Is your German health insurance valid in Spain? A comprehensive guide for 2025
25 Apr 2025
11
Minutes
Katrin Straub
Managing Director at nextsure
Planning a trip to Spain or a longer stay? Many Germans wonder: Does German health insurance apply in Spain? This article explains which services the European Health Insurance Card (EHIC) covers, when a private supplementary insurance becomes indispensable, and how to act correctly in an emergency.
The topic in brief and concise terms
The German statutory health insurance is valid in Spain through the European Health Insurance Card (EHIC) for medically necessary treatments within the public system.
The EHIC does not cover private treatments, medical repatriation, and often only limited dental treatments, which is why additional travel health insurance is strongly recommended. [1,5,6]
Privately insured individuals should review their policy terms; often there is Europe-wide coverage, but clarification regarding duration and scope, especially for long-term stays, is necessary. [2]
Quick Overview: Your Health Insurance in Spain at a Glance
For those insured under the statutory health system in Germany, the European Health Insurance Card (EHIC) is the first point of contact for medical care in Spain. It allows treatment in public health centres and hospitals under the same conditions as locals. However, it is important to know that the EHIC does not cover all costs, such as private doctor visits or repatriation to Germany. For those with private insurance, the specific terms of their policy apply, often including Europe-wide protection. [2] An additional travel health insurance is almost always a wise addition for any traveller.
The European Health Insurance Card (EHIC): What is covered in Spain?
The EHIC, found on the reverse side of your German health card, simplifies access to medical care during a temporary stay in Spain. It covers medically necessary services within the public Spanish health system, including emergency treatments or the management of acute illnesses. This means you will receive medical care, hospital treatments, and medication under the same conditions applicable to Spanish citizens. In practice, you need to present the EHIC to the doctor or hospital. Please note that it is common in Spain for medication to incur a co-payment, which you must cover yourself. The EHIC does not cover planned treatments; prior authorisation from your health insurer (via an S2 form) is required for this. For more comprehensive coverage, which includes private doctors, travel health insurance is essential.
Consider the following points when using the EHIC in Spain:
It is only valid with doctors and hospitals affiliated with the public system (Centros de Salud, public hospitals).
Private clinics and doctors usually do not accept the EHIC; you would need to initially bear the costs yourself.
The EHIC does not cover the costs of medically necessary repatriation to Germany.
Dental treatments are often very limited or not covered at all. [6]
Co-payments, reflective of Spanish standards, may apply during hospital stays.
The EHIC is an important first step, but it is often not sufficient for complete coverage.
Limits of the EHIC: When additional travel health insurance for Spain becomes essential
Although the EHIC ensures basic coverage, there are numerous situations where it is not sufficient and private international health insurance is crucial. A common scenario involves treatments by private doctors or in private clinics, which are particularly prevalent in tourist areas and are not covered by the EHIC. The costs for this can quickly amount to several hundred or thousand euros. Another important point is the medically necessary repatriation to Germany, which is generally not covered by statutory health insurance through the EHIC. [2] The costs for an air ambulance flight can easily reach five-figure sums.
International health insurance steps in here and typically covers the following services:
Costs for treatments by private doctors and in private clinics.
Medically appropriate and necessary repatriation to the home country.
Coverage of rescue and recovery costs, for example, after a hiking accident.
Higher reimbursement rates for dental treatments than those provided by the EHIC.
Rooming-in costs for a companion when children are in hospital.
Before your trip, check the exact conditions of your existing insurance policies and take out a comprehensive travel health insurance for Europe if necessary, to minimize financial risks.
Privately Insured in Spain: What You Need to Know
For individuals with private health insurance (PKV) from Germany, the question of whether their German health insurance is valid in Spain is somewhat different. Generally, private health insurance provides comprehensive coverage abroad in Europe, often even worldwide, at least for a limited period of usually one to three months. [2] The critical factor here is always the individual terms of your policy. It is advisable to clarify with your insurer before an extended stay or move to Spain how long the full coverage abroad lasts and exactly what benefits are covered. When permanently relocating to an EU country like Spain, it's often possible to continue the German PKV, although the benefits may be limited to the German level. [2] Any additional costs due to higher treatment costs in Spain or currency conversion fees need to be taken into account. For providing proof to Spanish authorities that adequate health insurance coverage exists (e.g., for exemption from a local insurance obligation), there is the "Certificate of entitlement". [2] Even for those with private insurance, an additional international health insurance for up to 30 days or longer can be advisable to cover specific risks such as repatriation, should this not be adequately included in the PKV contract.
Long-term stay and emigration: Arrange health insurance in Spain
If you plan to stay in Spain longer than just for a holiday or even to emigrate, the question "Does German health insurance apply in Spain?" becomes even more pressing. When relocating permanently to Spain, you are generally subject to Spanish social security law. This means you need to insure yourself within the Spanish health system (Sistema Nacional de Salud, SNS). This often happens by taking up employment, becoming self-employed, or as a pensioner with the S1 form. The Spanish system is funded by taxes, and employees contribute about four point seven percent of their gross salary. [4] Registering in the foreigners' register and obtaining the NIE number are the first steps for accessing the Spanish health system. For non-working individuals, proof of private health insurance and sufficient financial resources may be required. A German private health insurance can possibly be continued, but this needs to be clarified individually with the insurer. [2] A comprehensive consultation about health insurance abroad is particularly important here to avoid gaps in coverage.
Checklist: Remember insurance coverage before travelling to Spain
To ensure your health is well protected in sunny Spain, this checklist will help you clarify the most important points before your departure:
Check the validity of your EHIC: Is your electronic health card still up to date?
Understand the coverage of the EHIC: Do you know which treatments are covered in Spain's public system?
Private international health insurance: Do you have one? Does it cover all important risks like repatriation and private treatments?
Terms and conditions of private health insurance (if privately insured): Is your coverage valid in Spain and for how long? [2]
Store emergency numbers: The Europe-wide emergency number 112 and, if applicable, the service hotline of your international health insurance. [6]
Copy important documents: EHIC, insurance policies, ID card.
For chronic illnesses: Consult with your doctor and health insurance regarding medication transport and local care.
Gather information about the Spanish health system: Where are the nearest public health centres (Centros de Salud)?
Careful preparation ensures that the question “Does my German health insurance apply in Spain?” is answered positively and comprehensively for you.
nextsure: Your partner for tailored insurance coverage
The question of whether your German health insurance is valid in Spain is complex. While the EHIC provides basic coverage, there are often gaps that can become expensive. nextsure, as a digital insurance portal, understands the need for individual insurance solutions. We help you find the right protection for your travels or longer stays abroad so you can focus on what matters most: enjoying your time in Spain. Our expertise in the field of foreign health insurance ensures that you receive tailored and easily understandable solutions. A medical emergency abroad should not turn into a financial nightmare. With the right coverage, you are on the safe side.
Request an individual risk analysis now: Have your insurance situation checked for free and receive specific optimization suggestions.
More useful links
The Federal Ministry of Health provides comprehensive information on health insurance abroad.
The National Association of Statutory Health Insurance Funds provides information on European and international matters related to statutory health insurance.
Comprehensive details about the European Health Insurance Card (EHIC) can also be found at the National Association of Statutory Health Insurance Funds.
The Federal Statistical Office (Destatis) provides statistics on Germans living in the EU.
The Your Europe Portal of the EU offers information on unplanned healthcare during temporary stays in Europe.
Further details on health insurance coverage when living abroad can also be found on the Your Europe Portal.
The Federal Foreign Office provides travel and safety advice for Spain.
The Federal Office for Social Security (BAS) offers information on international health insurance.
FAQ
Gilt meine deutsche Krankenversicherungskarte direkt in Spanien?
Ja, die Rückseite Ihrer deutschen elektronischen Gesundheitskarte fungiert als Europäische Krankenversicherungskarte (EHIC). Diese können Sie bei medizinisch notwendigen Behandlungen im öffentlichen Gesundheitssystem Spaniens vorlegen.
Was passiert, wenn ich in Spanien einen Privatarzt aufsuchen muss?
Die Kosten für einen Privatarzt in Spanien werden von der EHIC nicht übernommen. Sie müssen diese zunächst selbst bezahlen. Eine private Auslandskrankenversicherung kann diese Kosten je nach Tarif erstatten.
Deckt die EHIC auch chronische Krankheiten in Spanien ab?
Die EHIC deckt medizinisch notwendige Behandlungen ab, die während eines vorübergehenden Aufenthalts aufgrund einer bestehenden chronischen Krankheit erforderlich werden (z.B. Dialyse), sofern die Reise nicht explizit zum Zweck der Behandlung angetreten wurde. Eine vorherige Absprache mit der Krankenkasse ist ratsam. [7]
Wie lange gilt die deutsche private Krankenversicherung in Spanien?
Der Geltungsbereich und die Dauer des Schutzes Ihrer deutschen privaten Krankenversicherung in Spanien hängen von Ihrem individuellen Vertrag ab. Üblich ist ein Schutz von mindestens einem Monat, oft auch länger, bei vorübergehenden Aufenthalten. Für dauerhafte Aufenthalte gelten gesonderte Regelungen. [2]
Was ist das Formular S1 und wann brauche ich es für Spanien?
Das Formular S1 (früher E106, E109, E121) benötigen Personen, die in einem EU-Land wohnen, aber in einem anderen versichert sind (z.B. Rentner mit deutscher Rente und Wohnsitz in Spanien). Es dient zur Anmeldung im spanischen Gesundheitssystem.
Welche Kosten können in Spanien trotz EHIC anfallen?
Trotz EHIC können in Spanien Kosten für Zuzahlungen zu Medikamenten, Krankenhausaufenthalten, bestimmte zahnärztliche Behandlungen, Behandlungen in Privatkliniken oder durch Privatärzte sowie für einen medizinischen Rücktransport anfallen.
