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Related guide: The Best Health Insurance for Expats in Spain: The 2026 Guide by Profile
Sanitas Más Salud vs. the Adeslas Plena Range, Point by Point
The Adeslas data comes from its official 2026 information notes for Plena, Plena Plus and Plena Extra. It is worth knowing that the Plena range has five plans and that reimbursement, copays and dental change depending on which one you take out, so in each section we say which plan we are talking about. We include no prices from either company: they depend on province, age and plan, and a figure on its own compares nothing.
The ranges: what is being compared
Sanitas’s health range is organized in three tiers. The base plan is Más Salud, a medical-network policy with no copays; anyone who prefers a lower premium in exchange for paying something per visit has the Plus and Óptima versions, with their published copay schedule. For reimbursement, to choose a doctor outside the network, there are Premium 500.000 and Más 90.000, plus Top Quantum, which includes reimbursement in the family specialties. And at the entry level, Avanza, Accede and Único +60. When a client walks into the office, the first step is to place them in one of those tiers according to how they are going to use their insurance.
SegurCaixa Adeslas’s Plena range has five plans: Plena Vital and Plena, with a copay per visit; Plena Plus, with no copay; Plena Extra, with no copay and 80% reimbursement; and Plena Total, whose premium stays flat for three years. Dental is a separate module across the whole range. The fair comparison, therefore, is Más Salud against Plena Plus, the two medical-network plans with no copay.
The medical network
Sanitas publishes more than 59,000 professionals and more than 4,100 own and partner centers, plus five own hospitals and 226 own dental clinics. It is by far the largest medical network of any we compare on this blog, and the only one in which part of the network belongs to the insurer itself.
Adeslas reports around 43,000 professionals and more than 1,100 centers in its partner network, by its own figures. The gap in size is the largest of the five comparisons we have made, and it shows above all outside the big cities, where having a specialist closer to home depends on how many are in the network.
Own hospitals
Sanitas is the only one of the major insurers with hospitals of its own: five in operation. Four are in Madrid and are university hospitals: La Zarzuela in Aravaca, La Moraleja in Sanchinarro, Virgen del Mar and Blua Valdebebas, its first digitally native hospital, accredited as a university hospital in April 2026. The fifth is CIMA, in Barcelona. La Zarzuela and La Moraleja rank in the top 10 of Spanish private healthcare, and La Zarzuela is fifteen minutes from our office. Having your own hospital means insurer and hospital are the same house: no money up front, no reimbursement claims, and your medical record in a single place.
Adeslas has no own hospitals: all hospital care is provided through partner centers. It works, and in many cities it works well, but on the day of surgery an Adeslas patient depends on the agreement between their insurer and a third-party hospital, while a Sanitas patient walks into a hospital owned by their insurer.
Reimbursement: choosing a doctor outside the network
If what you want is to choose a doctor outside the network, Sanitas covers it with two free-choice products: Premium 500.000 reimburses 90% of the bill up to €500,000 a year and Más 90.000 reimburses 70% up to €90,000. Both give access to a partner network in the United States, can be taken out up to age 64 and set no maximum age for staying insured. Top Quantum, in addition, includes reimbursement as standard in the family specialties. The base plan Más Salud, by contrast, works with Sanitas’s own and partner medical network, with no reimbursement.
At Adeslas, reimbursement exists only in Plena Extra, which returns 80% of the bill with limits per item, for example €5,000 a year for childbirth and postpartum care and €20,000 for robotic surgery outside the network. In Plena and Plena Plus, reimbursement is limited to physiotherapy and rehabilitation, at 50% and up to €500 a year, and to podiatry, up to €200 a year. In other words, if you want free choice with Adeslas you have to go to the top of the range.
Copays
Más Salud has no copays: you pay nothing per visit, whether for a consultation, a test or a video consultation. Anyone who prefers a lower premium has the copay range, whose full schedule is published. The most detailed case is Avanza: the first six services of the year are free, the seventh to the fifteenth cost €5 and from the sixteenth onward €10; tests and therapeutic procedures are €12, emergency visits €8, and podiatry and dental €3, with a cap of €350 per insured person per year, so the maximum outlay is known in advance.
At Adeslas, Plena and Plena Vital charge a copay per visit: €2.70 for general medicine, pediatrics and home visits, and €2.00 for nursing. Plena Plus and Plena Extra have no copay. These are low amounts, and it is one point where Adeslas’s copay range is simpler than that of other companies.
Dental
Sanitas health insurance includes basic dental cover as standard, with check-ups and cleanings at its 226 own dental clinics, and for anyone who wants more, Dental Milenium or Dental Premium can be added as a supplement with no health questionnaire and no age limit for taking them out. It is the only insurer among those compared whose basic dental cover is provided in its own clinics.
In the Plena range dental is not included: the Adeslas Dental Familia module is taken out separately, and under it the insured pays an amount for each treatment according to the module’s dental fee schedule. For a family that will have check-ups and cleanings every year, it is an annual cost difference worth working out.
Waiting periods
With Sanitas there is no waiting period for consultations or emergencies; there are 3 months for outpatient surgery in groups 0 to II, 6 for complex tests and psychology, 8 for childbirth and 10 for hospitalization and surgery in groups III to VIII. What matters for anyone switching from another company is that all of them, except childbirth, can be waived at enrollment by providing proof of the previous policy; it is an underwriting decision Sanitas makes when processing the application, and at the office we always request it and confirm it in writing before you cancel the other policy.
Adeslas applies 3 months for high-tech diagnostics and outpatient surgery in groups 0 to II, 6 for interventional diagnostics and 8 for hospitalization, implants and prostheses, with no waiting period for life-threatening emergencies or premature birth. For hospitalization, then, Adeslas is two months shorter than Sanitas if this is your first policy; if you are coming from another company, Sanitas’s waiver of waiting periods levels the field.
Remote care and second opinion
With Sanitas, 24-hour video consultation is included in the policy through Blua, its digital services in the Mi Sanitas app, together with a second medical opinion. On Más Salud it carries no copay, because the product has no copays.
Adeslas includes 24-hour telephone assistance and a second medical opinion in the Plena range. The difference lies in video consultation with any specialty within the policy, which at Sanitas is part of Blua.
Where and with whom you sign up
With Sanitas you can sign up at a physical office with an exclusive agent, like ours in Majadahonda: the same person before and after enrollment, service in eight languages, no surcharge for the advice and a reply in under 24 hours. The price is the official Sanitas price, the same as through any other channel.
Adeslas is sold through its agencies, at CaixaBank branches and through intermediaries, with no exclusive office of the insurer. The product is the same in all of them; what changes, just as with Sanitas, is who looks after you afterwards.
Comparison prepared in September 2026 from the official 2026 information notes for Adeslas Plena, Adeslas Plena Plus and Adeslas Plena Extra published on segurcaixaadeslas.es, and from Sanitas product documentation. Exact coverage and premiums depend on each policy taken out and may vary: always check the current terms with each insurer before deciding. Sanitas is a registered trademark of Sanitas, S.A. de Seguros; Adeslas and SegurCaixa Adeslas are registered trademarks of SegurCaixa Adeslas, S.A. de Seguros y Reaseguros; all other trademarks belong to their respective owners.
Common questions
Direct answers, the same we give at the office.
Which one is accepted for a Spanish visa or residency permit?
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, with the year's premium 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.
Where does Adeslas genuinely beat Sanitas?
In one specific plan: Plena Extra, which refunds 80% of the invoice when you go outside the network and has no copays, so it fits if you already have a private specialist you want to keep seeing. What is worth knowing is that this reimbursement is not in the rest of the range: in Plena and in Plena Plus it is limited to physiotherapy and rehabilitation, 50% up to €500 a year, and podiatry, up to €200 a year, according to their own 2026 information notes. And even in Plena Extra you get neither the insurer's own university hospitals nor its own dental clinics, because the company does not have them. Sanitas fits better in the rest of the cases, and for concrete reasons: five own hospitals, with four university hospitals in Madrid, 226 own dental clinics, the widest medical network in this comparison with over 59,000 professionals, and a physical office where a named person deals with you.
Why do the own hospitals matter if I am new to Spain?
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 five hospitals — La Zarzuela, La Moraleja, Virgen del Mar and the 100% digital Blua Valdebebas in Madrid, plus CIMA in Barcelona — as well as 226 own 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.
I have a pre-existing condition. Does that change the answer?
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.
How much does health insurance with Sanitas cost compared with Adeslas?
We do not publish prices for either company, and that is deliberate: Adeslas's premium depends on the province, the age and the plan, and ours comes from the Madrid rate table, one of the provinces with the highest premiums, so putting one figure next to the other would not be fair to either. What we do instead is the useful part: bring us your Adeslas quote at our Majadahonda office and we will set it next to the Sanitas one for the same age, the same postcode and the cover you will actually use: own hospitals, dental included, medical network and co-payments. Those are two figures you can genuinely compare. And if you have already chosen Sanitas, bring an official quote from another Sanitas office or from the company itself and we will improve on it.
Can I switch later if I choose wrong?
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.
Do I pay more for buying through your office instead of going direct?
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 eight languages (Spanish, English, German, French, Italian, Portuguese, Russian and Chinese), 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. We are an exclusive Sanitas agent registered with the DGSFP, the Spanish insurance regulator, under key C0320B67816207, with 5.0 stars and more than 400 reviews on Google. The easiest way to reach us is WhatsApp: writing is simpler than calling when Spanish is not your language, and we reply in under 24 hours, guaranteed.