Health Insurance In Communidad de Madrid

Best Ways To Get Health Insurance In Communidad de Madrid

Do you know that Spain is rated as having one of the best health systems in the world? And Communidad de Madrid is not an exception. This ranking is attributed to its comprehensive and high-quality care offered to residents and citizens at the lowest price. 

It’s important to have health coverage when moving into the city.

Although it is a requirement, there are ways you can get health insurance in Communidad de Madrid at an affordable cost.    

In this article, we will show you the different sources of health insurance in Madrid(as it is called for short) who are eligible, and the services they offer.

Read Also Best Ways To Get Affordable Health Insurance In Melilla.

Public Health Insurance In Communidad de Madrid

Spain has a decentralized health care system. Health insurance in Communidad de Madrid is provided by the Madrid Health Service which provides free, quality and comprehensive healthcare services to citizens and residents.

Similar to the UK, public health insurance in Madrid is funded by general taxation. Workers and self-employed individuals in Madrid contribute to the healthcare system. 

Do you know how? A certain amount of money is usually deducted automatically from a worker’s wages through the social security system and employers also contribute a percentage to the scheme for each worker. For this reason, most residents do not require private health insurance to access health care services.

While the Madrid Health Service provides excellent services, some residents and expatriates choose to take out additional private health coverage which cuts waiting times and provides easier access to see a specialist.

Who Needs Health Insurance In Communidad de Madrid?

Legal residents and workers in Madrid generally pay the Spanish income tax and social security that goes towards providing you with health care services.

Although it is important that every individual should have health cover, not all residents are eligible to access the public health insurance in Communidad de Madrid. If you are ineligible, you can either pay for your medical treatment yourself or take out a private health insurance plan.

Read Also Best Ways To Get Affordable Health Insurance In La Rioja.

Who Is Covered By Public Health Insurance In Communidad de Madrid?

  • Employees

In Madrid, all employees and self-employed workers must make social security contributions. This entitles them to public healthcare coverage.

  • Freelancers and business owners

Freelancers and business owners are responsible for paying their social security contributions toward public healthcare. 

Spouses and children

Children and spouses of workers are also entitled to free state healthcare, as long as they also reside in Madrid.

  • EU/EEA/Swiss nationals

EEA, EU, and Swiss nationals who have reached retirement age in their home country can also access free healthcare but to qualify, they must obtain an S1 form from their country of residence.

Also, residents from the above countries staying in Madrid temporarily can use their European Health Insurance Card(EHIC). The EHIC entitles them to receive treatment at the same cost as Spanish nationals.  

  • Students

Foreign students from the EU, EEA, and Switzerland will be covered by their EHIC throughout their period of study. 

However, non – EU nationals are not covered by the public health insurance in Communidad de Madrid. They may be required to provide proof of private health insurance before getting a Spanish visa. 

Also, some non-EU countries have agreements with Spain so it is important to check with the consulate in your home country before arrival.

Non-EU students may also need private health insurance to cover the medical expenses they might incur during their stay. Your university would provide more details.

Read Also Best Ways To Get Affordable Health Insurance In Catalonia

What Does Madrid’s Health Insurance Cover

The TSI(Spanish: targeta sanitaria individual) health card covers care from doctors and hospitals. It also provides cover for treatment at home, which can be particularly beneficial to the elderly and disabled.

When you present a TSI card,  you pay no fees when receiving treatment from a doctor or hospital in Madrid. However, prescription fees at pharmacies must be paid at the time of purchase.

TSI covers between 40–60% of the cost of prescription drugs for workers in Madrid, depending on your income, and up to 90% for pensioners. Although you would be required to pay the rest, prescription costs in Spain are relatively low. 

Madrid’s health service does not cover dental work. It must be paid for in full except if you have private health insurance.

Relatively, dentist fees are inexpensive and the quality of care is of a high standard. However, with private health insurance, you pay half the cost, with dental insurance costing as low as 10–20 Euros per month.

Read Also Best Ways To Get Affordable Health Insurance In Andalucía

How To Apply For Public Health Insurance In Communidad de Madrid

If you qualify for public health insurance in Madrid and want to apply, you need to register your address on the Padron at your local town hall.

Once you have done this, you will be issued a certificate of registration( Spanish: empadronamiento).

You can apply for your TSI card in Madrid either in person or online if you have a digital certificate. When applying you’d be required to show your residency card, TIE or DNI, your Padron certificate, and a document accrediting you the right to health assistance(DAD).

You will also need your social security number, which will be issued by your employer. If you haven’t received one, you can apply for a social security number at your nearest Social security office.

Once you’ve gotten your TSI  card, you can register with a doctor or at your local health center. You are also at liberty to select doctors and pediatricians from within your local healthcare district. However, to see any other specialist practitioners, you must be referred by your GP.

Your TSI health card is proof that you have health insurance in Communidad de Madrid and you can present it whenever you use a public health service or purchase a prescription from a pharmacy to enjoy discounted rates.

Public Health insurance For Unemployed/Low Earners In Madrid

Convenio Especial (special agreement) is a pay-in-scheme offered by Spanish authorities which is available to individuals who have issues accessing the benefits of the system such as unemployed individuals and low earners.

Basically, it is a low-cost insurance scheme that provides cover in exchange for a low monthly premium. You can opt to pay for either a minimum, average, or maximum contribution base.

The convenio especial do not operate during periods of normal employment because then your contributions will be met through your salary.

Private Health Insurance In Communidad de Madrid

Private health insurance is an alternative to public health care. Although Madrid’s health service provides wide coverage and excellent health care services, some residents opt for private health insurance.

The reasons are due to the shorter waiting periods which means faster access to specialist care, upscale healthcare facilities, additional health services (such as elective surgery), and freedom to choose which doctor/specialist sees you.

Expats who do not qualify for public health insurance in Communidad de Madrid also purchase a private health plan to cover their medical and health expenses. 

Private health insurers in Madrid offer a range of packages that cater specifically to your needs or circumstances. It is therefore important to research the private health insurance options available and seek as much advice before committing to a specific plan.

Advantages Of Private Health Insurance In Communidad de Madrid

Private health insurance is advantageous, especially in terms of waiting times. The public health system is plagued with lengthy waiting times which means you may not receive specialist care as soon as you need it.

If you require regular treatment, this should be an important factor to consider when weighing up the private care avenue.

Private health insurance also enables you to select a doctor with good fluency in English. Lists of English speaking doctors are available at embassies and tourist offices.

How To Choose A Private health insurance Provider

Comparing quotes from multiple health insurers would save you a lot of money. Some of the largest companies that provide private heath insurance in Communidad de Spain  include:

  1. Allianz Care
  2. Globality Health
  3. Cigna Global


Health insurance is undoubtedly important as it serves as security to your health and finances. But while it is necessary, it is advised to have an appropriate cover that would suit your needs and budget.

Above we have highlighted the ways of getting affordable health insurance in Communidad de Madrid. Which do you think is best for you?

Please drop your answers in the comment section below.

Leave a Reply