Sanitas vs Adeslas for Expats in Spain: Which Is Better in 2026?

Both insurers issue policies that Spanish consulates and immigration offices accept, so the brand is not what decides it — the policy conditions are. Whichever you choose, the certificate must state that the insurer is authorised to operate in Spain (DGSFP-registered), and that the policy has no copays, no waiting periods and covers the full Spanish territory. This is where applications fail: a plan with a small copay per visit, or one issued by a foreign entity, gets the file sent back weeks later. On the Sanitas side the visa-specific products are Residents and Residents Visado, from €780.60 per year paid up front, and we issue the certificate in under 24 hours in English or Spanish. Before you pay anything, send us the exact requirements your consulate published and we will tell you free of charge whether the policy you are considering complies.

In reimbursement. Adeslas Plena includes free choice of doctor with expense reimbursement as standard, whereas with Sanitas you need a specific product, Más Salud with Reimbursement, from €111.73 per month for an 80% refund up to €90,000 a year. If you already have a specialist you trust and want to keep seeing them outside any network — common among expats who move with an ongoing treatment — Adeslas can work out cheaper for that particular need. Adeslas is also usually cheaper on entry price, around €45-60 a month for a 35-year-old versus €74.81 with Sanitas in its most economical copay tier. We say this openly because you will find it out anyway, and because the honest comparison is what tells you which of the two fits your case.

Because they change what happens when something serious occurs, which is exactly when you are least equipped to navigate a foreign health system. Sanitas owns two university hospitals in Madrid, La Zarzuela and La Moraleja, plus its own Milenium medical centres and 200 dental clinics; Adeslas works with a contracted network without hospitals of its own. In practice, with an owned network the insurer controls the appointment, the medical record and the billing, so you book, attend and pay nothing — no claim forms, no upfront payment, no chasing invoices in a language you are still learning. If you settle outside Madrid the difference narrows, because there you use the contracted network in both cases: it is worth checking the specific centres near your address before you decide.

It can change it completely, and it is the one question you should not resolve from a comparison table. Both insurers ask a health questionnaire and can exclude, surcharge or decline based on it, and each applies its own underwriting criteria — which is why some expats end up with a third insurer entirely. What we can do at our office is review your case before you formally apply: if the condition is likely to be excluded by Sanitas, we tell you so upfront rather than letting you pay for a policy that will not cover the thing you actually need. One relevant detail either way: if you already hold private cover from another insurer, you can usually have the waiting periods waived by presenting a certificate from your previous company, which matters if you need hospitalisation or complex tests soon after arriving.

With Sanitas we can give you the exact figure because we work from the official April 2026 rate card: a 35-year-old adult in Madrid pays from €74.81 a month with the high-copay tier, €86.88 with the low-copay tier and €116.82 with no copays, and the family discount is 5% with two insured and 8% with three or more, plus a further 4% if you pay annually instead of monthly. For a family with children it is also worth pricing Más Salud Familias, which adds psychology with no waiting period, speech therapy and home help. For Adeslas we can only quote the public market range of roughly €45-60 a month per adult, because we do not have access to their rate card. Use the calculator on this site for your exact Sanitas figure by age and postal code, then ask Adeslas for a written quote and compare like for like — same copay tier, same cover.

Yes. Health policies in Spain are annual contracts, so you can move insurer at renewal, and the previous cover works in your favour: presenting a certificate of the time already insured normally waives the new insurer's waiting periods, so you do not start from zero on hospitalisation or complex tests. The two things to get right when switching are timing and continuity — do not cancel the old policy before the new one is in force, especially if you need the certificate for a residency renewal, because a single day without cover is exactly what immigration checks. If you are switching to Sanitas, we handle the overlap and the certificate for you; if you are leaving us, we will tell you plainly what you lose so the decision is informed.

No. The premium comes from the official Sanitas rate card, identical across every sales channel: our office adds no markup for advice, paperwork or issuing certificates. What you get on top of the same price is a physical office in Madrid with named people, the visa certificate guaranteed in under 24 hours, support in English, Russian and Ukrainian, and someone who tracks your renewal dates so they never collide with an immigration appointment. It is worth knowing that Sanitas has many independent agent offices across Spain, all selling the same products at the same price — what differs between them is the service, which is why public reviews are the fairest way to compare them.