In short
Spain's immigration regulation requires student visa applicants to hold health insurance from an insurer authorised to operate in Spain, with benefits similar to the Spanish public system's and valid for the whole stay (Royal Decree 1155/2024, article 35). London adds no co-payments, reimbursement or waiting periods, and also accepts the UK GHIC; New York, no co-payments or deductibles.
I'm Tomás Schwaighofer, an exclusive Sanitas insurance agent based in Mallorca. Sanitas prices its policies by province and I set them up anywhere in Spain. I only sell Sanitas, so read this page for what it is: the rule as Spain writes it, what the consulates in London and New York ask for in their own words, and where the Sanitas student policy fits.
You'll be in large company. In June 2026, 91,203 students from outside the EU held a study permit in Spain, according to Spain's Permanent Immigration Observatory (OPI).
One warning first. Consulates change their pages without notice. I read the London, New York and Chicago pages quoted here on 22 October 2026, and the one that counts is your consulate's page on the day you apply.
What health insurance does a Spanish student visa require?
Health insurance taken out with an insurer authorised to operate in Spain, with benefits similar to the core services of the Spanish National Health System, and valid for the whole planned stay. That's article 35.i of Spain's immigration regulation, Royal Decree 1155/2024, which in Spanish reads "entidad aseguradora autorizada para operar en España".
Each part of that sentence rules something out. "Authorised to operate in Spain" rules out a policy bought at home, unless the insurer holds that authorisation. "Similar benefits" means the care Spain's public system gives in health centres and hospitals: prevention, diagnosis, treatment and rehabilitation (article 8 bis of Law 16/2003), so a plan that only pays for emergencies falls short. And "the whole planned stay" means the whole course, not the first few months.
The rule covers everything this visa is for: a degree, master's or PhD, upper secondary school, pupil exchanges, volunteering and training activities (article 34). Training activities include Spanish language courses at an official language school or a centre accredited by the Instituto Cervantes, as long as Spanish isn't your mother tongue or an official language of your country (article 52). It's for stays of more than 90 days. As the New York consulate puts it, "Study stays of less than 90 days do not require a study visa."
What do the London and New York consulates ask for?
Both repeat the regulation and go further. London wants a policy "totally exempted from any form of co-payment, reimbursement or waiting period", with any cover limit at €30,000 or more, and turns down travel insurance. New York wants an insurer registered with Spain's insurance regulator, the DGSFP, "no co-payments or deductibles" and at least €30,000 of cover.
| What they ask | London | New York |
|---|---|---|
| Insurer | Authorised to operate in Spain | Registered with the DGSFP, Spain's insurance regulator |
| Cover | "All the risks insured by Spain's public health system" | "Benefits comparable to those of the Spanish National Health System" |
| Copays, waiting periods, deductibles | No co-payment, reimbursement or waiting period | No co-payments or deductibles |
| Minimum cover | If the policy has a limit, never below €30,000 | At least €30,000 |
| Travel insurance | "Not accepted, not even with a 30.000 euro coverage" | Not mentioned |
| How long | Not stated on its page | "The entire duration of the stay", one month before the programme to 15 days after |
| UK GHIC | Accepted for all student visas | Not applicable |
Chicago's page words its insurance requirement exactly as New York's does. In Latin America, the Bogotá, Buenos Aires and Mexico City consulates all add no copays and no waiting periods, and Bogotá and Buenos Aires turn down travel insurance too. My advice is to buy for the strictest page you might face: no copays, no waiting periods, no deductible, and cover from a month before the course to 15 days after it.
None of these pages, and nothing in the regulation, asks for repatriation cover. If yours does, check what kind, because policies don't all mean the same by it (I explain the Sanitas one below).
Can you use a UK GHIC for a Spanish student visa?
If you apply in London, yes. The consulate's student visa page says it in one line: "The UK Global Health Insurance Card (GHIC) is accepted as medical insurance for all the student visas." For a course in the EEA, the NHS issues a UK Student GHIC and asks for a letter from your university or college.
That letter has to show your UK institution if you're travelling as part of your course, where you'll study in the EEA, the qualification, the start and end dates of your study period and your permanent UK address.
So for many British students the cheapest route through the visa costs nothing. Know what you're getting, though. The GHIC is for state healthcare that "cannot reasonably wait" until you're back in the UK, and the NHS is clear that it doesn't cover "treatment in a private medical facility". With a GHIC, a private policy is a choice for the extras (private hospitals, specialists without the public waiting list), not something the London consulate needs from you. If you apply through another consulate, check its page before relying on the card.
Will US college insurance or a travel policy work?
Only if the insurer is authorised in Spain. New York puts it first: the provider "must be registered with the General Directorate of Insurance and Pension Funds", the DGSFP. Travel insurance is out in London even with €30,000 of cover, and a plan that only pays emergencies doesn't give benefits comparable to the Spanish public system.
A plan you buy in the US, through your college or a study-abroad programme, may meet that test or may not. Don't assume either way. Look up the insurer's exact name in the DGSFP's public register before you pay, and check the rest against your consulate's page: no copays, no waiting periods, no deductible and the right dates, plus the €30,000 minimum if you apply in New York or Chicago.
How long does the policy need to cover you?
From one month before your course starts to 15 days after it ends. That's how long the regulation makes the study permit last (article 55.2), and New York says the insurance must cover "the entire duration of the stay, corresponding to the validity of the study visa". For a course running from September to June, that means August to mid-July.
Chicago spells out the two cases. For a stay of up to six months, the insurance runs from a month before the course to 15 days after, or from the day you enter Spain if you already know it. Over six months, the visa is issued for a year "and the health insurance must also be valid for one year, starting from the date of entry into Spain".
The order of things matters. You apply for the visa at least two months before the course starts (article 36.1 of the regulation, repeated on the London and New York pages), and New York takes applications between six months and two months ahead. It also warns that the authorisation from Spain "typically takes approximately three weeks". Buy the insurance once you have your acceptance letter: Sanitas asks for it to set up the policy, and lets you buy six months in advance.
What changes if you stay more than 180 days?
Up to six months, the visa covers your whole stay and you don't need a foreigner's identity card (TIE). Over six months, the visa is valid for a year, and you have one month from entering Spain to apply for the TIE in the province where your permit was processed. London and New York both say so (article 34.3).
Crossing that line brings more paperwork. Adults need a criminal record certificate for stays over six months (article 35.j), and New York adds that "In the US, only FBI records are valid."
The trap is the extra 45 days. Chicago counts the month before the course and the 15 days after it when deciding whether you're over six months, so a five-month course can tip you into the longer visa, with the TIE and, in the US, the criminal-record check. Plan the dates of the course and the policy together.
And don't mix up the two certificates. The medical certificate that London and New York ask every applicant for (Buenos Aires only for stays over 180 days) is a separate document from a doctor; it has nothing to do with your insurance.
Which Sanitas policy fits a student visa?
Sanitas International Students, Sanitas' policy for foreign students in Spain. Sanitas describes it as "without co-payments" and "without waiting periods", covering GP care, specialists, tests, surgery and hospital stays. It's built around the visa: it runs for 3 to 14 months to match your course, and you can buy it six months ahead.
What to know before you buy, from the product page and its general conditions:
| Condition | Sanitas International Students |
|---|---|
| Age | Up to 35. Sanitas advertises it for ages 14 to 35 and sets 35 as the age at which cover ends; the footnote on the April 2026 rate card says "between 18 and 35" and "no age limit for staying on" |
| Who's covered | Only the student: it's an individual policy |
| Length | 3 to 14 months. After month 14 you can ask to extend it if you're still studying in Spain and under the age limit |
| At the end date | The contract ends on the date in its particular conditions unless Sanitas and you agree in writing to extend it: it doesn't renew itself |
| What Sanitas asks for | Your acceptance letter or enrolment, your passport or NIE and an address in Spain (your school's will do at first) |
| Payment | Monthly, quarterly, every six months or yearly; Sanitas advertises 4% off for paying the year |
| Repatriation | Only in the event of death |
| Emergencies outside Spain | Up to €12,000 a year, on trips of up to 90 days |
Two rows need a closer look. Repatriation here means bringing the body or ashes home after a death, to the international airport nearest the place of burial, plus up to 1,000 dollars of transport beyond that airport if the place is more than 30 km away. It isn't a medical flight home. If your consulate wants medical repatriation, this policy doesn't have it.
The second is an exclusion to state plainly. Sanitas' own English summary says "any medical service directly associated with pregnancy, delivery and newborn care is excluded". If you're pregnant, or might be during the course, this isn't the policy for you: message me and we'll look at another option.
As for health conditions you already have: the general conditions exclude anything that predates the start of cover, and you declare it on the health questionnaire. Sanitas then accepts the policy, turns it down or accepts it with some cover excluded. Answer every question accurately, because anything you leave out isn't covered.
If you're over 35, or your partner or children are coming with you, Sanitas' option is Residents for visas: also no copays and no waiting periods, with repatriation included, for new members up to 64 according to the rate card. It takes several people on one policy and costs more than International Students at the same age.
How much does student health insurance cost in Spain?
At 22, Sanitas International Students costs €60.31 a month in Madrid and €64.33 in Barcelona; a full year in Madrid is €723.72 paying monthly, a little less with the annual-payment discount Sanitas advertises. These are Sanitas' April 2026 rate-card prices for the first year, including the Consorcio surcharge, and they change with your age and the province you'll study in.
| Age | Madrid | Barcelona | Valencia | Rest of Spain |
|---|---|---|---|---|
| 14–15 | €47.25 | €50.37 | €48.34 | €42.71 |
| 16–19 | €53.50 | €57.05 | €54.74 | €48.32 |
| 20–30 | €60.31 | €64.33 | €61.71 | €54.43 |
| 31–35 | €67.89 | €72.45 | €69.48 | €61.24 |
The rate card has its own column for Madrid, Barcelona (with Girona, Lleida and Tarragona), Valencia (with Castellón), Seville, Zaragoza, A Coruña, Biscay and the Balearic Islands; in Seville it's €55.72 at 22. A province without its own column, such as Salamanca, Granada or Málaga, takes the "Rest of Spain" price.
If you'll study in Mallorca, where I'm based, the island has its own column: €62.14 a month at 22.
Residents for visas costs a good deal more. If you're 35 or under and coming on your own, International Students is cheaper at the same age: at 22 in Madrid, €60.31 a month against €104.57 for Residents for visas, and at 31, €67.89 against €112.59. Just keep the pregnancy exclusion above in mind.
Set the price next to the visa's money test. You have to show 100% of the IPREM, Spain's benchmark income figure, for each month of your stay (article 35.h). With the 2026 IPREM that's €600 a month.
What gets a student visa insurance policy rejected?
The mistakes the consulate pages themselves name: travel insurance; copays, deductibles or waiting periods; a reimbursement policy; an insurer that isn't authorised in Spain; cover below €30,000 where the consulate sets that floor (New York and Chicago always, London if the policy has a limit); and dates that stop short of the month before the course or the 15 days after it.
Go through them one at a time before your appointment:
- Travel insurance, however high its medical limit looks. London says so outright, and so do Bogotá and Buenos Aires.
- Copays, deductibles and waiting periods. A cheap Spanish policy from an authorised insurer can still have them: Sanitas' own Más Salud has waiting periods (3 months for the simplest operations, 8 for childbirth) even without copays.
- A reimbursement policy, the kind that pays you back after you've paid the doctor. London rules it out.
- An insurer that isn't authorised in Spain, however international its cover.
- Dates that are too short: a policy that starts on your first day of class or ends with the course.
- A quote or a "policy proposal" instead of the policy itself. The consulates ask for the policy or the insurer's certificate, and Bogotá spells out that a document from an agent or other intermediary won't do. That's why, even if you buy through me, the certificate comes from Sanitas.
What should the insurance certificate show?
A document from the insurer itself, not from an agent or any other intermediary. London asks for the original policy and a copy. Bogotá, the strictest page I've read, wants the insurer's certificate with the policy number and the policy's particular conditions, "firmado mediante firma digital con código de verificación": digitally signed, with a verification code.
Before your appointment, check that it carries the policy number, names you, and shows dates running from a month before your course to 15 days after it. It should also make clear that there are no copays or waiting periods, because that's what the consulate checks, and, if your consulate sets a minimum such as New York's €30,000, that the cover meets it. If something doesn't match, fix it before the appointment: at the counter it's too late.
Do you need to keep the insurance to extend your stay?
Yes. You have to keep meeting the conditions of your permit for as long as it lasts (article 55.2), and an extension, which you apply for in the two months before the permit expires, asks for the insurance again (article 55.3). The authorities can ask you to prove it at any time.
With International Students, keep its limit in mind: the contract runs for 14 months at most, and after that you can ask to extend it while you're still studying and 35 or under. On a degree lasting several years, plan the policy's extension alongside your permit's.
One useful exception. A higher-education study permit lets you work up to 30 hours a week (article 57), and if you work registered with Spanish social security, that registration counts as meeting the insurance requirement (article 57.5).
Studying in Spain with an EU passport?
Then you don't need a visa. If you hold, say, an Irish or Italian passport, you register as an EU resident, and for students the rule accepts a European Health Insurance Card (EHIC) that covers your whole stay (Order PRE/1490/2012, article 3.2.d). The card only works in the public system.
How Spanish public healthcare works, who's entitled to it and how to get a health card is in my guide to healthcare in Mallorca.
Your next step
Open your consulate's student visa page and go through it against the tables above, line by line. If you then want the price for your case, message me on WhatsApp with four things: your age, the city where you'll study, your course dates and the consulate where you'll apply.