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Best Health Insurance in Spain

7 insurers ranked and reviewed · Updated May 2026

Sources:OCU (Organizacion de Consumidores y Usuarios)ICEAFundacion IDISSelectra

Healthcare System Overview

Spain has a universal public health system (Sistema Nacional de Salud, SNS) funded by taxation, providing free healthcare to all residents. Around 25% of the population also holds private insurance, mainly for shorter waiting times and access to private hospitals. Private health insurance has grown rapidly, exceeding 14 million policyholders in 2024. The sector generated EUR 13.4 billion in premiums in 2025.

SegurCaixa Adeslas

private4.5M members

83.9Score

ICEA: #1 Market Leader (30.7%)(2025)OCU: Top Comparison Pick(2025)

★★★★☆4.0satisfactionFinancial strength: CaixaBank-backed — strong

Market Share

30.7%

Revenue

EUR 4.13B (2025)

Revenue Growth

+16.3%

Largest medical provider network in Spain (43,000+ professionals)
Plans include Adeslas Plena and Adeslas Plena Plus
No-copay plan options available
Backed by CaixaBank and Mutua Madrilena

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AXA Salud

private800K members

75Score

Selectra: Best International Coverage(2025)

★★★☆☆3.8satisfactionFinancial strength: AA- (S&P, AXA Group)

Parent Group

AXA Group (global)

International Coverage

Strong

Multilingual Support

yes

Part of global AXA Group with international coverage
Multilingual customer service
Strong corporate health packages for international companies
Modern digital platform and online services

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Generali Salud

Generali Seguros

private500K members

70Score

Selectra: European Coverage(2025)

★★★☆☆3.5satisfactionFinancial strength: A (S&P, Generali Group)

Parent Group

Generali Group (Italy)

Cross Border Coverage

European

Corporate Health

Strong

Part of Generali Group — one of Europe's largest insurers
Personalized health plans
Extensive private hospital network
Strong in employee benefits/corporate health

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Sanitas (Bupa)

Sanitas

private2.9M members

64.9Score

ICEA: #2 in Market Share (16.7%)(2025)Selectra: Digital Innovation Leader(2025)

★★★★☆4.2satisfactionFinancial strength: Bupa Group — A+ equivalent

Market Share

16.7%

Revenue

EUR 2.24B (2025)

Revenue Growth

+11.2%

Part of international Bupa Group — global standards
Operates own hospitals and medical centers
Blua digital health and telemedicine platform
EUR 2.24B revenue with 11.2% growth in 2025

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DKV (ERGO/Munich Re)

DKV Seguros

private2.0M members

48.9Score

ICEA: #4 Market Position(2025)Selectra: Best for Expats(2025)

★★★★☆4.0satisfactionFinancial strength: Munich Re/ERGO — very strong

Market Share

6.2%

Revenue

EUR 835M (2025)

Revenue Growth

-9.4% (exited Muface)

English-language website and services available
Fewest waiting periods of any major Spanish insurer
Backed by Munich Re — one of the world's largest reinsurers
Comprehensive DKV Integral Elite plan with no copays

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Asisa

private1.8M members

39.1Score

ICEA: Fastest Growth (+21.2%)(2025)

★★★☆☆3.8satisfaction

Market Share

13.7%

Revenue

EUR 1.84B (2025)

Revenue Growth

+21.2% (fastest)

Cooperative structure (Lavinia) — profits reinvested in healthcare
Fastest-growing major insurer in Spain (21.2% growth)
Operates own hospitals (HLA Grupo Hospitalario)
Competitive pricing vs Adeslas and Sanitas

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Mapfre Salud

private1.2M members

18.3Score

ICEA: #5 Market Position(2025)

★★★☆☆3.5satisfactionFinancial strength: A (S&P, Mapfre Group)

Market Share

~6.4%

Revenue

EUR 858M (2025)

Revenue Growth

+3.3%

Widest office network in Spain — offices everywhere
Customized packages by age group (young to elderly)
Part of Mapfre — one of Spain's largest global insurers
S&P A rating for financial strength

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About Health Insurance in Spain

Our editorial team has evaluated and ranked the top 7 health insurers in Spain based on editorial ratings from trusted sources, customer satisfaction, financial strength, and coverage quality. Rankings are updated regularly to reflect the latest market changes.

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