Copay or No-Copay? Choosing Your Sanitas Health Plan in Spain

No, waiting periods are the same across all three modalities: choosing the high copay option to save on the monthly fee doesn't lengthen any wait, and paying for the no-copay modality doesn't shorten it either. In all of them, consultations, emergencies and basic tests have no waiting period at all — you can see your family doctor, your pediatrician, or any of the more than 30 specialties as soon as the policy is active — while hospitalization and high-complexity tests, such as a CT scan or an MRI, have an indicative waiting period of 6 months, and childbirth has 8 months. These periods affect scheduled procedures, not day-to-day use. The way to shorten them isn't the modality you pick, but your history: in certain campaigns Sanitas removes waiting periods if you're coming from another insurer and had already completed them there, which is the most common case we handle at our Majadahonda office. Tell us about your situation before signing up and we'll confirm it in writing.

The one we use in the office is based on how often you use it: if you see a doctor less than 1-2 times a month, the copay modality tends to pay off, because the premium drops by around 22% and in exchange you pay a small amount for each medical visit (consultation, diagnostic test or session). If you make frequent use of the insurance, or have young children with constant pediatrician visits, the no-copay modality is more predictable: the fixed fee already includes everything. To put numbers on it, the real reference from the official April 2026 rate card for a 35-year-old adult in Madrid: €116.82/month with no copays, €86.88 with low copay (Plus) and €74.81 with high copay (Óptima). Our advice before deciding: work out how many medical visits your family made last year — it tends to be a surprise — and do the math with those real numbers. At our Majadahonda office we do it with you so you choose based on data.

Insuring the whole family together comes out cheaper per person, whichever copay modality you choose: Sanitas's official rate card applies a reduced price for policies with 2-3 insured members and an even lower one from 4 members onward, which in practice amounts to around a 5% discount with two insured members and 8% with three or more. Children also have their own lower premium — from €32.40/month in the Óptima modality — and if you add the dental add-on, the child rate is €9.90 versus €12.90 for an adult. In other words, the cost of adding a child is quite a bit lower than many families expect when they do the math based only on the adult price. This page's calculator applies all these discounts automatically based on your postal code and the ages you enter, and if you're unsure whether to include everyone now or in stages, at the office we'll prepare both simulations so you can compare at your own pace.

Yes, across all three Más Salud modalities (no copays, low copay and high copay) the coverage is exactly the same, including pregnancy, birth preparation and childbirth itself, after the corresponding 8-month waiting period. The difference between modalities is never about what the policy covers, only about how much you pay in fixed monthly premium and how much you pay per medical visit if your modality has a copay. This matters for anyone planning a pregnancy who is torn between modalities on price: choosing the cheaper modality (high copay) does not reduce or limit the pregnancy and childbirth coverage in any way compared with the no-copay modality — it only changes whether you pay something for each prenatal check-up on top of the monthly fee. Many families with young children on the way specifically prefer the no-copay modality for the predictability of the expense during that period.

There are four exclusions that apply equally across the three Más Salud modalities, with the copay having no bearing on them: pre-existing illnesses or injuries not declared on the health questionnaire at the time of taking out the policy, purely cosmetic surgery and treatments with no medical purpose, experimental treatments or those without recognized clinical evidence, and outpatient prescription medication, which is prescribed but not funded by the policy (it's bought separately at the pharmacy). These exclusions are standard across the private health insurance industry and aren't specific to any particular copay modality. The most important point on this list, especially the first exclusion, is to honestly declare any pre-existing condition on the health questionnaire when signing up: an undeclared pre-existing condition can void the corresponding coverage later on, while a correctly declared one is usually accepted, sometimes with a specific exclusion agreed in advance.

Yes. If in this page's calculator you choose annual payment instead of monthly or quarterly, an additional 4% discount is automatically applied to the total premium, and that saving applies regardless of which copay modality you've chosen: no copays, low copay or high copay. It's a discount for payment method, not for modality, so it's calculated on top of whichever price applies to your choice. For a family that already benefits from the discount for number of insured members, the annual payment saving is added on top of that family discount, not in place of it. The calculator shows the total annual amount with the saving already applied and compares it with the monthly equivalent, so you can see at a glance how much you save in euros per year by choosing this payment method over paying month by month.

Yes. Sanitas's official rate card applies the same family discount (5% off the premium if 2 or 3 people are insured, and 8% if 4 or more are insured) whether the policy is in the no-copay, low-copay or high-copay modality: the percentage saved for insuring the whole family together on the same policy doesn't depend on which copay modality you choose. This means a large family that prefers the no-copay modality for predictable spending doesn't lose any family discount compared with another family that chooses the high copay modality to save on the base fee: the two discounts — the family discount for number of insured members and the one for the chosen modality — apply independently and can be combined. This page's calculator automatically applies the correct family discount based on how many people you include on the policy.

Yes, across all three modalities. Sanitas prices by geographic residence zone: Madrid, Barcelona, Valencia, Seville and other provinces each have their own price column in the official rate card, reflecting real differences in the cost of private healthcare by area. This means the exact difference in euros between the no-copay modality, low copay and high copay also varies somewhat from one province to another, although the proportion of savings between modalities tends to stay similar across all areas. If you move to a different city after taking out the policy, your premium is recalculated according to the new pricing zone that corresponds to your updated postal code. This page's calculator automatically applies the rate for your zone as soon as you enter your postal code, so you don't have to manually look up which column of the rate card applies to you.

The high copay modality (Óptima) has the lowest monthly premium of the three: €74.81/month for a 35-year-old adult in Madrid, versus €86.88/month for low copay (Plus) and €116.82/month for no copays, all according to the official April 2026 rate card for an individual policy, first annual term. The difference between the most expensive and the cheapest is €41.94/month for that profile, a considerable difference over the course of a year. In exchange for that lower premium, in the high copay modality you pay a larger amount each time you use the insurance (a consultation, a test), whereas in the no-copay modality you pay nothing extra per visit. The modality with the cheapest monthly fee isn't necessarily the cheapest overall if you use the insurance very frequently: it's worth estimating how many times you typically see a doctor per year before deciding on premium price alone.

Yes, basic dental coverage is included in most Más Salud plans regardless of which copay modality you choose — no copays, low copay or high copay — with the general health insurance copay having no effect on that base dental coverage. If you need something more complete than the basic coverage, you can always upgrade it by adding full Dental Milenium as an add-on to the same policy, for €12.90/month for adults and €9.90/month for children under 15, with more than 40 treatments included at no extra cost and discounts of up to 40% on more complex treatments such as orthodontics or implants. This combination of health insurance plus complementary dental coverage is common among families who want to sort out both types of coverage in a single transaction and a single monthly payment, rather than taking out dental coverage separately with another insurer.