Healthcare Costa del Sol

Who is this for?

This article is primarily intended for those who either live permanently on the Costa del Sol or who plan to spend extended periods there. However, even those who do not fall into these categories would certainly do well to read this article.

Well insured under the Spanish sun

The Costa del Sol is renowned for its climate, its beaches and its international residential areas. And anyone considering buying a property here or settling permanently will also want to know about healthcare. That is an understandable question, and the answer is reassuring: healthcare on the Costa del Sol is of a high standard and easily accessible to international residents.

World Wide Properties operates in Marbella, Estepona and Benahavís. In our day-to-day work, we assist Dutch and Belgian buyers with the purchase of their property, and questions about healthcare almost always come up. In this article, we share the information we have gathered over the years and explain how healthcare is organised in this region. This article was updated in April 2026.

A highly rated healthcare system

Spain has one of the best-rated healthcare systems in Europe. According to the latest OECD report (Health at a Glance 2025), Spain scores above average on eight out of ten key indicators of health status. Life expectancy in Spain is 84 years, almost three years above the OECD average.

The region of Andalusia, which includes the Costa del Sol, has its own regional health service: the Servicio Andaluz de Salud (SAS). This service tailors healthcare to local needs. The Spanish system consists of two pillars: the public healthcare system, funded through social security contributions and taxes, and a strong private sector offering rapid access, personalised care and multilingual staff.

Hospitals and clinics in the region

The Costa del Sol has a wide network of hospitals and medical centres, both public and private. In practice, we find that the proximity of good hospitals is a factor for many of our buyers when choosing a property or a residential area.

Public hospitals

The Hospital Universitario Costa del Sol is located seven kilometres east of Marbella town centre and is one of the best-equipped public hospitals in Spain. It has 400 beds and a 24-hour A&E department. A major new extension opened in March 2025. As around 15 per cent of patients do not speak Spanish, volunteer interpreters are available.

The Hospital de Alta Resolución has recently opened in Estepona, a modern public hospital offering A&E, diagnostics, day surgery and specialist outpatient clinics. This hospital significantly improves access to public healthcare in the western part of the coast.

However, in terms of luxury, privacy and food, they do not match the standard of private hospitals.

Private hospitals

The private sector is well represented in the region. The leading names are:

Quirónsalud Marbella — part of Spain's largest private healthcare group, with a 24-hour A&E department and English-speaking staff.

HC Marbella International Hospital — an exclusive hospital with an international team, renowned for its oncology and fertility treatments.

Hospiten Estepona — part of an international group of twenty private hospitals, with a 24-hour A&E department.

Hospital Recoletas Salud Marbella — opening in 2025 in a new building equipped with state-of-the-art technology.

Vithas Xanit International Hospital in Benalmádena.

Many of these hospitals have English-speaking and multilingual staff, making it considerably easier for international residents to receive care without a language barrier.

Public or private: which is right for you?

Many expats on the Costa del Sol combine public and private healthcare. In our experience, the majority of Dutch and Belgian buyers we assist opt for private insurance to supplement the public system. Public healthcare covers the basic package and is of good quality, but waiting times for specialists can be longer. Private healthcare offers faster access, shorter waiting times and the option of being treated directly in English or Dutch.

Private health insurance typically costs between fifty and two hundred and fifty euros per person per month, depending on your age, health and cover. Well-known providers include Sanitas, Adeslas, DKV, Cigna, AXA and Mapfre. Please note that you must always complete a medical questionnaire when taking out private insurance; if you have pre-existing conditions, an insurer may refuse to cover you or exclude specific treatments.

Supplementary insurance for ambulance transport

If you call 112 for an ambulance, you do not have the option of choosing a private hospital; you will be taken to the nearest public hospital. It is therefore advisable to join an organisation such as Helicopteros Sanitarios, for which you pay between three hundred and six hundred euros a year, depending on your family circumstances.

You have Dutch or Belgian health insurance

If you have Dutch or Belgian health insurance and/or travel insurance with medical cover, we recommend that you check with your insurer whether you are permitted to use private doctors and/or hospitals here.

How do I arrange my health insurance from the Netherlands?

This is a question we regularly receive from Dutch buyers. The answer depends on your personal situation.

You are going to work in Spain

As soon as you are employed in Spain or registered as self-employed (autónomo), you will contribute to the Spanish social security system, the Seguridad Social. This automatically gives you access to the public healthcare system. Your employer usually takes care of the registration. As a self-employed person, you do this yourself.

The moment you deregister with your local authority in the Netherlands, your entitlement to Dutch basic health insurance ceases. Bear in mind that there may be a short transitional period during which you could be temporarily uninsured. It is advisable to take out temporary travel insurance or bridging insurance for this period.

You are retired and receive a state pension (AOW) or a private pension

If you receive a Dutch pension or state pension (AOW) and are moving permanently to Spain, you can apply for an S1 form via the CAK (Central Administration Office). You use this form to register with the Spanish Social Security (Seguridad Social). The healthcare costs are reimbursed by the Netherlands to Spain. The contribution is deducted from your pension, so you do not need to take out separate insurance.

In practice, we find that this is a straightforward route for retired buyers, provided you follow the steps in the correct order.

You are retiring without a pension or employment

If you have no income from employment or a pension, you are not initially eligible for the public healthcare system. You must take out private health insurance yourself. This is also a requirement for certain residence permits, such as the non-lucrative visa. If you are refused cover by a private insurer due to your medical history, you can opt for the Convenio Especial after one year of registration in the population register. This is a scheme whereby, for a fixed monthly fee (approx. €60 for those under 65 and approx. €157 for those aged 65 and over), you purchase full access to the public healthcare system.

How do I arrange my health insurance from Belgium?

The principle is similar. As a Belgian pensioner moving to Spain who is not accruing pension rights there, you retain your entitlement to Belgian health insurance. You should request an S1 or E106 form from your Belgian health insurance fund or mutuality. With this document, you can register with the Seguridad Social in Spain and gain access to the Spanish healthcare system. Further information can be found on the RIZIV website.

If you are going to work in Spain, you will be covered by the Spanish social security system and will pay your contributions there.

What steps do I need to take?

Regardless of your situation, as a new resident of the Costa del Sol you will need to follow these steps:

Step 1: Apply for an NIE number — the Número de Identificación de Extranjero is mandatory for all foreign nationals staying in Spain for more than three months. It is comparable to the UK's National Insurance number.

Step 2: Empadronamiento — registering with your local Spanish council. This is mandatory if your permanent residence is in Spain. Without this registration, you cannot register for social security or apply for a health card.

Step 3: Arranging health insurance — depending on your situation: register with the Seguridad Social using an S1 form (pensioners), via your employer (employees), or take out private insurance (self-employed individuals).

Step 4: Apply for a Tarjeta Sanitaria — once you have registered with the Seguridad Social, you can apply for a health card at your local Centro de Salud.

Step 5: Be assigned a GP — based on your residential address, you will be assigned a GP at the nearest health centre.

Step 6: Apply for a Tarjeta Sanitaria Europea (TSE) — once you are insured in Spain, you must apply here for the Spanish European Health Insurance Card to cover medical care whilst travelling within the EU, such as when visiting family in your home country.

A medical examination is not required to access the public healthcare system.

Practical information

The general emergency number in Spain is 112, which is free to call and available 24 hours a day.

Pharmacies are marked with a green or red cross and are usually open from Monday to Saturday. Outside normal opening hours, there are always duty pharmacies available. Spanish pharmacists are well-trained and can offer immediate advice for many minor ailments, without the need for a doctor's visit.

Why healthcare plays a role in your choice of home

Good healthcare is one of the factors that makes the Costa del Sol attractive to international buyers. The proximity of high-quality hospitals, the availability of multilingual staff and the affordability of private healthcare contribute to the comfort and peace of mind of residents in this region. Several hospitals have been expanded or newly opened in 2025, demonstrating that the region continues to invest in medical infrastructure.

When choosing a home, it may be wise to consider the distance to medical facilities, especially if you intend to live here permanently or are planning to retire. In our guidance, we take these kinds of considerations into account when advising buyers on suitable residential areas.

In conclusion

Healthcare on the Costa del Sol combines the quality of the Spanish healthcare system with the accessibility that international residents require. Whether you opt for public healthcare, private healthcare or a combination of both, the facilities in Marbella, Estepona and Benahavís are of a high standard and easily accessible.

World Wide Properties will guide you through the process of buying your home on the Costa del Sol and advise you on practical matters. Would you like to know more about living in this region? Please feel free to get in touch via the contact form, by email or by phone. We'd be happy to help.

This article has been prepared by World Wide Properties Andalucía S.L. and is intended as general information. Regulations relating to health insurance and social security are subject to change. We always recommend that you discuss your personal situation with a (legal) adviser in Spain.

Sources include: OECD Health at a Glance 2025, Central Administration Office (CAK), National Institute for Health and Disability Insurance (RIZIV), Andalusian Health Service (SAS).

Partly in view of the regular changes to legislation, regulations, etc. in Spain and Andalusia, World Wide Properties Andalucía S.L. accepts no legal responsibility whatsoever for the content of this article.