When it comes to health insurance in Spain, your choices are fairly simple and straightforward.
The most challenging part is figuring out how the nation healthcare system works, which may be foreign to people coming from the West–particularly America.
But once you understand how Spain’s healthcare system works, you will be able to buy the right private health insurance or enroll in the social healthcare system with ease.
This guide will break down everything for you, so that you will have the confidence it takes to get health insurance in Spain.
- 1 Before You Come to Spain
- 2 Social Security and Private Insurance
- 2.1 Local Insurance
- 2.2 Local Insurance – Individual Private Medical Insurance (IPMI)
- 2.3 Supplementary Private Medical Insurance
- 2.4 Private Medical Group Insurance
- 2.5 Travel Insurance
- 2.6 Offshore Private Medical Insurance
- 3 National Social Security SHS / NHS
- 4 Private Medical Insurance
- 5 Insurance Plans Explained
- 6 Applying
- 7 Direct Billing and Pre–Authorizations
- 8 Denial of Claims
- 9 Finding the Right Insurance Plan
- 10 Recommended Insurance Plans
- 11 Now, on to You
Before You Come to Spain
Before you travel or move to Spain, there are a few things you should know about health insurance in Spain.
Good to Know
It doesn’t matter what kind of trip you are planning to Spain: working, traveling, studying, or just enjoying your retirement.
Whatever your case, it will be useful to have some basic culture knowledge about the country as well as knowing some basic phrases in Spanish to get around more easily.
Some Spaniards speak English, but not as much as you would find in other European countries.
And that ties into health insurance and related topics. Information can be found in Spanish, but in English it is limited. Especially if you have to deal with local doctors.
Many doctors may require a translator before treating you if you can’t speak Spanish.
Like every other European Union country, Spain has a very sufficient social security system and one of the best public healthcare systems in the word.
Health insurance in Spain is compulsory for every resident in one way or another.
Not only employees and students have to be insured, but also freelancers and any other long-term residents.
In fact, Spain’s constitution provides the right for basic medical treatment including preventative care for every resident, and therefore the government makes sure that everyone is insured.
For any EU citizen, healthcare in Spain is for free for the first three months with the EU health insurance card.
After this period, any EU citizen is required to get a private plan or register with the national healthcare system.
Non-citizens to have insurance in place before entering the EU and Spain.
Check Your Existing Insurance
Before you buy health insurance in Spain, it’s best to check what your existing insurance covers you for.
If you plan only traveling to Spain (and perhaps other parts of the European Union), then you need valid travel medical insurance.
Within the EU, travel insurance has to have at least EUR 30,000 coverage and will usually be checked when applying for your EU Visa.
These regulations are the same for all EU countries.
Now, this amount is usually covered by most private medical insurance plans in an emergency in out of area coverage.
On the other hand, you may have an insurance plan with worldwide coverage, and therefore Spain might be covered fully within the limits of your existing insurance plan.
But even if you have local insurance somewhere, it is worth checking for any existing emergency coverage you may have on your policy while traveling outside of your usual area of coverage.
In addition, many banks these days include travel insurance with their credit card packages—check with them as well.
Furthermore, within the EU all countries have an intergovernmental agreement that covers anyone with existing social insurance healthcare from one country in any other country within the EU.
This may not apply for all benefits, but at least for accidents and emergencies, and it’s worth checking with your home country’s social security health insurance carrier for any coverage you may have while traveling within the EU if you are an EU citizen.
To receive treatment while traveling you may have to get your European Health Insurance Card.
If you are planning on moving to Spain and become a resident, general speaking you are required to have medical insurance either through the social security system or through a private medical insurance plan. Travel insurance is just not enough.
As an expat, if you have health insurance in place already then you can keep it.
However, this will not exempt you from the social security while employed in Spain.
You may check out further information below to decide whether or not to keep your existing health insurance plan, or sign up for a new plan within Spain’s health insurance system.
If you cannot prove you have insurance your permanent residence application will most likely be denied.
You can find further information for EU Citizens here.
Social Security and Private Insurance
If you become a resident in Spain and earn your living through a normal job (employed or freelance) or study in Spain, then you will be most likely covered by Spain’s national social security system and do not need to worry further.
You only need to worry about which doctor you can go to or which hospital is the nearest in case of an emergency.
Most foreigners and Spaniards will use the universal national healthcare system SNS (Sistema Nacional de Salud, or also NHS – National Health System), but that does not mean you can’t buy private medical insurance if you would like to enhance your doctor and hospital visit experience.
Overall, it may not always be easy to find an English-speaking doctor within the NHS, but it will be much easier in a private clinic.
Also, not all expenses are covered under the SNS/HNS system (such as dental, medication, or ambulances), but with a private plan you have more benefits in general and less waiting times.
Statutory health insurance in Spain will cover mostly everything medically necessary if you part of the system. To become a part of the system you have to be employed or voluntarily enroll.
However, as a freelancer in Spain it is compulsory to enroll into the system as well, which means you will be secured on the one hand and don’t need to worry if something unforeseen happens. But on the other hand, it means additional costs if you just start your business.
In terms of treatment, any public hospitals are as good as private hospitals.
As in many European countries the only main differences are the waiting times. In public hospitals and clinics you may have to wait a bit for your treatment for non-emergency situations.
In fact, if anything serious happens you may be transferred to a public hospital as most private clinics are not equipped for emergency circumstances.
You can find further information about the social security here.
Also, as mentioned, it is possible to enroll into Spain’s national system voluntarily, which is called “Convenio Especial” under the SNS/HNS system and provides the possibility to have access to the public healthcare system for anyone not eligible.
This plan is considerably cheap at just EUR 60 for under 65 and EUR 157 for over 65 years old, but it mainly covers standard treatment without prescription drugs or other expensive therapies.
Employment in Spain
Employees in Spain are automatically enrolled into the social security system through their company and the fees are shared with a ratio of about (employee) 15% to 85% (employer), but they can vary slightly depending on the actual contract and job.
The general percentages in 2019 are 6.35% for employees and 29.9% for employers (additional fees may apply and vary for occupational risks and accident insurance).
The premiums for social security – health and maternity, pension, unemployment, disability and others – are deducted from your monthly wages and paid directly to the “Seguridad Social” through the employer.
In 2019 the minimum monthly salary base in terms of social security contribution is EUR 1,050.00 and the maximum is EUR 4,070.10.
Self-Employed in Spain
Freelancers (autónomos) earning more than the minimum wage have to contribute into Spain’s social security system as well, which includes health coverage and pension at a rate of 30%.
The minimum income contribution base is EUR 944.40 if 47 years old or younger and EUR 1,018.50 if above 47.
The maximum base income is EUR 4,070.10. The minimum contribution of about EUR 275 is compulsory. Everything above is on a voluntary basis to gain a higher pension.
Apart from that it is also possible to contribute more to cover accidents or sickness daily allowances.
However, most people do not pay more than the minimum contribution, even if they are earning more than the minimum wage.
Because social security is compulsory for freelancers in Spain and the public hospital system is one of the best in the world, for most people it doesn’t make much sense to buy more private healthcare.
The advantages of a private plan are slim, and in the end you would have to pay double.
But there are some supplementary private medical insurances that can balance out the short falls of the SNS/HNS.
Retiring in Spain
Spain is one of the main destinations for retirees from many European countries, especially from the UK, Italy, Germany, or Romania.
Living in Spain when retired can perhaps be easier than in other European countries – costs of living may be less expensive, daily life may not so fast-paced, and there is this all year long steady climate.
As an EU citizen you are allowed to moved to any other EU county and live there.
The easiest way to get covered is to reach out to your country’s state health insurance and clarify how you will be covered while living in Spain.
Usually you will be covered for emergencies through your home country’s insurance if you have your EU Health Insurance card with you.
Your home country’s statutory health insurance may cover you beyond emergencies while residing in Spain, but check it out before moving.
If you are covered through your home country’s insurance then you are usually only allowed to use Spain’s public hospitals—not private clinics.
If you worked in Spain before and may be eligible for a retirement pension through Spain’s SNS/HNS system, then you are also eligible to be medically covered and allowed to access Spain’s public healthcare system without any other insurance.
If you are just covered for emergencies in Spain through your home country’s statutory health insurance, then you may want to weigh up the costs of buying private medical insurance.
Or you can enroll voluntarily into the SNS/HNS for retirees and travel back to your home country for any routine doctor visits, medication, and check-ups. But be careful. You may not get your resident permit in Spain if you do that.
Again, everyone residing in Spain has to be insured.
Unless you have worked in Spain and receive a pension through Spain’s national social security system, there won’t be any solution to get you fully covered other than getting yourself insured through an international plan or a local IPMI plan.
If you receive a local pension, then most likely you have also access to Spain’s full public health insurance system for state retirees.
But of course, you could also join the national health insurance system “Convenio Especial” voluntarily and get at least limited coverage under the public health care system.
Studying in Spain
All students in Spain, international or local, need medical insurance. There are basically three scenarios for international students in Spain to be covered for medical treatment.
First of all, any EU citizen covered in their home country will also be covered in Spain, as long as the EU Health Insurance card has been obtained before departure.
This may also apply to other nationalities.
Spain has several international student agreements with countries like Peru, Paraguay, Chile, Andorra, Brazil, and Ecuador.
You may check with your home country’s national system if you have coverage while studying in Spain and for what period of time.
If you are not covered through your home country’s social health insurance then you can always apply to be covered under Spain’s SNS/HNS system.
Anyone younger than 28 and studying in Spain has access to the system and can be covered under the national health insurance.
If your home country’s insurance provide only coverage for emergencies, it may not be a bad idea to get yourself covered under the SNS/HNS for students anyway.
Please check with your home country insurance provider for what exactly you are covered for while studying in Spain before deciding.
Spain’s national social security has a school insurance program that is very affordable. But keep in mind that with any national health insurance like the Spanish SNS/HNS, you will only have access to the public health care system but not private medical healthcare.
You can enroll in the system through the school or university you are going to study at—usually with your student application.
In case none of the options above apply to you and you aren’t able to find affordable medical insurance through your home country, then there are plenty of private medical insurance solutions for students available Spain.
Further general information for students in Spain are available on Studying in Spain.
Interning in Spain
Anyone doing an internship as part of a training program–paid or unpaid–at private company, organization, or institution needs to be enrolled into social security as well. The costs have to be covered by the employer.
Local Insurance – Individual Private Medical Insurance (IPMI)
Not many people (citizens or long-term residents) in Spain are using private medical insurance to be covered for medical expenses.
The main reason is obviously the universal healthcare system, which allows everyone to access the public system for a fairly-priced monthly contribution.
Another reason is that the quality differences between private medical care and public hospitals are slim.
Therefore, for most people the added costs are disproportionate to the actual value.
On the other hand, private medical insurance can be useful for those who might be unable to access the SNS/HNS or for people with unique needs, such as but not limited to additional coverage for medication, dental care, or perhaps those who just want to avoid any waiting times.
In addition, there are also options for supplementing your SNS/HNS public coverage if you wish to have additional private coverage for certain benefits.
However, many of the local private medical insurance plans allow only access to certain doctors and clinics within their insurance company’s network.
Therefore, you need to be careful and check with your provider first before rushing to the next private clinic. But you will always be covered for emergencies at public hospitals.
IPMI Under Employment
Even if you are covered under the SNS/HNS your company might provide private medical insurance as additional employee benefits, but don’t count on it.
Any private medical insurance plan would be an unnecessary cost for your company as the universal health care system provides you with mainly everything you need.
However, your company may provide additional supplementary medical insurance to compensate any shortfalls under the SNS, such as benefits for dental or medication.
You may check with your employer if such plans can be provided. Perhaps your company has a group plan for their employees in place.
In addition, it is of course possible to buy any private medical of your choice separately.
IPMI for Students
As mentioned above, if you can’t access social security or you prefer a private plan then there are many private medical insurance plans for students.
For international students in Spain a minimum coverage of EUR 30,000 is required for your student application.
Health insurance usually costs between EUR 40 to EUR 50 per month and can be purchased usually up to the age of 35.
Potential private medical insurance for students you can find under the following websites:
IPMI for Retirees
Local IPMI plans are generally available until the age of 75 for first applicants.
The need to buy a local IPMI plan is perhaps a result of your residency application.
Local governments may require you to have a Spanish local medical insurance in place that is as close to the social security as possible.
This means you can’t just purchase any private medical insurance because it may end in a rejection of your residency application. Some reasons for rejections could be:
- no proof of payment
- too many restrictions on pre-existing conditions
- the policy has too many co-pays that is not in line with the social security system
- the policy expiration date is too soon and it’s not an insurance policy with annual renew-ability
- your policy is restricted to your province and doesn’t cover you nationwide
Therefore, please be aware of the requirements before buying medical insurance for residency applications.
Make sure you are covered for hospitalization and outpatient without or low co-pays and that the policy covers you everywhere in Spain.
Supplementary Private Medical Insurance
Private medical insurance companies offer a wide variety of options for full private medical insurance, but also limited supplementary medical insurances to cover just some particular benefits.
Such plans vary in price based on benefits and age. Among others the following plans are available:
Supplementary outpatient plan: such plan provide additional coverage for any out-of-pocked outpatient costs you may have under your social security—check out Sanita Expat
Dental: basically all local insurance companies offer several Dental insurance plans—check out:
Additional emergency medical assistance and hospitalization plan: provides better coverage in emergency situations in Spain and worldwide—check out:
Accident insurance: provides a lump sum compensation for any loss you may have caused by an unforeseen event
Pastoral / Peace of mind insurance: covers things link provision of funeral services, helps with bureaucratic procedures for burial, death certificates and others, and offers coverage for repatriation of mortal remains nationally and internationally, funeral services, and legal guidance.
Outbound travel insurances: if you live in Spain and are covered under the SNS/HNS system or perhaps have a local IPMI plan then you do need travel insurance when traveling outside of Spain. Such short-term insurance will protect you for any risk you may have in case of accidents or sicknesses and medical treatments while outside of your country of residence. These insurances are called Seguro Salud de Viaje, or travel insurance for residents in Spain who are not covered worldwide through their health insurance plan.
But again, if you are just traveling through the EU, you might just get your European health insurance card and that’s basically all you need.
Private Medical Group Insurance
Group medical insurance is available at all major private medical insurance companies. The companies offer insurance for small, medium, and large companies.
Similar to IPMI plans for individuals, group plans offer a variety of options for companies and organizations to cover their employees.
They provide better benefits beyond the social security system or a full private medical insurance and offer coverage for hospitalization, outpatient including medication, dental, and emergency assistance.
Prices are of course cheaper than buying individually and can be bought usually with at least five people (three employees plus family members) in the group.
As explained in the beginning, one solution to be covered in Spain can be by simply buying travel insurance.
Also, for anyone entering the EU who is not an EU citizen, you need at least EUR 30,000 in medical insurance coverage.
Such policies are available online and many people these days have such coverage already through their credit cards.
If you need to buy travel insurance you may consider buying a policy with more than just EUR 30,000 coverage, because the price differences are not that big and secondly this amount is basically nothing if you get into a big accident.
Offshore Private Medical Insurance
In case you don’t plan on living in Spain long term and you have no access to the national SNS/HNS, then you might buy a private medical insurance through any of the many available international medical insurance providers.
Private medical insurance is definitely a better solution than purchasing long term travel insurance.
The main reason is that travel insurance companies tend to cancel policies if they are facing large claim.
In such situations, it makes it even more complicated or even almost impossible to find new insurance.
One recommendable provider with a good reputation and a competitive medical insurance plan for expats with coverage in Europe and emergency cover beyond is ACS.
It doesn’t matter whether it’s IPMI or social security, both systems will cover you at least for hospitalization, outpatient—including limited coverage for medication and therapies, basic dental, and emergency assistance and evacuation.
Everything beyond this you can buy separately.
For a detailed rundown on general insurance plans, check out any of the links below.
National Social Security SHS / NHS
The SNS/NHS (national healthcare system in Spain) covers you for hospitalization, general healthcare, medication, and medically necessary therapies such as physiotherapy and other alternative treatments as long as they are prescribed by a doctor.
However, the SNS/HNS does not cover everything fully.
There are some out-of-pocked expenses such as co-pays for drugs, ambulances, certain therapies, and coverage for dentists that are limited, as well as coverage for vaccinations—especially for adults.
Like in many other countries, another downside to the public healthcare system is the waiting times.
If you need to see a specialist you may have to wait one to two months, depending on where you live.
Co-pays for medication depend on income and range from zero to 60% for people with annual incomes over EUR 100,000 per year.
In addition, there are also excesses for physiotherapy and other alternative treatments.
Also, the SNS/NHS only provides coverage in Spain and for emergencies throughout EU countries as long as you have your EU health card.
Further information about the SNS/NHS you can find on Europa.
General Exclusions / Pre-Existing Conditions
Under the SNS/HNS are no exclusions, nor cover limitations for pre-existing conditions in terms of necessary medical treatments.
In fact, health protection is a constitutional right for all citizens and long term residents in Spain.
This law guarantees medical treatment even for pre-existing conditions.
However, it mainly covers hospitalization for emergencies in case you don’t have insurance.
If covered through the SNS/NHS then pre-existing coverage will be granted for outpatient and medication as well.
Also, for chronic conditions the co-pays for medications are reduced.
Private Medical Insurance
IPMI plans generally provide better coverage in terms of co-pays, but obviously this also depends on the insurance plan you decide to get.
However, most IPMI providers have preferred providers you can go to for full coverage.
Otherwise you may end up paying more co-pays or perhaps you won’t be covered at all.
Therefore, before going for treatment or to the pharmacy please check with your insurance company first for which hospital, doctor, or specialist you can go to and if there are any limitations on preferred pharmacies.
IPMI plans can be as essential as the SNS/NHS with coverage for hospitalization, outpatient with co-pays for medication and therapies, and limited dental coverage. But they can also be as comprehensive as a fully worldwide medical insurance without co-pays.
Nevertheless, no insurance plan has any annual overall limits – even if you need to be hospitalized for one year, so be it – there won’t be any cap.
For the self-employed, most insurance companies offer specially designed plans which are slightly different than normal IPMI plans to ensure best coverage for this particular group.
Please also be aware of any waiting periods.
Most IPMI plans in Spain have waiting periods for non-emergency treatments on outpatient, maternity, advanced imaging (MRI, CT, and so on), planed inpatient surgeries, psychiatric treatments, and even cancer treatment.
These waiting periods can be months, especially for things like maternity. But even for outpatient coverage it can be up to three months.
Also, some IPMI plans do not even cover vaccinations, nor alternative treatments.
Therefore, check the policy details before applying.
General Exclusions and Pre-Existing Conditions
General exclusions depend on the provider you choose to buy from.
For instance, most do not cover chronic alcoholism, drug addiction, or intoxication due to abuse, nor self-inflicted injuries, which is basically the same for any medical insurance in the world.
However, private medical insurances have to follow the constitutional right of citizens as well.
This means that no-one can be excluded from medical care, even for pre-existing conditions. This does not mean that the insurance company can’t charge additional premiums for pre-existing conditions, or perhaps deny an applicant with a pre-existing condition at all.
As any other private company, insurance companies need to make a profit.
Also, for major surgeries, people with pre-existing conditions have to wait longer than usual. Even if it’s an emergency situation, because the general waiting time for complex operations can be months.
Insurance Plans Explained
Before you buy any insurance plan, be aware that prices aren’t the only thing to consider.
Take the time to read through the fine print of any insurance plan you’re interested in buying.
No matter where in the world you’re buying insurance for, there are some general things to be aware of.
We’ve listed each of them in a separate guide. Click on any of the links for more info.
- Age restrictions
- Areas of coverage
- Cancellations or non-extensions
- Coverage limits
- Pre-existing conditions
- Prior authorizations
Cancellations or Non-Extensions
Any private medical insurance (supplementary or full IPMI plan) is based on a one-year contract, which you can cancel with one month’s notice prior to the end of the policy year.
The insurance company on the other side has no right to cancel your policy.
Unless you do not pay your premiums, the insurance company can’t kick you out–even for age.
Under the SNS/HNS you will be covered as long as you are employed, study, self-employed, or are a national pensioner.
You can only cancel if you are on a voluntarily plan, in which case you need to prove you have other insurance as long as you live in Spain.
Areas of Coverage
The SNS/HNS will generally cover you within Spain and with your EU health insurance card in EU countries.
IPMI plans on the other hand can cover you worldwide, but most available plans are only within Spain–the choice is yours.
Age Limits and Restrictions
Once you are insured by any private medical insurance plan there is no age limit until which you can be covered.
That does not mean the rates for your insurance are affordable endlessly.
The latest entry age for any IPMI plan varies from insurer to insurer but is usually at the age of 75.
If you got your insurance before that, you can be covered until 100+.
IPMI plans are usually paid monthly in Spain by automatic deduction from any Spain bank account.
Therefore it is requisite to have a bank account in Spain if you want to buy locally and pay monthly.
Most insurers also offer annual payment transfers from any bank account in the world.
Under the SNS/HNS your contribution has to be done monthly.
As an employee your fees will be deducted automatically from your salary. For any voluntarily plans, the contributions have to transferred or will be deducted from your local bank account.
Optional Coverage Choices
Except any of the supplementary private medical insurances, there are no other options to enhance your social security experience.
Under IPMI you can choose the plan based on the benefits that are important to you and may apply for any additional plans like travel insurance.
To apply for health insurance in Spain, follow the steps below.
First of all you need to register at any of the Social Security offices (Tesorería General de la Seguridad Social – TGSS), which have offices throughout Spain.
In case your employer doesn’t do it for you or can’t help you (which is most unlikely), or you want to enroll voluntarily, you better take a Spanish speaking person with you.
You can do this also online through Seg-Social.
If you do it in person, you need to fill out this application and bring it to any local social security office.
- copy of passport
- certificate of residence, including proof of address and your Spanish NIE (tax number)
- completed application, which needs to be submitted to the TGSS in order to receive a national social security number
Then take your residency certificate, copy of passport, and your insurance number to a local health center and register for a general practitioner.
After that, you should apply for your Spain health insurance card (tarjeta sanitaria individual – TSI).
Your insurance card should arrive at your home by post within a few working days after applying for it at the TSI. You need to show the card every time you visit your doctor, pick up your medications from the pharmacy, or go to a public health center or hospital.
A general practitioner will be assigned to you based on your location and usually you don’t have a choice of the family / general practitioner.
If you need to see a specialist, then your general practitioner will transfer you to someone.
Only under private medical care do you have a choice. The paperwork will be in Spanish and you have to be registered in Spain for at least three months before a general practitioner can be assigned to you.
Most IPMI plans are available online and the paperwork is straight forward.
You simply apply online, print it out, sign, and send back with a copy of your passport.
However, you may get yourself help from a professional insurance broker who can help you with the process and give some tips about the application form to get everything done smoothly.
Direct Billing and Pre–Authorizations
The SNS/NHS provides easy direct billing through your insurance card, which you need to show each time you are seeking treatment or picking your medications up.
IPMI plans provide direct billing at their own clinics and through doctors within their own network.
Moreover, private insurers will directly settle any emergency bill at any hospital even it is not within their network, as long as you inform them within 48 to 72 hours.
If it isn’t an emergency situation you can try to get a guarantee letter before undergoing any treatment in an hospital outside of your network.
Make sure to reach out to your insurance company before you arrange a surgery at a hospital of your choice.
Some IPMI plans may have additional co-pays for treatment out of network or won’t cover the particular hospital at all.
Denial of Claims
As in many other countries, denial of claims also exist in Spain. Insurance companies with tricky policy wording and claim procedure obstacles can be found anywhere in the world. Some common issues with insurance claims are:
- Fine print is unclear or does not explain properly what benefits are covered and up to which amount and may even hide unclear conditions. The purpose of such policy wording prevent costs for the insurer.
- Undeclared pre-existing conditions or if the insurer thinks the condition has been developed prior to coverage.
- Insurers may try to avoid paying for medical expenses claiming it is not covered under the policy; even if it is. For example, if a surgery has been done in a hospital out of network where a co-pay applies, the insurer may claim you have to pay it all.
It is essential to double check your policy wording and your certificate of insurance beforehand.
Obviously not everyone is an insurance expert and even for specialists it is sometimes difficult to find the right answer in the fine print.
The best advice is therefore to check with your broker or insurance company directly in advance and get it in writing.
Especially for more costly treatments it is always better to get approval from your insurance company.
For any denial you receive it is always possible to file an official objection with the insurance company or even go to court—but make sure your claim has a legit base.
Finding the Right Insurance Plan
There are countless options available to get yourself covered in Spain.
The most valuable option perhaps is joining the SNS/NHS, but if that is not possible, or you don’t like waiting times and limited practitioner choices, then many private medical options are available.
Even high-end plans in Spain are very affordable in comparison to other country’s IPMI plans.
In order to get the best solution for your situation, you may speak to a broker of your choice or perhaps check one of the direct online links of available insurers.
Many insurance brokers in Spain can be found easily online. Here are some options:
Here are online comparison tools you can use:
Recommended Insurance Plans
One of the best providers in Spain with a variety of options in English is Sanitas Expat.
If looking for an offshore plan then ACS can be a good alternative.
If you looking for long term offshore insurance, even after retirement age, then speak to an international insurance broker or purchase any of the many international medical insurance plans online directly.