Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, where he focuses on helping people compare health plans for life abroad. He emphasizes clear information, neutral analysis, and practical decision support.
Our Top Picks
Spanish expats have strong ties to Latin America, making Spanish-language support essential. Here's what we recommend based on destination and needs:
- Cigna Global: Best overall for Spanish expats. Full Spanish support, strong networks worldwide, comprehensive coverage.
- Sanitas Global: Spanish company (Bupa-owned) with excellent Spanish-language service. Great for maintaining familiar healthcare relationships.
- Mapfre Global: Spanish insurer with outstanding Latin American networks. Ideal for expats in Mexico, Argentina, or other LATAM countries.
- ASISA Internacional: Budget-friendly Spanish option with good EU coverage. Lower premiums for younger expats.
- Bupa Global: Premium international option for those wanting top-tier coverage outside Spanish networks.
Going to Latin America?
Spanish expats often move to Latin America where language and cultural ties are strong. Mapfre and Cigna have the strongest LATAM networks. Sanitas is good but more EU-focused.
Compare LATAM OptionsWe may earn a commission when you apply through our links. This does not affect our recommendations.
Leaving Spanish Healthcare
Spain's public healthcare system (Sistema Nacional de Salud) provides excellent coverage for residents. When you leave, several things change:
Tarjeta Sanitaria and Empadronamiento
Your Spanish health card (tarjeta sanitaria) is linked to your empadronamiento (census registration). When you deregister from your municipality, you lose access to public healthcare. Your EHIC remains valid for EU travel emergencies until it expires.
Private Insurance in Spain
If you have private Spanish insurance (Sanitas, Adeslas, Mapfre, ASISA), these typically don't cover you long-term abroad. Options:
- Cancel and get international coverage
- Switch to the same company's international product if available
- Maintain Spanish coverage for visits home and get separate international insurance
Autónomos and Social Security
Self-employed workers (autónomos) who leave Spain can maintain voluntary Social Security contributions through a convenio especial. This affects pension rights more than healthcare, but it's worth understanding.
Convenio Especial Option
The convenio especial allows Spanish citizens abroad to maintain certain Social Security rights. Here's what it covers:
What Convenio Especial Provides
- Continued accumulation of pension contributions
- Access to Spanish public healthcare during visits (with limitations)
- Maintaining your connection to the Spanish system
Limitations
- Does NOT provide healthcare abroad—you still need international insurance
- Coverage in Spain is limited to urgent/necessary care during visits
- Monthly cost varies based on your contribution base
- Must apply within 12 months of leaving Spain
Consular Registration
Register with your local Spanish consulate when you move abroad. This is required for voting, passport renewal, and can help with accessing certain rights including emergency healthcare coordination through consular services.
Quick Comparison
| Provider | Spanish Support | Latin America | Spain Coverage | Starting Price |
|---|---|---|---|---|
| Cigna Global | Full | Strong | Add-on | €180/mo |
| Sanitas Global | Full (Spanish) | Good | Included | €150/mo |
| ASISA Internacional | Full (Spanish) | Limited | Included | €130/mo |
| Mapfre Global | Full (Spanish) | Excellent | Included | €170/mo |
| Bupa Global | Yes | Good | Add-on | €200/mo |
Detailed Reviews
Cigna Global
Cigna Global offers comprehensive international coverage with full Spanish-language support. Their Global Health Plan comes in three tiers (Silver, Gold, Platinum) with coverage from €1 million to unlimited. Strong networks across Latin America make this ideal for Spanish expats in the Americas.
Claims processing is efficient, with Spanish-speaking representatives available 24/7. Direct billing works at major hospitals throughout Latin America, Europe, and Asia.
Best for: Spanish expats who want comprehensive global coverage with native Spanish support.
Sanitas Global
Sanitas is Spain's largest private health insurer, owned by Bupa. Sanitas Global extends their coverage internationally while maintaining the Spanish service experience. If you're already a Sanitas customer in Spain, the transition is seamless.
Plans include Spain coverage automatically, so visits home are straightforward. EU networks are strong, though LATAM coverage is less comprehensive than Mapfre or Cigna.
Best for: Spanish expats in Europe who want to stay with a familiar Spanish provider.
Mapfre Global
Mapfre is a major Spanish insurer with excellent presence throughout Latin America. Their international health plans are specifically designed for Spanish-speaking expats, with outstanding networks in Mexico, Argentina, Chile, Colombia, and throughout Central America.
All service is in Spanish, claims are straightforward, and the Mapfre brand is recognized throughout the Spanish-speaking world. Spain coverage is included in all plans.
Best for: Spanish expats in Latin America who want strong local networks and familiar Spanish service.
ASISA Internacional
ASISA offers budget-friendly international coverage for Spanish expats. While networks are more limited than Cigna or Mapfre, pricing is competitive and service is fully in Spanish. Good option for younger expats or those in EU countries where ASISA has partnerships.
Best for: Budget-conscious Spanish expats, particularly those staying within the EU.
Get Spanish-Language Quotes
Compare prices from Spanish and international insurers. Most offer quotes and service entirely in Spanish.
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Returning to Spain
Returning to Spanish healthcare is relatively straightforward for Spanish citizens:
Re-registering (Empadronamiento)
Register at your local ayuntamiento when you return. This is the first step to accessing public healthcare. You'll need proof of address (rental contract, property deed, or family member's authorization).
Tarjeta Sanitaria
Apply for your health card at your local centro de salud or through the regional health service. Processing typically takes 1-2 weeks. In the meantime, your empadronamiento certificate serves as proof of healthcare entitlement.
Private Insurance Transition
If returning to private Spanish insurance, you may face waiting periods for pre-existing conditions. Some insurers waive these if you had continuous coverage abroad—keep documentation of your international insurance.
Common Questions
Does my EHIC work abroad?
Your Spanish EHIC covers emergency care in other EU/EEA countries. It's not valid outside Europe and doesn't cover routine care or repatriation.
Can I keep Sanitas abroad?
Standard Sanitas plans are for Spain residents. For long-term abroad, you need Sanitas Global or another international policy.
Is convenio especial worth it?
For pension contributions, possibly yes. For healthcare, it's limited. You still need international insurance for actual coverage abroad.
Which insurer is best for Mexico?
Mapfre has the strongest Mexican network among Spanish insurers. Cigna is also excellent. Both offer full Spanish-language service.
Can I use Spanish doctors abroad?
In cities with Spanish communities (Miami, Buenos Aires, London), you can often find Spanish-speaking doctors. All international insurers cover any licensed physician.
What about my Spanish pension?
Consider convenio especial to continue accumulating pension rights. Spain has bilateral agreements with many countries that help coordinate benefits.
Final Verdict
Spanish expats have excellent options, especially those heading to Latin America where Spanish insurers have strong networks. Cigna Global is our top recommendation for comprehensive coverage with native Spanish support. Mapfre Global is ideal for Latin America with outstanding regional networks.
Sanitas Global makes sense for those already with Sanitas who want continuity, while ASISA Internacional offers budget-friendly coverage for younger expats or EU destinations.
Before leaving, consider convenio especial for pension rights, and register with your local consulate. Keep documentation of continuous insurance coverage—it helps when returning to Spanish private insurance.
