In this article
Related guide: The Best Health Insurance for Expats in Spain: The 2026 Guide by Profile
Sanitas Más Salud vs. Mapfre Salud, Point by Point
These sections set out the verified facts on Sanitas Más Salud against Mapfre Salud: medical network, hospitals, dental, copays, waiting periods and enrollment age, using Mapfre’s official pre-contractual documentation from June 2026. We include no prices from either company, because they depend on province, age and plan, and we point out where Mapfre matches or beats Sanitas.
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.
At Mapfre, Salud Esencial is outpatient only and does not cover admissions; then come Salud with copay and Salud without copay, which are the full medical-network plans; and the Seguro de Reembolso, separately. Reimbursement is not part of the medical-network plans. The fair comparison is Más Salud against Mapfre Salud without 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.
Mapfre publishes more than 50,000 professionals, more than 16 own medical centers and agreements with close to 300 hospitals. Alongside Sanitas, it is the only insurer compared with medical centers of its own, although not hospitals.
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.
Mapfre’s medical-network plans have no reimbursement. Its Seguro de Reembolso, a separate product, pays 80% of outpatient care and 90% of hospital care, with a cap of €250,000 a year and sub-limits per treatment, such as €230.88 per primary care consultation. Those per-treatment sub-limits are the practical difference from Premium 500.000, which reimburses 90% without that kind of ceiling per consultation.
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.
Mapfre’s copay plan charges €3.61 for general medicine, €5.79 for specialists and special diagnostics, €13 for special treatments and €11.53 for hospitalization, with no published annual cap, and waives the copay if you go to its own centers. The no-copay plan keeps some deductibles, such as €12 per psychotherapy session. That nuance, that “no copay” does not mean no deductibles, is what most surprises anyone comparing plan names alone.
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.
Mapfre includes basic dental cover: a treatment plan, one cleaning a year, X-rays and simple extractions. Periodontics, root canals, fillings, orthodontics, prostheses and implants are excluded unless the dental cover is added, and are paid at an agreed price. On dental, Mapfre is the closest to Sanitas of the five compared, with the difference that Sanitas provides it in its own clinics.
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.
Mapfre applies 8 months for surgery, hospitalization of any kind and childbirth or cesarean; 6 months for MRI, PET, rehabilitation, psychotherapy, osteopathy and genetics; and 48 months for assisted reproduction. There is no waiting period for accidents or for extreme or life-threatening emergencies. For hospitalization it is two months shorter than Sanitas for a first policy; with a previous insurer, Sanitas’s waiver levels the field.
Enrollment age
Sanitas enrolls from age 0 to 75 and, according to its product documentation, sets no maximum age for staying insured. The Único +60 plan, designed for older clients, has no upper age limit for enrollment from age 60, something rare in the market.
Mapfre enrolls up to age 65 in the plans with hospitalization and in the Seguro de Reembolso; the age of 75 applies only to Salud Esencial, which does not cover admissions. It is the lowest limit of the five companies compared, and for anyone between 65 and 75 it leaves Sanitas practically alone in this comparison.
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.
Mapfre’s terms and conditions include an international second diagnosis and 24-hour medical guidance by telephone. Video consultation and chat appear on its commercial website, not in the contractual documentation, and that difference matters: what is in the contract is enforceable.
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.
Mapfre is sold through its own offices and through intermediaries, with no office dedicated exclusively to health insurance. Of the five companies, it has the largest physical network of offices, although a general-purpose one.
Comparison prepared in September 2026 from Mapfre’s official pre-contractual documentation of June 2026 published on mapfre.es, including the information notes and general terms and conditions, edition 06/26, for Asistencia Sanitaria and the Seguro de Reembolso, and from Sanitas product documentation. Exact coverage depends on the plan taken out: always check the current terms before deciding. Sanitas is a registered trademark of Sanitas, S.A. de Seguros; Mapfre is a registered trademark of Mapfre España, Compañía de Seguros y Reaseguros, S.A.; all other trademarks belong to their respective owners.
Common questions
Direct answers, the same we give at the office.
How much does health insurance with Sanitas cost compared with Mapfre in 2026?
We do not publish prices for either company, and that is deliberate: Mapfre'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 Mapfre 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 copays. 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.
Which insurer has the larger medical network, Sanitas or Mapfre?
Sanitas confirms on its own website more than 59,000 professionals and more than 4,100 own and partner centres in Spain, plus its 5 own hospitals: the university hospitals La Zarzuela, La Moraleja, Virgen del Mar and the fully digital Valdebebas in Madrid, and CIMA in Barcelona. Mapfre's figure, usually quoted as more than 50,000 professionals, we treat with low confidence: it does not appear on Mapfre's official website with a primary source of its own, and it coincides suspiciously with the old public figure for Sanitas, which suggests it may be a number repeated from one comparison site to the next. What is better documented is that Mapfre has around 16 own medical centres and agreements with close to 300 partner hospitals: a largely partner-based network, with no own university hospitals equivalent to those of Sanitas. If the real size of the network is a deciding factor for you, we confirm it in detail at the office before you decide.
Do Sanitas or Mapfre offer reimbursement of medical expenses (free choice of doctor)?
Both do, but in a separate product, not in the medical-network plan. With Sanitas it is Más 90.000 with Reimbursement, which covers 70% of the bill up to €90,000 a year. With Mapfre it is its Seguro de Reembolso, which pays 80% of outpatient care and 90% of hospital care, with a cap of €250,000 per insured person and year and sub-limits per treatment, such as €230.88 for a primary care consultation. Its Élite range advertises higher percentages on the commercial website, but Mapfre publishes neither the policy conditions nor the information note for that product, so we do not take that figure as confirmed. At the office we work it out with you based on how much you spend a year on private consultations.
I am over 60. Which of the two can I actually take out?
This is the row that decides it for many people and it is rarely mentioned in comparisons: Mapfre caps entry at 65 in its main plans, offering 75 only in its Asistencia Sanitaria Esencial plan, whereas Sanitas accepts new policies up to 75 and, through Único +60, has no upper entry age at all from 60 onwards. If you are moving to Spain as a retiree, that difference is not a detail — it decides whether you have a policy or not, and it also decides whether you can meet the insurance requirement of a non-lucrative visa. One more thing worth knowing: entry age limits apply to signing up, not to staying insured, so taking the policy out before a birthday rather than after can matter.
Is dental included in either of them?
Both include something, but not the same thing. Basic dental comes included in Sanitas Más Salud, backed by 226 Sanitas-owned dental clinics, with the option to upgrade to Dental Milenium or Dental Premium. Mapfre also includes a basic dental cover — a treatment plan, one annual cleaning, X-rays and simple extractions — but periodontics, root canal treatment, fillings, orthodontics, prostheses and implants are excluded unless you take out its dental guarantee, and are then paid at agreed prices. When you compare the two monthly totals, add what the dentist will actually charge you on each side, otherwise you are comparing an incomplete policy against a complete one.
Where does Mapfre genuinely beat Sanitas?
In two places. First, reimbursement: Mapfre offers free choice of doctor in a separate product, its Seguro de Reembolso, which pays 80% of outpatient care and 90% of hospital care with a cap of €250,000 a year — its medical-network plans do not include it — whereas the equivalent Sanitas product is Más 90.000 with Reimbursement. If keeping your own private specialist is your priority, Mapfre is likely cheaper for that need. Second, extras: Club Mapfre discounts and an international second medical opinion including the US are real benefits that Sanitas does not match in the same form. We say this plainly because you will find it out anyway, and an honest comparison is more useful to you than a sales pitch.
Does Mapfre have its own hospitals, like Sanitas does?
Not quite: Sanitas has 5 own hospitals in operation, whereas Mapfre relies on around 16 own medical centres and a partner network of close to 300 hospitals, with no equivalent university hospitals. The Sanitas hospitals are the university hospitals La Zarzuela (Aravaca), La Moraleja, Virgen del Mar and the fully digital Valdebebas in Madrid, and CIMA in Barcelona, and they form part of its own healthcare network. Mapfre, according to the information available (medium confidence, not directly confirmed on mapfre.es), has around 16 own medical centres and a partner network of close to 300 hospitals, but no own university hospitals to compare with. That does not mean Mapfre's care is worse, only that its model leans more on the partner network than on hospital infrastructure of its own. If being able to go to a university hospital owned by your insurer matters to you, it is a point worth clearing up before you sign, and at the Majadahonda office we explain in detail what each model means in practice.
Watch out for the waiting periods, right?
Yes, and this is the row we would read most carefully if you expect to need something specific soon. Sanitas applies 6 months for complex tests and 10 months for hospitalisation and 8 months for childbirth, all waivable if you arrive from another insurer with the periods already served. Mapfre's range is wider, from 6 up to 48 months depending on the benefit, with the longest applying to cases such as assisted reproduction. If you are planning a pregnancy, fertility treatment or scheduled surgery, ask both insurers in writing for the exact waiting period for that specific benefit before you sign anything — this is where the real difference shows up, not in the monthly premium.
Do I pay more for going through your office rather than direct?
No. The premium comes from the official Sanitas rate card and is identical across every channel: we add no markup for advice, paperwork or 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 tracking your renewal so it never collides with an immigration appointment. Mapfre works mainly through agencies and brokers, so the level of follow-up you get there depends entirely on which one you land with. 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.