Related guide: Más Salud, Avanza or Único +60: which Sanitas plan to choose
Sanitas Avanza vs Más Salud Óptima for a 25-year-old in Madrid
The two options we put on the table when someone is taking out their first insurance. Official Sanitas prices of April 2026 for a 25-year-old in Madrid. The row that decides it is hospitalization: it is the only important thing Avanza does not have. Avanza and Óptima share unlimited consultations in every specialty, advanced-technology tests with a 6-month waiting period, physiotherapy and basic dental care; the table shows only what changes.
Swipe the table to see all columns
| Coverage | Sanitas Avanza | Más Salud Óptima |
|---|---|---|
| Price at 25 in Madrid | €39.35/month (€38.20 in most of Spain) | €66.78/month |
| Hospitalization and admission | Not included. This is the fundamental difference between the two products | Included, with a 10-month waiting period |
| Surgery | More than 400 procedures without hospital admission, with a 3-month waiting period | Surgery with and without admission |
| Childbirth | Not covered | Covered, with an 8-month waiting period |
| 24-hour video consultation and app | Video consultations for general medicine, specialties and emergencies 24 hours a day, same-day digital consultations with doctors from 10 specialties, digital physio and the Cuida tu mente mental wellbeing programme | The same digital services |
| Copays | The first 6 visits of the year at €0; from the 7th to the 15th, €5; from the 16th, €10. Tests and procedures €12, emergencies €8, dental €3 | A copay from the first visit, which is why the monthly premium is higher than Avanza's but lower than the no-copay plans |
| Annual copay cap | €350 per insured person per year | Depends on the plan taken out |
| Age at sign-up | From 0 to 59, with no maximum age for staying on it | From 0 to 75 |
Official prices of Sanitas, S.A. de Seguros, April 2026, for age 25 and a Madrid postcode; they vary by age and province, so check yours with the calculator on this website or with us. Cover, waiting periods and copays according to the current product sheet: the policy's general terms and conditions always prevail. We are an authorized exclusive agency of Sanitas; the premium is the official Sanitas price and is identical across every sales channel. Sanitas is a registered trademark of Sanitas, S.A. de Seguros.
Common questions
Direct answers, the same we give at the office.
If it does not cover hospitalization, what happens if I need an operation?
It depends on the type of operation, and this is the question to settle before you sign. Avanza covers more than 400 surgical procedures without hospital admission, the ones where you are operated on and go home the same day: knee meniscus arthroscopy, carpal tunnel, simple hernias, many orthopaedic and dermatology procedures, with a 3-month waiting period from sign-up. What it does not cover is admission: if you need to spend nights in hospital or have a major operation, that part is not included and you would go to the Spanish public health system, which covers exactly that, and covers it well. Our honest recommendation: Avanza makes sense if you see it as the fast everyday layer on top of the public system, not as a replacement for it. If what you want is not to depend on the public system at all, your product is Más Salud, and we will tell you so.
I am young and hardly ever get ill. Why would I want it?
It is the first thing almost everyone your age tells us, and our answer is not "in case something serious happens": it is that at 25 you do not take out insurance to be ill, you take it out so you do not end up ill. Having direct access to all of primary care and the specialties means being able to get checked when it is time, not when it already hurts. What we actually see people in their twenties and thirties use at the office is dermatology (a mole that has changed, acne that will not go away), orthopaedics for gym or running injuries, physiotherapy for those same injuries, gynecology, full blood tests whenever you feel like it, and an MRI or CT scan in days rather than months. That is the real value: not waiting. If in the last year you paid out of your own pocket for private doctors even two or three times, do the maths: one private specialist visit costs roughly what almost two months of Avanza do.
It is three in the morning and I feel awful. Do I have to go to A&E?
No, and this is the example that makes it click for most young people. Avanza includes 24-hour emergency video consultations, general and paediatric, in the app: at three in the morning you open your phone, talk to a doctor from your bed and they tell you whether what you have can be sorted with rest and a treatment plan or whether you really need to go to a medical centre. For almost everything that happens to us in the small hours (a rising fever, a urinary infection, a pain that is scarier than it should be) that gets you through the night without getting dressed or waiting four hours in a cubicle. And it does not stop there: the app has same-day digital consultations with doctors from ten specialties, digital physio and the Cuida tu mente programme. We know many clients in their twenties and thirties would rather talk to a doctor remotely than book an in-person appointment, and with this product that option is included, not an extra.
How much do I end up paying in copays in a normal year?
Less than people fear, because the first 6 visits of the year are free. After that you pay €5 per visit from the seventh to the fifteenth and €10 from the sixteenth; diagnostic tests, therapeutic treatments and procedures are €12, emergencies €8, a podiatry session €3 and dental €3. A year of heavy use for a young person, say eight consultations, two tests and one emergency, comes to about €42 in copays for the whole year. And there is a ceiling: €350 per insured person per year, so however much you use the insurance, your spending is capped. If you would rather pay nothing when you see the doctor, that exists, but it is a different product: the no-copay Más Salud plans, with a higher monthly premium.
Does it really cost €38, or is that a teaser price?
It is the real official Sanitas price of April 2026, not a hook. The 20 to 39 age band costs €38.20 a month in most of Spain and €39.35 in Madrid; in Barcelona it goes up to €43.09 and in Ibiza and Formentera to €71.28, because the premium depends on the province. From 16 to 19 it is €35.80 and from 40 to 59, €40.60, at the national reference price. On top of that there is a 5% discount if there are two of you insured, 8% from three, and an extra 4% if you pay annually rather than monthly. Use the calculator on this website with your age and postcode and you will have the exact figure without anyone calling you.
If I later want to move up to Más Salud, do the waiting periods start again?
This is the most important question of all, because taking out Avanza at 25 only makes sense if it does not penalise you at 32. The time you have been insured works in your favour: moving from Avanza to Más Salud is handled as a product change within the same company and your seniority counts, so you do not arrive as a new client. That said, we are not going to give you an absolute answer in an article: exactly how the waiting periods for hospitalization and childbirth work out depends on your specific seniority and the date of the change. What we do at the office is ask Sanitas for it in writing before you sign anything, so you know on what terms you would move up. And if you are going to want childbirth covered in the next two years, say so from the start: then the conversation changes and we will probably recommend a different product from day one.
Up to what age can I take it out, and what happens when I reach it?
Avanza can be taken out from 0 to 59 inclusive and has no maximum age for staying on it: once you are in, the policy renews for life, so turning 60 does not take you off the insurance. What you can no longer do is join from that age, and that is where many people miss the boat without realising it. If you are 58 or 59 and thinking it over, taking it out before your birthday rather than after makes a real difference. For anyone already past 59 there are other ways in: Más Salud goes up to 75, and Único +60 has no upper age limit for joining from 60.
Does it include the dentist?
Yes, and it is one of the covers people use most and expect least: check-ups, cleanings, fillings and simple extractions for a €3 copay, in Sanitas's own network of dental clinics. A single private dental cleaning costs more than a whole month of Avanza, so if you have your check-up and cleaning once a year the insurance starts paying for itself. If what lies ahead is orthodontics, implants or whitening, that basic cover is not enough and it is worth adding a dental plan: Dental Milenium from €12.20 a month, with more than 40 treatments included at no cost, or Dental Premium from €19.90 with the most complete cover. If you are thinking about getting braces soon, tell us and we will work out both options with the price of each treatment in front of you, because sometimes the higher plan works out better.
Does it cost more to take it out with you than directly with Sanitas?
No. The premium is the official Sanitas price and is identical across every channel: our office adds no surcharge for advice, paperwork or issuing certificates. What you get for the same price is a physical office in Majadahonda with real people, service in eight languages (Spanish, English, German, French, Italian, Portuguese, Russian and Chinese), and someone who reminds you about your renewal instead of you finding out from your bank. And if you would rather sort it out without setting foot in the office, it works just the same on WhatsApp or by video call.