Spain is one of the great long-haul moves — the climate, the food, the pace of life, and a healthcare system that genuinely stands up to scrutiny. But there is one thing every Australian and New Zealander has to get straight before they go: Medicare does not cover you in Spain, and neither does New Zealand’s publicly funded health system. You will need private health insurance from an insurer authorised in Spain — both to satisfy the visa rules and to actually get seen by a doctor. This guide explains exactly how that works, route by route.
Trusted by international residents
Let’s answer the question people actually type into Google, and answer it plainly: no, Medicare does not cover you in Spain. Not as a tourist, and certainly not as a resident.
Medicare is Australia’s domestic health scheme. It funds care delivered in Australia to people who are enrolled and eligible. The one mechanism that extends any Medicare-style benefit overseas is the network of Reciprocal Health Care Agreements (RHCAs) that Australia has signed with a small number of countries — and this is the crucial detail: Spain is not one of them.
Australia currently has reciprocal healthcare agreements with eleven countries: Belgium, Finland, Italy, Malta, the Netherlands, New Zealand, Norway, the Republic of Ireland, Slovenia, Sweden and the United Kingdom. Spain does not appear on that list. Several of Spain’s European neighbours do, which is precisely why so many Australians assume Spain must be covered too. It isn’t.
Sources: Services Australia — Reciprocal Health Care Agreements, servicesaustralia.gov.au; and Victorian Department of Health — Reciprocal healthcare agreements (country list), health.vic.gov.au.
It is worth understanding what an RHCA actually delivers, because it explains why it would not solve your problem even if Spain were on the list. These agreements are designed for visitors. In general they give a visiting resident of one country access to the other country’s public system for immediate, medically necessary treatment that is required before returning home. The official guidance is explicit that the agreements do not cover treatment where there is no immediate medical necessity, treatment in a private hospital, ambulance cover, dental care, elective treatment, or medical evacuation home.
In other words, an RHCA is emergency-style cover for a traveller who will be going back. It is not a substitute for the ongoing, routine, chronic and preventive healthcare that a person who has actually moved to another country needs. So even in Italy or Ireland, an Australian who relocates permanently would still need proper local cover. In Spain, where there is no agreement at all, the point is simply more obvious.
Source: Victorian Department of Health — what reciprocal healthcare agreements do and do not cover, health.vic.gov.au.
New Zealanders
Australians
The answer is the same, for the same underlying reason. New Zealand’s publicly funded health and disability services are delivered in New Zealand, to people who are eligible and physically there. Being a New Zealand citizen does not create a pot of money that follows you to Valencia and pays your Spanish medical bills.
New Zealand does have reciprocal health agreements — but only two, and both are for temporary visitors: one with Australia and one with the United Kingdom. Official guidance notes that these agreements provide some publicly funded health services in some situations, and that neither agreement covers everything. Spain is not part of any New Zealand reciprocal health agreement.
Sources: New Zealand Government — Who can get public health services in NZ, govt.nz; Health New Zealand — Eligibility for publicly funded health services, healthnz.govt.nz; Health New Zealand — Reciprocal health agreements, healthnz.govt.nz.
New Zealand’s own travel guidance is refreshingly direct about the consequences. The Ministry of Foreign Affairs and Trade warns travellers not to go overseas without insurance, pointing out that even minor medical treatment can be expensive and stating flatly that the New Zealand Government will not pay these costs. The same guidance specifically addresses people who are moving abroad rather than holidaying, suggesting they consider cover for the journey and for the period it takes to arrange insurance at their destination.
Source: SafeTravel (New Zealand Ministry of Foreign Affairs and Trade) — Travel insurance, safetravel.govt.nz.
The practical upshot for New Zealanders is identical to the Australian position: you arrange private health insurance in Spain, from an insurer authorised to operate there. For most residence visa routes that is not optional — it is a document the Spanish authorities expect to see.
Yes. Australian and New Zealand citizens are non-EU, third-country nationals in the eyes of Spanish immigration law. As an Australian or New Zealand passport holder you can currently travel to Spain and the wider Schengen area as a visitor without a visa for short stays — the standard allowance is up to 90 days in any 180-day period. That is generous for a holiday or a scouting trip. It is not a way to live in Spain.
To stay beyond that short-stay allowance and become a resident, you need to apply for the appropriate residence visa, and for most routes you apply from Australia or New Zealand, at the Spanish consular office that covers where you live, before you travel. And here is the link back to healthcare: the main long-stay routes require you to hold private health insurance from an insurer authorised in Spain as part of the application file. No suitable health policy, no visa.
The table below sets out the routes Australians and New Zealanders most commonly use.
| Visa route | Who it’s for | Health insurance |
|---|---|---|
| Non-Lucrative Visa (NLV) | Retirees and financially independent people living on pensions, savings or investment income who will not work in Spain | Required — full private cover, no copayment, no limits |
| Digital Nomad Visa (DNV) | Remote workers and freelancers earning from employers or clients outside Spain | Required — full private cover, or the social security route depending on how you are engaged |
| Student visa | Australians and New Zealanders studying in Spain — language school, university, exchange or postgraduate | Required — visa-suitable student cover |
| Work / highly qualified visa | Those with a Spanish job offer, sponsorship or an intra-company transfer | Often via the employer and Spanish social security once working; private cover may be needed to bridge the gap |
| Family route | Joining a spouse, partner or family member who already holds Spanish residency | Depends on the sponsor’s status — private cover often required for each person named |
We help most often with the Non-Lucrative Visa and the Digital Nomad Visa, because those are the two routes where the health-insurance rule is applied most strictly and where the exact policy wording matters most.
For an Australian or New Zealander moving to Spain, private health insurance does three jobs at once. First, it satisfies the visa rule. Second, it fills the hole left by Medicare or the New Zealand system not covering you abroad. Third — and this is the part people underrate — it gives you fast, direct access to GPs, specialists, diagnostics and hospital care from the day your policy starts, without waiting to qualify for the Spanish public system.
But not any policy will do. Spanish consular guidance is specific about what visa-compliant cover looks like. For the Non-Lucrative Visa, the published requirements state that the policy must be with an insurance entity authorised to operate in Spain, must be valid for one year, and must cover all beneficiaries of the visa for the risks insured by Spain’s public health system. It must have no deductible, no copayment, no waiting period and no coverage limit, and must cover 100% of medical, hospital and out-of-hospital expenses. The guidance is also explicit that travel insurance with medical assistance coverage will not be accepted.
Source: Spanish Ministry of Foreign Affairs, European Union and Cooperation — consular guidance on the non-lucrative residence visa, exteriores.gob.es.
These requirements vary slightly by route and by consular office, and they do get updated, so the safest approach is to have the policy set up by someone who does this every day. A comprehensive Spanish health insurance policy built for visa applicants is designed to tick these boxes from the outset rather than being retrofitted to them.
Here is where moving from Australia or New Zealand differs materially from moving from, say, the UK or Canada. Distance changes the logistics, and the logistics are what trip people up.
For the NLV and most long-stay routes you apply before you move, in person, at the Spanish consular office responsible for your state or region. Spain maintains a consular network across Australia, and its diplomatic mission in Wellington serves New Zealand. Which office handles your file depends on where you live, and appointment availability can be tight — particularly in the popular months. For a New Zealander in particular, an application may involve dealing with an office in another country or arranging documents to be sent a very long way. None of that is a problem if you plan for it. It is a serious problem if you leave it to the last month.
The second distance issue is document legalisation. Supporting documents issued in Australia or New Zealand — police checks, medical certificates, marriage and birth certificates — typically need to be legalised with an apostille and then officially translated into Spanish. In Australia the apostille is issued by the Department of Foreign Affairs and Trade; in New Zealand it is issued by the Department of Internal Affairs. Both are routine processes, but they take time, they sometimes require documents to be posted, and every step adds days. Confirm the current requirement for each document with your consular office, because what needs apostilling can differ by route.
Because the health certificate has to exist before you file, insurance is one of the items to sort early rather than late. The good news is that it is also one of the quickest: an English-speaking adviser can usually get a policy and certificate issued far faster than a police check or an apostille comes back. If you want a hand with it, get a quote or contact us and we will walk you through the sequence.
This is the part that reassures people. Spanish healthcare is genuinely good. The public system is well regarded internationally for outcomes and life expectancy, and the private sector that sits alongside it is modern, well equipped and fast. Australians and New Zealanders arriving with quiet anxiety about “giving up Medicare” usually find the reality far better than they feared.
The structural comparison is interesting. In Australia you are used to a mixed model: Medicare underneath, private hospital and extras cover on top, gap payments in between, and the Medicare Levy Surcharge nudging higher earners into private cover. In New Zealand you are used to a strongly public system with private cover used to skip queues for elective work. Spain runs a similar mixed model — a strong public system funded through social security contributions, and a large, competitive private sector used by a substantial minority of the population for speed and choice.
What changes for you is the entry point. As a new arrival on a residence visa you are typically outside the public system until you earn access through employment and social security contributions, or through another defined route. Private cover is what bridges that, and for a retiree on the NLV it may well be the arrangement for good.
The practical experience of Spanish private healthcare tends to surprise people from both countries. You generally book specialists directly rather than needing a GP referral for everything. Diagnostics — scans, bloods, imaging — are usually arranged in days rather than weeks or months. Many insurers operate their own clinics and hospitals in the larger cities, alongside a wide network of contracted providers, and the possibility of English-speaking support depends on the doctor, centre and availability, though it is more common in the big cities and the expat-heavy coastal areas.
If you want to understand how that speed compares with what you are used to, our guide to healthcare waiting times in Spain goes through it properly.
On price, private health insurance in Spain is usually far cheaper than Australians and New Zealanders expect — considerably less than comparable private hospital cover costs at home, and a fraction of what private care costs in the United States. We do not quote a flat figure, because the honest answer depends on your age, where in Spain you are settling and the plan you choose. But it is normal for people from both countries to find the number lower than they had budgeted for.
Retirement is one of the most common reasons Australians and New Zealanders look at Spain, and the Non-Lucrative Visa is the classic route for it. The NLV is designed for people who can support themselves from pensions, superannuation drawdowns, KiwiSaver, savings or investment income, and who will not work in Spain. You demonstrate sufficient funds, provide a clean background check and a medical certificate, and — central to this guide — hold a full private health policy that meets the no-copayment, no-limit requirement.
For retirees the healthcare piece carries more weight than for anyone else. Medicare or the New Zealand system will not cover you. You are past the age where public access through Spanish employment is likely. And health needs generally increase with age. That makes a robust, visa-suitable policy from an insurer authorised in Spain not a box-ticking formality but the actual foundation of your move. Our health insurance for retirees in Spain guide covers the specifics for older applicants.
We will not pretend everything is automatic. Age and medical history affect which plans are open to you and on what terms. Insurers underwrite — they may accept a condition, exclude it, ask for reports, or in some cases decline. Cover for retirees is very often achievable, and many people with managed long-term conditions are insured perfectly happily. But nobody can promise acceptance in advance, and you should be sceptical of anyone who does. The sensible step is to have your specific situation reviewed by an adviser before you commit to a moving date, so you know where you stand rather than hoping.
One more retiree-specific point worth flagging, without straying outside our lane: how your Australian Age Pension or New Zealand Superannuation is treated once you live overseas is a separate question with its own rules, and it is handled by Services Australia and Work and Income respectively. It has no bearing on your health cover, but it does affect the income figures you present for the visa, so check it early with the relevant agency rather than assuming.
If you work remotely for an Australian, New Zealand or other non-Spanish employer, or you freelance for clients outside Spain, the Digital Nomad Visa is the route to look at. It exists to let remote workers live in Spain legally while continuing to earn from abroad, and it has been popular with tech workers, consultants, designers and other professionals from both countries who want the European base without giving up the job.
The DNV has a nuance the NLV does not. Depending on how you are engaged — as an employee of a foreign company, or as self-employed and registered as an autónomo in Spain — your healthcare position may run through Spanish social security rather than purely through private insurance, and in some employee cases a certificate of coverage arrangement may be relevant. Where private insurance is your main proof, it is assessed strictly against the same authorised-insurer, no-copay, comprehensive standard. Where you are covered through social security, private cover may be a supplementary choice rather than a visa requirement.
Because the answer genuinely depends on your employment structure, this is one to check against your exact circumstances rather than copying what a friend did. Get the structure confirmed first, then match the cover to it.
A practical note for both countries: Spain sits many hours behind eastern Australia and New Zealand, and the exact gap shifts with daylight saving at both ends. Plenty of people make it work — early mornings for calls home, or a deliberately asynchronous setup — but it shapes your working day. It also shapes your healthcare: if you are working odd hours, the ability to see a specialist quickly and at a time that suits, rather than waiting months for a slot, is worth real money. That is exactly what a good private policy buys.
Not every Australian or New Zealander moving to Spain is retiring or working remotely. Two other groups come up regularly.
Spain is a popular study destination for Australians and New Zealanders — Spanish language courses in Salamanca, Granada or Seville, business school in Madrid or Barcelona, university exchanges and postgraduate programmes. A student visa is required for study stays beyond the short-stay allowance, and health insurance is part of the file. Student cover is a specific product category with its own age and duration parameters, and applicants generally need proof of enrolment or acceptance before a student policy can be issued. If the course is long, or the applicant falls outside the usual student age band, a different plan may need to be reviewed instead.
If you have a Spanish job offer, sponsorship or an intra-company transfer, your healthcare position will usually run through your employer and Spanish social security once you are actually working and registered. The catch is the gap: there is often a period between arriving and being fully registered, and there may be a requirement to show cover as part of the visa application itself. Private cover frequently bridges that window. The key thing is not to cancel anything on the assumption that public cover has already kicked in — confirm it has, then decide.
If you are joining a spouse, partner or family member who already holds Spanish residency, the position depends on the sponsor’s own status and healthcare route. In many cases each joining family member needs to be individually named on suitable cover. A policy that covers only the sponsor is generally not enough.
If you are relocating as a family, the same principles apply to every single person — Medicare and New Zealand public cover follow none of you, and on a visa application a spouse or partner and each dependent child generally each need to be named on compliant cover. A policy listing only the main applicant is one of the classic reasons a family file gets held up.
Spanish insurers offer family policies designed for exactly this, and Spain is a genuinely good place to raise children, with strong paediatric care and a culture that welcomes kids everywhere. When we quote a family we make sure every person who needs to be on the policy is included, and that the certificate lists them correctly, so one missing name does not stall the whole application.
Children’s cover, maternity provisions and any waiting periods vary between plans, so if you are moving with young children or planning to grow your family in Spain, flag it early. Cover varies by plan, so always check your particular policy details — or ask us for a plan that includes what you need.
One situation worth calling out: families where one partner holds an EU passport — an Irish or Italian passport through a grandparent is common among both Australians and New Zealanders. If one of you is an EU citizen, that partner may be able to use the EU registration route rather than a third-country visa, while the non-EU partner and children follow a family route. The healthcare requirements differ between the two, so a mixed family needs the cover mapped person by person rather than treated as one block.
Almost every one of these is avoidable with a short conversation up front. Of all the moving parts in a relocation from Australia or New Zealand, the health policy is the one where a specialist most reliably saves you time, money and the risk of a rejected application.
We have dedicated pages for both nationalities that go deeper into plan options, pricing factors and the certificate process. If you already know which passport you are travelling on, start there.
If you are researching alongside friends or family from other countries, our moving to Spain from Canada guide covers a very similar non-EU position — the visa routes and the insurance rules are the same; only the home-country health system differs.
Tell us your age, where in Spain you are heading and your visa route, and an English-speaking adviser will find a visa-suitable plan and issue the certificate your consular office needs.
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