Sanitas and Adeslas are the two names you’ll see most when shopping private health cover in Spain. This guide compares real costs (as of 2026), visa and residency traps, who has better English support, and which one I’d pick depending on your situation.
By Iria Mos·Editor — money, healthcare and housing
How we compare: providers are assessed on published terms and visa compliance. We may earn a commission from partners, which never changes the ranking or what we report.
As of 2026 expect a mid-level private policy from Sanitas or Adeslas to cost roughly €90–€150/month for a healthy 65–70-year-old — and jumping below €80 usually brings exclusions that will fail a non-lucrative visa check.
Key takeaways
Sanitas typically costs more but has stronger English-language support and a highly rated private hospital network.
Adeslas is usually cheaper for the same basic cover and offers competitive dental add-ons — good if you prioritise price and broad primary-care access.
For a non-lucrative visa, buy a policy the consulate accepts: repatriation + no lifetime caps; cheap policies and some online ‘EU’ plans will be rejected.
Watch waiting periods and pre-existing condition exclusions — these drive long-term value more than a €10 difference in premium.
Excellent national network; strong private hospitals in big cities
Very large network; particularly strong in Madrid and many provincial capitals
English customer service
Better availability of English-speaking staff and materials
Less consistent English support; depends on region
Direct billing to clinics
Widespread; good for hospital admissions
Widespread; more private practitioners operate on direct billing
Waiting periods & underwriting
Standard 6–9 month waiting for some services; strict underwriting on pre-existing conditions
Similar waiting periods; often more flexible pricing choices with copays
Dental & extras
Dental add-ons available; tend to be pricier
Very competitive dental plans and hygiene packages
Suitability for non-lucrative visa
Widely accepted — but check policy wording for repatriation & caps
Widely accepted; watch small-print on territorial limits
What drives the price (and where you can save)
Three things move the premium more than the brand: your age and health, the excess (copay) you accept, and whether you add dental or repatriation. For a 65–70 year-old buying cover to satisfy a non-lucrative visa, you’ll usually choose a mid-tier plan with hospitalisation, specialists and diagnostics. Expected ranges (as of 2026): Adeslas €75–€130/month, Sanitas €90–€150/month. If you accept a €150–€300 annual excess or a per-visit copay (€10–€20), you can shave 10–30% off the monthly premium. Adding a dental rider typically adds €10–€35/month; full dental policies cost more.
Pre-existing conditions are the real budget killer. If you have diabetes, a cardiac history, or recent cancer treatment, insurers either load the price, exclude related claims, or put long waiting periods on those items. Always get a written quote showing underwriting outcomes before you cancel any existing cover.
Network, clinics and who actually treats you
Sanitas markets itself on premium clinics: private hospitals with short wait times, private rooms and English-speaking teams in tourist areas. That’s real value if you expect to use private hospitals regularly, prefer private-room surgery stays, or live near Málaga, Madrid or Barcelona.
Adeslas tends to win on breadth. It has one of Spain’s largest provider networks and more primary-care agreements in smaller towns — handy if you retire outside a major city. In practice that means an Adeslas policy often gets you faster access to local GPs and diagnostics in provincial capitals, while Sanitas gets you better private-hospital options in big-city catchment areas.
If you care about English-language customer service, Sanitas is the safer bet. Adeslas will still serve you well, but expect more Spanish-only paperwork unless you use an English-speaking broker or a clinic that handles the translation for you.
Visa, residency and the 'consulate trap'
If you’re applying for a non-lucrative visa (NLV), consulates look at the policy wording — not the insurer’s brand. The policy must be valid in Spain, have no lifetime maximum that’s too small, include repatriation (some consulates insist on it), and normally have no exclusions that would make it equivalent to no cover. Cheap UK/EU ‘travel’ plans or global plans with narrow territorial limits are frequently rejected.
Trap: the consulate will reject policies that call themselves "international" but exclude hospital care in Spain or cap annual payouts at a low figure. Before you pay, ask the insurer for a letter in Spanish and English confirming coverage in Spain, repatriation, and the policy number. See the consulate checklist at exteriores.gob.es — read it.
Once resident, you can register with Seguridad Social if eligible and access public healthcare (see seg-social.es for eligibility). Many people switch from private-only to a hybrid plan after registering; that’s when price differences and extras (dental, English support) matter more.
Small print: waiting periods, exclusions and claims
Don’t focus on premium alone. Waiting periods — typically 6–9 months for specialist consultations and certain surgeries — are standard. Pre-existing conditions are often excluded or subject to long waiting periods. Both insurers operate medical underwriting: the application form asks about past conditions and treatments.
Claims and direct billing are where you notice friction. Both Sanitas and Adeslas offer apps, doctor booking and direct billing for their network clinics. Experience varies by region and by the specific clinic: some smaller private surgeons still ask you to pay and claim back. If mobility is an issue, pick the insurer that has direct-billing ties with your nearest hospital.
Verdict: which to pick
I’ll be blunt: for most retirees who value straightforward service, English help in a city and fewer headaches with private hospitals, pick Sanitas. For retirees prioritising price, broad regional GP access, and cheaper dental add-ons, pick Adeslas.
If you plan to live in a city (Madrid, Barcelona, Málaga) and want better English support and private-hospital access: choose Sanitas.
If you’re moving to a provincial town, want the lowest reasonable monthly cost, and expect to use GPs and diagnostics rather than private hospitals: choose Adeslas.
If you need cover mainly for visa purposes and won’t use private care much: buy a mid-tier policy from either, but have the consulate-proof letter in Spanish/English before you book travel.
If you have significant pre-existing conditions: speak to a broker experienced with older expats — the underwriting differences will matter more than the brand name.
Questions worth asking a lawyer, gestor or broker
Does this specific policy wording satisfy the consulate I’m applying to? Can you read the Spanish wording?
Are there territorial limits (e.g. cover only in Spain but not in the Canary Islands / Balearics)?
How does my existing medical history affect premiums or exclusions — and can any exclusions be time-limited?
What waiting periods apply to hospital admission, surgery and chronic disease treatment?
Will the insurer directly bill my preferred local hospital/clinic?
If I register for public healthcare later, what happens to the private policy and any no-claims benefits?
FAQ
How much will a private policy cost me at age 75?
Expect a noticeable jump. For a healthy 75-year-old, mid-tier policies from Sanitas or Adeslas commonly sit in the €130–€220/month range (as of 2026), depending on excess, dental add-ons and underwriting. Get personalised quotes — age bands and health answers change prices sharply.
Can I use a UK or US insurer instead of Sanitas/Adeslas?
You can, but the consulate and hospitals care about territory and direct-billing. Many UK/US policies are fine if they explicitly cover healthcare in Spain and provide the consulate wording; however, Spanish hospitals often prefer local insurers for direct billing. If you plan to rely on private care, a Spanish-based policy is simpler.
Do Sanitas or Adeslas cover pre-existing conditions?
Neither guarantees acceptance of pre-existing conditions. Both perform medical underwriting and may exclude or charge for specific conditions. Read the exclusions and ask for them in writing before you travel.
Can I switch insurers after I become resident and join the public system?
Yes. Many expats move to a cheaper private top-up or dental-only plan after registering with Seguridad Social. Check for cancellation penalties and whether any no-claims bonuses carry over. Also confirm waiting periods if you change to a new insurer.
Add healthcare to a free plan and see what you may need to arrange before you move — cover for the visa, the S1 route, and registering once you arrive.
Iria works between Spain and France and comes from the same corner of the tourism sector, the part that ends up answering questions about doctors, contracts and money rather than beaches. On HolaRetire she looks after healthcare, tax and housing, and is the reason those guides quote figures and form names instead of generalities.
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