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Get a Quote →Living in Spain with real ties to the United States? Sanitas Residents Platinum gives you comprehensive private healthcare in Spain, plus three distinct benefits for life across the Atlantic — a dedicated USA Cover benefit, 90% worldwide reimbursement, and emergency cover abroad. We help you get the Spanish and US sides right, in plain English.
Overview
For US citizens living between Spain and the USA, a Spanish private health insurance plan is designed for your healthcare in Spain. What it does back in the USA is plan-specific and governed by the policy terms, so it is worth checking those terms rather than assuming US treatment is covered. We help you arrange a suitable Spanish plan and understand the US side.
Americans who move to Spain, or split their time between the two countries, usually rely on a Spanish plan for care here, with the US side handled separately. The sections below explain what a Spanish plan does and does not do for US trips, how it works for retirees, and what to check on your policy before you travel.
One quick point on who decides what: whether you qualify for a Spanish residence route is for the Spanish authorities; whether a particular plan and certificate suit that route is what we advise on; and whether Sanitas can offer you cover, and on what terms, is the insurer’s decision.
Spanish plan
A Spanish private health insurance plan — such as Sanitas Residents or Residents Platinum — is built around healthcare in Spain: the medical network, ongoing private care, and the certificate many visa and residency routes expect. It is an annual policy for living in Spain, not a global travel product. For US citizens this is the foundation, and for visa applicants it is usually the piece the route requires. See visa-compliant cover.
USA side
Sanitas Residents Platinum covers healthcare abroad in three distinct ways. USA Cover is a dedicated benefit for eligible treatment in the United States, with its own authorisation, network and limits. Worldwide reimbursement pays back 90% of eligible costs, up to €500,000 per insured person per year, subject to terms and sub-limits. Emergency healthcare abroad covers urgent care while travelling, up to €30,000 per insured person per year. Read more: Sanitas Medical Cover in the USA →
What your Spanish plan does when you are back in the USA is plan-specific and set by the policy terms. Some plans or add-ons may include limited international or reimbursement elements; a standard Spain-focused plan is not designed to act as US health insurance. US healthcare can be very expensive, so this is the part to plan deliberately: never assume US treatment is covered.
Medicare
Many American movers ask how US Medicare interacts with living in Spain. In short, US Medicare generally does not pay for routine care received in Spain, so it does not replace a Spanish plan for your healthcare here. The detailed Medicare rules — keeping Part B, Advantage and Medigap abroad — are a US decision to check with the US authorities. We cover what this means for your cover in Spain on our dedicated keep US health insurance when moving to Spain page and point you to the official US sources for the US decision.
Two policies
Whether you need one plan or two depends on how much time you spend in each country and where. If you are mostly in Spain with occasional US trips, a Spanish plan plus trip cover for the States usually works. If you split the year more evenly, an international-style arrangement may fit better. There is no single right answer — it depends on your pattern, which we help you map. See keep US insurance when moving.
Visa
If you are moving on a visa, the Spanish plan is usually the piece the route requires, and different routes have different expectations. For the Non-Lucrative Visa private cover is commonly part of the file; for the Digital Nomad Visa there is also a Social-Security route where you are covered publicly. A plan being comprehensive does not guarantee any office accepts a specific certificate — acceptance is case by case, and the visa decision rests with the Spanish authorities. See private insurance or Social Security.
Retirees
For retirees, the picture usually combines a Spanish plan for healthcare here with careful thought about the US side and about age. Plans have contracting-age rules — see Sanitas Residents Platinum for Americans for the Platinum age position — and it is worth comparing options rather than assuming. We help retired couples get a coordinated, realistic arrangement. See retiree health insurance and cover over 60.
Underwriting
Whether Sanitas accepts you, and on what terms, is decided by the insurer’s underwriting — separate from visa eligibility and from plan suitability. Age and medical history can affect the outcome. We do not promise acceptance; we help you present your situation accurately. Declare any pre-existing conditions honestly to protect your cover.
Table
| Spain (your Spanish plan) | USA (back home) | |
|---|---|---|
| Purpose | Healthcare where you live | Trips / time in the States |
| How cover works | Direct medical network | Plan-specific; often needs dedicated cover |
| Visa relevance | Usually needed | Not part of the Spanish visa file |
| Cost of care | Covered under the plan | Very high; confirm cover before travel |
| What to confirm | Suitability + terms at quote | Exactly what your plan does in the USA |
This is a general guide; the binding detail is always your specific policy’s current terms.
What we can help with
We work with Americans in English: arranging a Spanish plan for your life in Spain, matching it to your visa route where that applies, and setting out plainly what it does and does not do once you are back in the USA, so you can decide whether you need separate US cover. You’ll get a personalised quote rather than a fixed price. Get a quote or contact an adviser.
Next
The sensible approach is to get the Spanish foundation right first — a suitable plan for healthcare in Spain, with the certificate if your route needs it — then plan the US side deliberately around how much time you spend there. Tell us where you expect to live and travel, and we’ll explain which Sanitas options may suit your time in Spain and what you should check separately for the United States. Get a quote.
Important information
Tell us how your time splits between Spain and the USA, your route and your ages, and we will recommend a suitable Spanish plan and explain the US side. We help with the health-insurance part of your application. Acceptance and exact policy terms depend on the insurer’s rules; visa decisions rest with the Spanish authorities.
English-speaking Sanitas specialists can help with the health-insurance part of your visa or residency application.
FAQs
Common questions about health insurance for Americans living between Spain and the USA. Always confirm current rules with the official authorities or a qualified immigration specialist.