Healthcare on the Costa del Sol: public, private — or both? A guide for new residents

For many of the families I work with, good medical care is a top reason for moving here. The Costa del Sol runs two parallel tracks — public and private — and most expats combine the two. Here's how it actually works, what it really costs, and which clinics are genuinely worth knowing.

The public system (SAS)

Andalusia's public healthcare is Servicio Andaluz de Salud (SAS). Residents who contribute (employment, self-employment) or qualify under their specific status get access. After registering you receive a health card (tarjeta sanitaria) and an assigned family doctor (médico de cabecera) at the local centro de salud.

The medicine itself in the public sector is good — the Hospital Costa del Sol in Marbella is a modern regional hospital with full coverage. The weak points are waiting times (specialists can be 2–6 months out) and the language barrier: front-line staff often don't speak English. As a tourist you use the EHIC.

Private care — the expat default

Most of our clients lean private — shorter queues, fast specialist access, multilingual staff (English in 95% of clinics, in some places Polish, German, Russian, Dutch). The big insurers are Sanitas, Adeslas, DKV, Cigna, Mapfre and Bupa Global (Sanitas).

Premiums depend on age and scope — compare a few quotes. Indicatively: a 35-year-old in good health pays €45–90/month for a standard policy without co-payments, a 55-year-old €120–250, a 65+ easily passes €300. A family bundle with two children is around €200–400/month.

Hospitals worth knowing

• Quirónsalud Marbella — large, full-service private facility, one of the most modern in Andalusia, full specialty range, 24/7 ER.
• HC Marbella International Hospital — international standard, close to the centre, strong obstetrics and paediatrics, one of two private maternity units in the area.
• Vithas Xanit Internacional (Benalmádena) — a strong alternative on the east side, with serious oncology and orthopaedics.
• USP Hospital Marbella — smaller but valued for service quality and personalised care.
• Helicopteros Sanitarios — private ambulance service with helicopter (door-to-door in 20 minutes), very popular in the expat community, family subscription about €300–500/year.
• Hospital Costa del Sol (public, Marbella) — the region's reference public hospital.

Polish-speaking doctors and others

Around Marbella there are currently a dozen or so Polish or Polish-speaking doctors — mostly in dentistry, gynaecology, paediatrics and rehabilitation. The Polish Cultural Association and several Facebook groups keep up-to-date lists. Pharmacies in Marbella (especially Farmacia Internacional on Avenida Ricardo Soriano) increasingly have English- and Polish-speaking staff.

Residency implications

Non-EU applicants usually need to show private health insurance (no co-payments, with repatriation cover) when applying for residency, golden visa or digital nomad visa. EU citizens register as residents — if they work in Spain, they automatically get SAS access; if living on passive income, in the first year private insurance is often required. Confirm with an immigration advisor before you move.

Dentistry, optics, vet care

Standard health policies rarely fully cover dentistry and optics — these are usually add-ons or paid privately. Prices are healthier than in many countries on simple procedures (cleaning €30–50, filling €60–100) but implants cost similarly or more (€1,200–2,200 per tooth). Vet — €40–80 per visit, dog vaccinations €30–50.

Day to day

Pharmacies (farmacia) are everywhere, marked with a green cross, with a night-time farmacia de guardia rota (use the Farmacias Open app). Emergency number is 112 (police, fire, ambulance in one). Basic Spanish helps in the public system; private clinics will almost always handle English. For local admin culture, see our everyday life on the Costa del Sol guide.