How much does private health insurance cost in Spain in 2026? Real prices by age

€74.81/month is the price of Más Salud Óptima, the high-copay plan, not the no-copay one: the larger the copay the insured person absorbs for each consultation, test or admission, the lower the monthly premium — and Óptima is precisely the variant where that copay is highest within the Más Salud range. The price hierarchy makes it clear: no copays costs €116.82/month because you pay nothing at the point of use; Plus, with a low copay, costs €86.88/month; and Óptima, with a high copay, costs €74.81/month. Before deciding on price alone, work out how many times a year you typically see a doctor: if you go often, a high copay can end up costing more than the premium difference versus Plus.

A private health insurance premium rises for three main reasons: the insured person's age, the copay plan chosen, and the postcode of residence, which sets the insurer's pricing zone according to the healthcare cost of that specific area. The age effect is the most visible: an adult paying €116.82/month on Más Salud with no copays at 35 would pay €197.87/month on that same standard plan at 67, a jump that reflects the statistically higher use of consultations and hospitalisation from that age onwards. The copay plan moves the premium in the opposite direction: the more copay the insured person absorbs, the lower the monthly payment. And within the same age and plan, the postcode introduces differences because each zone has its own medical network and its own associated cost of care.

Único +60 costs €55.02/month for a 67-year-old because it is a plan designed specifically for people over 60, with no upper age limit for signing up, compared with the €197.87/month that standard Más Salud would cost at that same age. The difference is neither an error nor a one-off promotion: they are different products within the Sanitas catalogue, built for different profiles. Standard Más Salud keeps the generic coverage of the full range, and its price scales steeply with age because it is not segmented into senior brackets. Único +60, by contrast, is priced specifically for the age bracket it targets, which makes a more contained premium possible from 60 onwards without excluding anyone on age grounds. At the office we recommend reviewing both options before renewing a policy after 60.

The Sanitas family discount is 5% when the policy includes two insured people and rises to 8% with three or more, a saving applied automatically when all the policies of the same household are paid from the same contract. This discount stacks on top of, for example, the already lower price of a child on a family policy, which starts from €32.40/month on the Óptima plan: a family of three or more not only pays less per insured person thanks to the child rate, but also takes 8% off the total of the combined policy. At the office we calculate this discount along with the rest of the conditions before issuing the proposal, so the final price you receive already includes it.

Paying the premium annually, in a single charge rather than monthly instalments, earns an extra 4% discount on the policy total, a saving that stacks with the family discount if you insure several people from the same household. In practice that means a family of three insured people who also pay in a single annual receipt accumulates two separate discounts off the list price: 8% for family and 4% for annual payment, applied to the total premium of every policy on the contract. Worth bearing in mind: for some visa or residency procedures the first year requires full annual payment anyway, as a consulate or immigration requirement, so in those cases the 4% discount arrives almost automatically.

Waiting periods are the initial stretches of the policy during which a given benefit is not yet covered, and on Sanitas Más Salud they vary by type of care: there is no waiting period for consultations or emergencies, which are covered from day one; hospitalisation and complex tests have a 6-month waiting period; and childbirth has 8 months. These waiting periods can be waived if you are coming from another insurer and had already served the equivalent period on your previous policy, something common in portability campaigns that we review case by case at the office before signing up. It matters especially if you are pregnant or expect to need a scheduled procedure in the short term, because the exact policy start date can determine whether coverage arrives in time or not.

Avanza costs €39.35/month because it is the cheapest Sanitas Más Salud plan, since it does not include hospitalisation coverage, so it works as a top-up for access to consultations and tests, not as a replacement for full health insurance. At the office we mainly recommend it to people who already have hospitalisation covered some other way — for example the public health system as a regularised resident — and only want to speed up access to specialists and diagnostic tests without the public system's waiting lists. It is not the right option for visa or residency procedures that expressly require full hospital coverage with no copays and no waiting periods, such as arraigo, the non-lucrative visa or the student visa: for those specific cases, the no-copay plan or Plus are the ones that meet the requirement.

A child included on a family policy on the Óptima plan costs from €32.40/month, lower than an adult on the same plan because the Sanitas child rate is priced according to the typical statistical usage of that age bracket. The family discount can be added on top of that base price (5% with two insured people, 8% with three or more) if the child is part of a joint policy with their parents or siblings, along with the extra 4% for annual payment if the family chooses that option. At the office we often see families torn between insuring their children on the same plan as the parents or on a cheaper one: our general recommendation is to keep the same plan for the whole family, unless there is a specific medical reason to do otherwise.