NOW Health International: Comprehensive Expat Insurance in Spain
NOW Health International plans for expats in Spain have an annual benefit limit of up to USD $4,500,000. These plans are comprehensive and provide coverage for inpatient, outpatient, emergency evacuation and repatriation, dental, maternity, and wellness.
NOW Health International’s plans offer the following comprehensive benefits to expats in Spain:
- Inpatient Treatment
- Outpatient Treatment
- Emergency Evacuation
- Emergency Repatriation
- Dental
- Maternity
- Optical Benefits
NOW Health International’s monthly premiums start at USD $535 monthly for a 30-year-old female expat in Spain. A plan with this premium has an annual benefit limit of USD $4,500,000 and a deductible of USD $15,000.
The wide variety of deductible options through NOW Health International helps to make expats’ insurance plans in Spain customized. You’ll be able to decide how much to spend or save on premiums versus out-of-pocket costs for treatment.
Deductibles through NOW Health are available in the following amounts.
- USD $15,000 deductible plans
- USD $10,000 deductible plans
- USD $5,000 deductible plans
- USD $2,500 deductible plans
- USD $1,000 deductible plans
- $0 deductible plans
The following table offers an overview of what types of coverage are available on NOW Health International plans.
| NOW Health International Insurance Coverage Availability for Expats in Spain | |
| Benefit | Availability through NOW Health Intl. |
| Inpatient & Outpatient Coverage | Available |
| Emergency Evacuation and Repatriation | Available |
| Dental Coverage | Available with a 9-month waiting period |
| Maternity Coverage | Available with a 12-month waiting period |
| Coverage for Annual Health Checks | Available |
| Vaccination Coverage | Routine and travel vaccinations are covered up to the annual health check benefit limit. |
April International: Affordable Coverage for Expats in Spain
April International has some of the most affordable comprehensive coverage with unlimited annual benefits for expats in Spain. Plans with an annual benefit limit are also available with a generous limit of up to USD $2,000,000. Dental coverage has some of the shortest waiting periods.
April International’s plans offer the following comprehensive benefits:
- Inpatient Treatment
- Outpatient Treatment
- Emergency Evacuation
- Emergency Repatriation
- Dental
- Maternity
- Optical Benefits
Comprehensive coverage through April International with an unlimited annual benefit starts at only USD $309 monthly for a 30-year-old female expat in Spain. It’s not uncommon for comprehensive insurance plans in the same region to cost more than USD $1,000 monthly.
The following table illustrates what types of coverage are available through April International’s expat insurance plans in Spain.
| April International Insurance Coverage Availability for Expats in Spain | |
| Benefit | Availability through April International |
| Inpatient & Outpatient Coverage | Available |
| Emergency Evacuation and Repatriation | Available |
| Dental Coverage | Available with a 3-month waiting period for routine dental care and a 6-month waiting period for major/restorative care |
| Maternity Coverage | Available with a 12-month waiting period |
| Coverage for Annual Health Checks | Available after a 6-month waiting period |
| Vaccination Coverage | Unavailable |
AXA: High Coverage Limits for Expats Living in Spain
AXA Health Insurance plans are among the best plans for expats in Spain because of the high annual benefit limit. AXA’s highest annual benefit limit is USD $8,000,000. One thing that sets AXA apart is that coverage for travel vaccinations is available when most insurers exclude this.
AXA health insurance plans are comprehensive plans with basic coverage like inpatient, outpatient, emergency evacuation & repatriation, and additional coverage, including maternity and dental.
AXA offers plans with $0 deductibles, and the highest deductible option is only $3,200 a year.
As a large, well-known insurance company, you can rest assured that you’re in good hands with AXA while living in Spain. The following table shows the extensive coverage available through AXA.
| AXA Health Insurance Coverage Availability for Expats in Spain | |
| Benefit | Availability through AXA |
| Inpatient & Outpatient Coverage | Available |
| Emergency Evacuation and Repatriation | Available |
| Dental Coverage | Available |
| Maternity Coverage | Available with an 18-month waiting period |
| Coverage for Annual Health Checks | Available |
| Vaccination Coverage | Available including travel vaccinations |
Cigna: Reliable Expat Health Plans in Spain with Flexible Deductibles
Cigna is one of the largest insurance companies, and it offers expats in Spain outstanding plans with an option to have a $0 deductible. The annual benefit limit for Cigna’s expat plans is USD $2,000,000. One of their most popular plans is the Cigna Silver plan with comprehensive coverage features.
Cigna’s premiums for the Silver Plan can be as low as USD $177 monthly for a 30-year-old female in Spain with a deductible of USD $10,000 annually. Coverage includes inpatient, outpatient, and dental for this price.
The following table will allow you to compare the coverage options available through Cigna compared to other plans.
| Cigna Insurance Coverage Availability for Expats in Spain | |
| Benefit | Availability through Cigna |
| Inpatient & Outpatient Coverage | Available |
| Emergency Evacuation and Repatriation | Available on most plans |
| Dental Coverage | Available with waiting periods of 3, 12, or 18 months |
| Maternity Coverage | Available on Gold or Platinum Plans |
| Coverage for Annual Health Checks | Available |
| Vaccination Coverage | Available, but travel vaccinations are excluded |
Cigna’s popular Silver plan does not include maternity coverage, but its Gold and Platinum plans do. For additional information about the best expat maternity insurance, see our maternity plans page.
Allianz Care: Worldwide Health Insurance Options for Expats in Spain
Allianz Care plans are available for expats in Spain. Expats can choose to have worldwide coverage that includes or excludes the United States. Annual benefit limits of up to USD $5,000,000 are available on select plans.
Policyholders with Allianz Care can take advantage of benefits like getting a second medical opinion and an Expat Assistance Program.
The following table highlights the coverage options available for expats in Spain through Allianz Care plans.
| Allianz Care Insurance Coverage Availability for Expats in Spain | |
| Benefit | Availability through Allianz Care |
| Inpatient & Outpatient Coverage | Available |
| Emergency Evacuation and Repatriation | Available |
| Dental Coverage | Available |
| Maternity Coverage | Available with a waiting period of 12 months |
| Coverage for Annual Health Checks | Available |
| Vaccination Coverage | Available |
Bupa: Customizable Health Insurance Plans for Expats in Spain
Bupa offers customizable coverage options, such as deductibles ranging from $0 to USD $20,000, for expats in Spain. Additional benefits available to Bupa’s policyholders include 24/7 Global Virtual Care, an extensive direct billing network, and coverage for routine and travel vaccinations.
Bupa’s most affordable plan starts at USD $488 monthly for a 30-year-old female and has an annual benefit limit of USD $4,764,300 with a yearly deductible of USD $20,000. This plan also boasts worldwide coverage.
The following table displays the coverage options available to expats in Spain through Bupa’s plans.
| Bupa Insurance Coverage Availability for Expats in Spain | |
| Benefit | Availability through Bupa |
| Inpatient & Outpatient Coverage | Available |
| Emergency Evacuation and Repatriation | Available on many plans |
| Dental Coverage | Available with a 24-month waiting period for orthodontic benefits |
| Maternity Coverage | Available with a 12-month waiting period |
| Coverage for Annual Health Checks | Available |
| Vaccination Coverage | Available for routine and travel vaccines |
Generali: International Health Insurance Coverage for Expats in Spain
Generali is a leading international insurance provider. Expats living in Spain can benefit from their travel and health insurance products. You can choose between their Medical Prime plan with the signature Generali coverage or Medical Select, which offers extensive care with an alliance in Europe.
The Medical Prime plan is ideal for expats in Spain who want quick, comprehensive treatment for any health need from a single service point. Coverage combines inpatient and outpatient benefits with access to cutting-edge technology and treatments from highly specialized staff.
The table below shows a quick comparison of available benefits for Generali health insurance plans for expats in Spain.
| Generali Insurance Coverage Availability for Expats in Spain | |
| Benefit | Availability through Generali |
| Inpatient & Outpatient Coverage | Available |
| Emergency Evacuation and Repatriation | Available |
| Dental Coverage | Not Available |
| Maternity Coverage | Available |
| Coverage for Annual Health Checks | Available |
| Vaccination Coverage | May be available |
| Optical Coverage | Available |
Aviva: Comprehensive Health Plans for Expats in Spain
Aviva has provided international health insurance for expats all over the world for over 30 years. Their core health plan includes coverage for consultations, specialists, diagnostic tests, hospital charges, cancer, mental health care, and more.
In addition to health insurance, Aviva is one of the only providers that also insures your car, home, boat, property and liability, life, travel, pet, retirement, and much more! If you want one insurer to use for everything, Aviva is your choice.
Tools that come with Aviva insurance include:
- MyHealthCounts: an online health and wellbeing tool
- Aviva Digital GP for video consultations
- Get Active that grants you discounted services at gums and health and fitness clubs
- 24-Hour Stress Counseling Helpline
- Mental health support
- Cancare Care with Get Active
The following chart gives you a snapshot of the health benefits offered to expats in Spain who are insured by Aviva.
| Aviva Insurance Coverage Availability for Expats in Spain | |
| Benefit | Availability through Aviva |
| Inpatient & Outpatient Coverage | Available |
| Emergency Evacuation and Repatriation | Not covered |
| Dental Coverage | Optional add-on available |
| Maternity Coverage | Not available |
| Coverage for Annual Health Checks | Available |
| Vaccination Coverage | Not covered |
| Optical Coverage | Optional add-on available |
IMG: Flexible Health Insurance Solutions for Expats in Spain
IMG’s top-rated international health insurance plans offer flexibility when it comes to getting worldwide or regional coverage. The Bronze Global Medical Insurance plan for a 30 year old female living in Spain for a year begins at USD $90 a month with a $10,000 deductible.
Expats in Spain can choose to be covered wherever they go, or to exclude certain countries like the U.S., Japan, and others. All 4 IMG plans include prescription drug coverage.
Here are the annual plan limits for each of IMG’s expat health insurance packages:
- Bronze: $1,000,000
- Silver: $5,000,000
- Gold: $5,000,000
- Platinum: $8,000,000
The deductible options available with IMG global medical plans in Spain include:
- USD $25,000 annual deductible
- USD $10,000 annual deductible
- USD $5,000 annual deductible
- USD $2,500 annual deductible
- USD $1,000 annual deductible
- USD $500 annual deductible
- USD $250 annual deductible
Next is a chart that details some of the core benefits available in Spain for expatriates who get insured through IMG Global.
| IMG Insurance Coverage Availability for Expats in Spain | |
| Benefit | Availability through IMG |
| Inpatient & Outpatient Coverage | Partial to full coverage available |
| Emergency Evacuation and Repatriation | Available |
| Dental Coverage | Optional add-on available |
| Maternity Coverage | Available with Platinum plan |
| Coverage for Annual Health Checks | Available |
| Vaccination Coverage | Available |
| Optical Coverage | Optional add-on available |
Additional Health Insurers for Expats in Spain
In addition to the top ten providers of health insurance in Spain, there are a few more great options. A+ International, HealthCare International, and Passport Card are all reliable health insurance companies for expats.
A+ International Insurance in Spain for Expats
A+ International Insurance is a great insurance provider for expats in Spain who want a bargain on basic coverage. A+ Insurance plans cover inpatient, outpatient, emergency evacuation, and emergency repatriation. These plans do not cover dental or maternity expenses.
A+ International Worldwide Health Insurance plans are offered with an annual benefit limit of up to USD $4,050,000.
The following deductibles are available through A+ International Insurance:
- $0 deductible plans
- USD $250 deductible plans
- USD $500 deductible plans
- USD $1,000 deductible plans
- USD $5,000 deductible plans
A+ International Insurance plans for expats in Spain with higher annual benefit limits and lower deductibles cost more than plans with higher deductibles and lower annual benefit limits.
| A+ International Insurance Coverage Availability for Expats in Spain | |
| Benefit | Availability through A+ International |
| Inpatient & Outpatient Coverage | Available |
| Emergency Evacuation and Repatriation | Available |
| Dental Coverage | Optional add-ons for Global 80, Global 100, and Global 100 Plus plans |
| Maternity Coverage | 80% Coverage up to $12,000 for Global 100 Plus Plan |
| Coverage for Annual Health Checks | Unavailable |
| Vaccination Coverage | Unavailable |
HealthCare International in Spain for Expats
HealthCare International offers plans with relatively high annual benefit limits for expats in Spain. These comprehensive insurance plans provide inpatient, outpatient, emergency evacuation and repatriation, maternity, and dental coverage with a co-pay between 10-30%.
Policyholders in Spain can choose one of the following annual benefit limits through HealthCare International’s NIMBL Health Plans:
- USD $250,000
- USD $1,000,000
- USD $2,000,000
- USD $3,000,000
| HealthCare International Insurance Coverage Availability for Expats in Spain | |
| Benefit | Availability through HealthCare International |
| Inpatient & Outpatient Coverage | Available |
| Emergency Evacuation and Repatriation | Available |
| Dental Coverage | Available with a 6-month waiting period |
| Maternity Coverage | Available with a 12 to 18-month waiting period |
| Coverage for Annual Health Checks | Available with a 12-month waiting period |
| Vaccination Coverage | Available, but travel vaccinations excluded |
Passport Card for Expats in Spain
Passport Card sells expat health insurance in Spain with annual benefit limits ranging from USD $2.5 million to USD $5 million. Passport Card plans in Spain are comprehensive plans with coverage for dental and maternity in addition to inpatient, outpatient, and emergency evacuation and repatriation.
Expats can choose a deductible as low as $0 or a higher deductible plan with a deductible as high as USD $1,000. This means that the Passport Card’s deductibles are relatively low. This is great for expats who want to reduce their point-of-service spending.
| Passport Card Insurance Coverage Availability for Expats in Spain | |
| Benefit | Availability through Passport Card |
| Inpatient & Outpatient Coverage | Available |
| Emergency Evacuation and Repatriation | Available |
| Dental Coverage | Available with a 3-6 month waiting period |
| Maternity Coverage | Available with a 16-month waiting period |
| Coverage for Annual Health Checks | Available |
| Vaccination Coverage | Available for children only, and travel vaccinations are excluded |
Choosing the Best Expat Health Insurance in Spain
There is no single insurance company that is right for every expat in Spain. Choosing the best health insurance plan depends on what types of coverage are most important to you. You’ll have to compare the specific coverage available with each plan and provider.
Do not forget to compare the following benefits:
- Inpatient Coverage
- Outpatient Coverage
- Emergency Evacuation and Repatriation
- Dental
- Optical
- Maternity
- Wellness
Working with an insurance broker can help expats find and compare plans from multiple insurance companies. On the other hand, an insurance agent only represents one company. A broker’s services do not cost the expat anything.
Find out more about using an insurance broker here.
Frequently Asked Questions
Do Americans get free healthcare in Spain?
American citizens residing in Spain may access the universal healthcare system by working and paying taxes in Spain. Supplemental insurance or private insurance provides coverage for private hospitals, including international ones.
How much does health insurance in Spain cost for expats?
Basic expat health insurance with an annual limit of USD $200,000 and a deductible of $5,000 costs as little as USD $91 per month in Spain for a 30-year-old female. This coverage includes outpatient, inpatient, emergency evacuation, and emergency repatriation.
Can I use my US health insurance while traveling to Spain?
Most US domestic health insurance plans will not cover you while traveling abroad, including travel to Spain. Additionally, Medicaid and Medicare only provide coverage within the United States and its territories. You can secure travel insurance before visiting Spain.
Conclusion
The top ten health insurance companies for expats in Spain in 2026 are Blue Cross Blue Shield, AXA, Cigna, NOW Health, April International, Allianz, Bupa Global, IMG, Generali, and Aviva.
Expats can review each company’s offerings to select the best coverage for their situation. Working with a broker like Pacific Prime can help make the process go more smoothly.
Contact an insurance expert today for personalized assistance.
Are you still exploring places to live abroad? Check out the Top Insurance Companies in China or the Top Insurance Companies in Indonesia.
Additional Resources for Living Abroad in Spain in 2026 as an Expat
Find out more information with these additional resources for expats in Spain:
- Jobs for American Expats in Spain
- Guide to Living Abroad in Spain with Cost of Living Information
- The Best Places for Expats to Live in Spain
After obtaining his Bachelor’s Degree in Social Sciences, International Relations from Mahidol University International College, Veerabhatr has forged his career as a content writer in the travel, lifestyle, and real estate industries, writing in both English and Thai. He now continues to hone his skills as a writer at Pacific Prime, looking to engage and educate the audience by simplifying insurance.
Writer by day, and a DJ by night, Veerabhatr is a staunch music lover, and listens to all spectrums of genres available. He also loves to drink beer (moderately), eat all types of food, go to the beach, and learn about different cultures across the globe. He is also a die-hard fan of football and motorsports.
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