If you are self-employed in Spain, private health insurance can give faster access to doctors, specialists and hospitals alongside the public system, often with English-speaking support — and premiums may be tax-deductible up to a legal limit. This guide explains the options for autónomos, including the visa route, with a personalised quote rather than a fixed price.
Who for
This page is for self-employed people (autónomos) in Spain, and for those moving to Spain to work for themselves — freelancers, contractors, consultants, remote workers and small business owners. Private health insurance can complement the public system or, on some routes, form part of your visa file.
Public + private
A registered autónomo paying Spanish social security usually has access to the public healthcare system. Many still choose private cover as an upgrade — for faster specialists, diagnostics and hospital access, and English-speaking support — rather than as a replacement. Before you are registered, or while it is being set up, private cover can also bridge the gap.
Plans
Common options for self-employed people:
| You want | Sanitas option to consider | Notes |
|---|---|---|
| Comprehensive no-copay cover | Más Salud Sin Copago | No per-visit charge for covered services |
| A lower monthly premium | A copay Más Salud option | Small per-visit fees on some services |
| A lower-cost entry point | Sanitas Accede | Entry-level cover, subject to terms |
| Cover for a non-EU visa route | Residents / Residents Platinum | Visa-suitable cover, subject to terms |
See Más Salud, copay vs no-copay and comprehensive cover.
Tax
Self-employed workers in Spain can often deduct private health insurance premiums from their income tax up to a limit set by law — commonly cited as up to around €500 per insured person per year (higher in certain cases such as disability), and premiums for a spouse and children may also count, subject to the current rules.
Visa
If you are moving to Spain to work for yourself, your route matters. Where private insurance is your main healthcare proof (for example on the Digital Nomad Visa before social security is active), it usually needs to be visa-suitable, so Sanitas Residents, Residents Platinum or another suitable Sanitas option may need to be reviewed. Once you are a registered autónomo with public cover, private insurance is often a supplementary upgrade instead.
For Digital Nomad Visa applicants, the correct route can depend on whether you will be registered with Spanish social security as an autónomo, have another recognised social-security arrangement, or need private medical insurance as the main healthcare evidence for the application. See the DNV health insurance guide.
Pre-existing
Declare any medical history, medication or previous treatment where requested. Having a condition or taking medication does not automatically mean a refusal. Each case is assessed individually through the health declaration and underwriting, and the outcome can be standard terms, an exclusion, a request for more information, or a decline. Nothing is guaranteed, so a personalised review is essential and you should never cancel existing cover until a new policy is confirmed.
Cost
There is no single fixed price — it depends on your age, the plan and cover level, copay vs no-copay, and any medical history. We prepare a personalised quote, and can explain how a possible tax deduction may affect the net cost (confirm with your gestor).
Next steps
Continue with the pages most relevant to you:
Important information
Tell us your age, whether you are a registered autónomo or still setting up, whether a visa route is involved, your location in Spain and any medical history, and we will compare the suitable Sanitas options and prepare a personalised quote. Please check the actual current policy terms and your personal conditions before purchasing or using any Sanitas policy. Policies change and individual terms can vary.
We match the right Sanitas option to your situation, in English, with no obligation.
FAQs
Common questions about health insurance for self-employed people in Spain. Tax and cover depend on your circumstances — confirm current rules with your gestor.