Understanding the Spanish Convenio Especial for Healthcare
The Convenio Especial de Asistencia Sanitaria is a public healthcare scheme in Spain designed for individuals who do not have automatic access to the national health system (Sistema Nacional de Salud). It provides an alternative for those who do not qualify for healthcare coverage through employment, residency status, or other means.
Who Can Apply?
The Convenio Especial is available to Spanish residents who have lived in the country for at least one year and do not have any other entitlement to public healthcare. This includes early retirees, self-employed individuals without sufficient contributions, and non-EU nationals who do not qualify through international agreements.
If you are moving to Spain from a third-country (outside the EU), you will need private health insurance to obtain residency. The Spanish authorities require comprehensive private medical coverage, which means that the Convenio Especial is not an immediate option for new residents. Only after one year of legal residence without other healthcare entitlements can you apply for the Convenio Especial.
Coverage and Costs
The scheme offers access to Spain’s public healthcare services, including primary care, specialist consultations, and hospital treatments. However, it does not cover prescriptions, which must be paid in full by the patient. It is important to note that private health insurance in Spain also does not cover prescription costs, so in both cases, patients must pay out of pocket for medications.
The cost of the Convenio Especial depends on the applicant’s age:
- Under 65 years old: €60 per month
- 65 years and older: €157 per month
These fees provide access to the same healthcare services as any Spanish citizen, but without the benefits of subsidized prescriptions or international coverage. (Prices 2025)
Benefits of Private Health Insurance Over the Convenio Especial
For those who are required to take out private health insurance for residency, it is worth considering the benefits of private healthcare over the Convenio Especial before cancelling the renewal of your private health policy:
- Faster Appointments: Private healthcare often provides quicker access to specialists and diagnostic tests.
- International Coverage: Many private plans include worldwide coverage, unlike the Convenio Especial, which is limited to Spain.
- More Treatment Options: Private hospitals often have access to treatments or procedures that may have longer waiting lists in the public system.
- Private Room: Most health insurance companies offer you a private room whilst staying in hospital
When Might the Convenio Especial Be Worth Considering?
While private health insurance is a requirement for residency, some policies come with exclusions for pre-existing conditions or specific treatments. In such cases, the Convenio Especial could be a valuable option for people with significant exlcusions on the private health policy. However, since new residents must maintain private insurance for at least the first year, the Convenio Especial can only be considered as a long-term alternative.
Understanding your healthcare options is essential when moving to Spain. While private insurance is mandatory for newcomers, the Convenio Especial may serve as a useful backup for those facing limitations in their private coverage.
