Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, helping expats find health coverage that works for their specific situations.
Last updated: April 28, 2026
Quick Comparison: Spain vs Italy
Here's a side-by-side look at the key factors that matter most to expats. We'll dive deeper into each below.
| Factor | Spain | Italy |
|---|---|---|
| Monthly Cost of Living | $1,500-2,500 | $1,500-2,800 |
| Healthcare Rating | Excellent | Very Good |
| Insurance Required | Yes | Yes |
| Private Insurance Cost | €80-200/month | €80-200/month |
| Primary Language | Spanish (Castilian) | Italian |
| Climate | Mediterranean | Mediterranean |
Cost of Living
Your budget will go further in some places than others. Here's what to expect for monthly expenses:
Spain
$1,500-2,500/month
- Rent (1BR): $600-1,200
- Food: $300-500
- Utilities: $100-150
- Healthcare: €80-200/month
Italy
$1,500-2,800/month
- Rent (1BR): $600-1,400
- Food: $350-500
- Utilities: $100-150
- Healthcare: €80-200/month
Both countries have similar cost of living. Your choice should depend more on lifestyle preferences and visa requirements.
Healthcare Systems
Spain
ExcellentUniversal public healthcare, high-quality private options
Public System
SNS: Residents
Italy
Very GoodRegional variation, good in north, slower in south
Public System
SSN: Residents
Both countries have private healthcare options that work with international insurance plans. Most expats use private care for faster service and English-speaking doctors, even if they qualify for public healthcare.
Visa Options
Your visa determines everything from how long you can stay to whether you can work. Here are the main options:
Spain Visas
Digital Nomad Visa
Duration: 1-3 years
€2,520/month income, health insurance
Non-Lucrative Visa
Duration: 1 year (renewable)
€2,400/month passive income, no work
Golden Visa
Duration: 2 years
€500,000 property investment
Italy Visas
Elective Residence Visa
Duration: 1 year
€31,000/year passive income
Digital Nomad Visa
Duration: 1 year
€28,000/year income (new 2024)
Investor Visa
Duration: 2 years
€250,000+ investment
Insurance Requirements
Spain
⚠️ Insurance Required for Visas
Required for non-EU visa holders.
Typical cost: €80-200/month
Italy
⚠️ Insurance Required for Visas
Required for visa holders.
Typical cost: €80-200/month
Compare Insurance for Both Countries
International plans work in both destinations. Get quotes to see your options.
Compare PlansClimate & Weather
Weather affects everything from your wardrobe to your energy bills. Here's what to expect:
Spain
- Climate type: Mediterranean/Continental
- Summer: Hot (75-95°F)
- Winter: Mild (40-60°F)
- Best time to visit: Apr-Jun, Sep-Nov
Italy
- Climate type: Mediterranean/Alpine (north)
- Summer: Hot (75-90°F)
- Winter: Mild-Cool (35-55°F)
- Best time to visit: Apr-Jun, Sep-Oct
Expat Life & Community
Spain
Language: Spanish (Castilian). English common in tourist areas and among younger people.
Popular expat cities: Barcelona, Madrid, Valencia, Málaga, Alicante. These areas have established expat communities, international schools, English-speaking services, and coworking spaces.
Italy
Language: Italian. English limited outside major tourist centers.
Popular expat cities: Rome, Milan, Florence, Bologna, Naples. You'll find other expats, international amenities, and communities here.
Who Should Choose Which?
Different situations call for different destinations. Here's our take:
Digital Nomads
Either worksBoth have similar costs. Consider visa requirements: Spain requires insurance, Italy requires insurance.
Retirees
SpainMilder winters (Mild (40-60°F)), various visa options. Healthcare: Excellent.
Families with Children
SpainExcellent healthcare system. International schools available in Barcelona, Madrid.
Frequently Asked Questions
Which is cheaper to live in, Spain or Italy?
Spain costs approximately $1,500-2,500/month while Italy costs $1,500-2,800/month. This includes rent, food, utilities, and basic expenses. Healthcare costs and insurance add €80-200/month in Spain and €80-200/month in Italy.
Do I need health insurance in Spain and Italy?
Spain: Yes, insurance is required for visa applications. Required for non-EU visa holders. Italy: Yes, insurance is required for visa applications. Required for visa holders.
Which has better healthcare, Spain or Italy?
Spain: Excellent - Universal public healthcare, high-quality private options. Italy: Very Good - Regional variation, good in north, slower in south. Both countries have private healthcare options that accept international insurance.
What visas are available for Spain vs Italy?
Spain offers: Digital Nomad Visa, Non-Lucrative Visa, Golden Visa. Italy offers: Elective Residence Visa, Digital Nomad Visa, Investor Visa. Requirements and processing times vary—check official immigration websites.
Where do expats live in Spain and Italy?
Popular expat areas in Spain: Barcelona, Madrid, Valencia, Málaga, Alicante. In Italy: Rome, Milan, Florence, Bologna, Naples. These cities have established expat communities, international services, and English-speaking professionals.
Our Verdict
There's no objectively "better" choice between Spain and Italy. The right answer depends on your priorities:
- Budget: Similar costs in both
- Healthcare: Spain has excellent healthcare
- Visa ease: Compare specific visa requirements based on your nationality and situation
- Climate: Mediterranean/Continental vs Mediterranean/Alpine (north)—personal preference matters
Our recommendation: Visit both places before committing if possible. Short-term stays reveal things research can't—the pace of life, the culture, and whether you actually enjoy being there.
Whichever you choose, get health insurance sorted early. International plans work in both countries, so you can even switch destinations later without changing coverage.
Ready to Make Your Move?
Compare insurance plans that work in both Spain and Italy.
Compare Insurance PlansRelated Resources
Disclaimer: Costs, visa requirements, and policies change frequently. This comparison uses estimates and may not reflect current conditions. Always verify information with official government sources and consult immigration professionals before making decisions.