Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, focusing on clear, neutral information to help people find health coverage abroad.
Last updated: January 29, 2026
Quick Summary: Health Insurance in Andorra
- CASS (Caixa Andorrana de Seguretat Social) is mandatory—covers 75% of costs, supplemental insurance covers the rest.
- Passive Residence requires €600,000+ deposit and private insurance; Active Residence requires CASS enrollment.
- Hospital Nostra Senyora de Meritxell is the only hospital; complex cases go to Barcelona (2.5 hours) or Toulouse (2 hours).
- Low tax jurisdiction—max 10% income tax, no wealth tax, no inheritance tax. Popular with retirees and remote workers.
- Ski country—winter sports coverage essential; high altitude (1,000-2,900m) affects some health conditions.
Do You Need Private Health Insurance in Andorra?
Insurance requirements depend on residence type. Active Residence (working in Andorra): mandatory CASS enrollment through employer or self-employment—covers 75% of costs, most residents add supplemental insurance for the remaining 25%. Passive Residence (non-working): requires comprehensive private health insurance as condition of residency; you can't join CASS without Andorran income. Digital Nomad Residence: requires private insurance valid in Andorra.
Insurance is required for:
- Passive residents—mandatory private insurance required; no CASS access without Andorran income
- Active residents—CASS is mandatory but covers only 75%; supplemental insurance recommended
- Digital nomad visa holders—private insurance required for application
- Skiers and outdoor enthusiasts—mountain rescue and ski injury coverage essential
- Those with complex conditions—only one hospital; Barcelona/Toulouse evacuation may be needed
Public vs Private Healthcare in Andorra
Public Healthcare
CASS (Caixa Andorrana de Seguretat Social)
- Access: Active residents (employed/self-employed in Andorra); not available to passive residents
- Cost: ~22% of salary (employer 15.5% + employee 6.5%); self-employed pay full amount on declared income
CASS covers 75% of medical costs—you pay 25% unless you have supplemental insurance (mutua). Hospital Nostra Senyora de Meritxell in Escaldes-Engordany is Andorra's only hospital—small but modern, handles routine surgery, emergencies, obstetrics. Specialists visit from Spain/France. Complex cases (major trauma, cancer treatment, cardiac surgery, transplants) transfer to Barcelona or Toulouse. CASS has agreements with Spanish and French hospitals. Wait times are short due to small population (80,000).
Private Healthcare
International or Local Private
- Access: Open to anyone
- Cost: €100-200/month (supplemental to cover CASS 25%); €200-400/month (comprehensive for passive residents)
Private insurance in Andorra typically means: 1) Supplemental coverage (mutua) that pays the 25% CASS doesn't cover—offered by local insurers like Assegurances Generals or Spanish insurers (Sanitas, Adeslas), or 2) Comprehensive international coverage for passive residents who can't join CASS. Many expats choose Spanish insurance that covers both Andorra and Barcelona hospitals. International insurers (Cigna, Allianz, Bupa) provide broader coverage including evacuation worldwide.
Plan Options to Compare
Here are the most popular insurance options for expats in Andorra. Each has trade-offs depending on your situation.
Cigna Global
Best for: Passive residents needing comprehensive coverage for residence card; Barcelona hospital access
Not ideal for: Active residents with CASS—local supplemental insurance is more cost-effective
Allianz Care
Best for: Seamless Spain/France coverage for Barcelona and Toulouse hospital access
Not ideal for: Those already covered by CASS with local mutua supplement
BUPA Global
Best for: Pre-existing conditions and ski injury coverage—Andorra is a ski destination
Not ideal for: Healthy passive residents who could use Spanish insurers (Sanitas, Adeslas) for less
IMG Global
Best for: Digital nomad visa holders needing affordable coverage that meets requirements
Not ideal for: Passive residents with complex conditions—Barcelona evacuation coverage needed
Comparison Table: Top Expat Health Plans for Andorra
Compare the leading options side by side. Click "Details" to learn more about each provider.
| Provider | Best For | Coverage Style | Includes U.S.? | Notable Limits | Learn More |
|---|---|---|---|---|---|
| Cigna Global | Passive residents needing comprehensive | International comprehensive | Higher cost than local options | Details → | |
| Allianz Care | Seamless Spain/France coverage for | International comprehensive | Deductibles apply to savings | Details → | |
| BUPA Global | Pre-existing conditions and ski | International premium | Premium pricing | Details → | |
| IMG Global | Digital nomad visa holders | International standard | 12-month pre-existing exclusion | Details → |
Common Watch-outs for Andorra
Keep these points in mind when choosing coverage:
- Passive vs Active residence: Passive Residence (for those with independent means) requires €600,000+ bank deposit or investment in Andorran property/business, plus comprehensive private insurance—no CASS access. Active Residence (for workers) gives CASS access but requires actually working in Andorra. Choose your path carefully; it affects healthcare options.
- Single hospital limitation: Hospital Nostra Senyora de Meritxell is competent for routine care but limited for complex cases. Serious trauma, advanced cancer treatment, and specialized surgery typically mean transfer to Barcelona (Hospital Clínic, Vall d'Hebron) or Toulouse. Ensure your insurance covers cross-border care.
- Mountain/ski coverage: Andorra is a ski destination with peaks up to 2,900m. Standard travel insurance often excludes skiing; some health policies do too. Verify your plan covers ski injuries, mountain rescue (helicopter evacuation costs €3,000-10,000), and altitude-related conditions.
- Altitude considerations: Andorra la Vella sits at 1,023m; ski areas reach 2,900m. If you have heart conditions, respiratory issues, or other altitude-sensitive health problems, consult your doctor. The altitude affects medication storage, some medical conditions, and physical exertion.
- Tax residence rules: To claim Andorra's tax benefits, you must spend 183+ days per year there. Health insurance often requires proof of residence. If you split time between countries, ensure your coverage is valid wherever you actually are.
Frequently Asked Questions
How does Andorra's Passive Residence work for retirees?
Passive Residence allows non-working individuals (retirees, investors) to live in Andorra. Requirements: 1) Clean criminal record, 2) Deposit €50,000 with AFA (financial authority) plus €10,000 per dependent, 3) Investment in Andorran assets of €600,000+ (property, business shares, or bank deposit), 4) Comprehensive private health insurance, 5) Commit to residing 90+ days per year (183+ for tax residency). You cannot work in Andorra on passive residence. CASS is not available—you must maintain private coverage.
What is Andorra's Digital Nomad Visa?
Andorra introduced a Digital Nomad Residence in 2022. Requirements: Proof of remote work for non-Andorran company, minimum income €40,000/year, valid health insurance covering Andorra, clean criminal record, €50,000 AFA deposit. The permit allows 2-year residence (renewable). Unlike Passive Residence, deposit requirement is lower and no €600,000 investment needed. You still can't access CASS—private insurance is mandatory. Tax benefits apply if you meet the 183-day residency threshold.
Is Andorra's hospital adequate for expats?
Hospital Nostra Senyora de Meritxell handles most routine care well: emergency services, general surgery, orthopedics (lots of ski injuries), obstetrics, basic cardiology. It's modern and uncrowded. Limitations: complex cancer treatment, advanced cardiac surgery, transplants, rare conditions, and specialized pediatrics require transfer to Barcelona (2.5 hours by road) or Toulouse (2 hours). CASS has agreements with major Spanish and French hospitals. For routine healthcare, Andorra is fine; for complex needs, you're really using Barcelona with Andorran residence.
How does CASS supplemental insurance work?
CASS covers 75% of approved healthcare costs—you pay 25% out of pocket (ticket moderador). Supplemental insurance (mutua) covers this 25%. Options: 1) Andorran insurers (Assegurances Generals, AXA Andorra) offer local mutua plans €30-80/month. 2) Spanish insurers (Sanitas, Adeslas, DKV) offer plans covering both Andorra and Spain—useful for Barcelona hospital access—€50-150/month. 3) International insurers provide global coverage but are pricier. Most working expats get employer-arranged mutua or Spanish health insurance for seamless Barcelona access.
What are Andorra's actual tax benefits?
Andorra offers: Maximum 10% income tax (compared to 40-50%+ in France/Spain), no wealth tax, no inheritance tax, 10% capital gains tax, corporate tax max 10%. VAT equivalent (IGI) is 4.5%. To qualify for tax residency: spend 183+ days per year in Andorra and establish it as your center of economic interests. Andorra is not a zero-tax jurisdiction—it's low-tax. The combination of low taxes, Pyrenean lifestyle, ski access, and Barcelona proximity makes it attractive to high earners, retirees, and remote workers willing to actually live there.
Related: Comparisons and Next Steps
Disclaimer: This guide is for informational purposes only. Healthcare policies, insurance requirements, and visa rules change. We are not insurance brokers, immigration consultants, or licensed advisors. Verify all information with official sources and insurance providers before making decisions.