In an increasingly connected world, working from anywhere is no longer a surprising exception, it’s a reality for thousands of professionals. Aware of the growing appeal of this lifestyle, Spain has embraced the digital nomad movement by creating a dedicated legal framework. This framework is designed to attract international talent, offering the possibility to live and work in Spain while ensuring clarity around rights, responsibilities, and legal status.
In this article, we will explain in detail what it means to reside in Spain as a digital nomad, the rights you gain once authorized, and the legal commitments you’re expected to fulfil in 2025.
The Digital Nomad Visa and its connection to healthcare access
The digital nomad visa allows non-EU citizens to reside in Spain while working remotely for a foreign company or as freelancers offering services to international clients.
If you’re not yet familiar with what it means to be a digital nomad or with the legal requirements to live and work as one in Spain, we recommend reading our articles: “How to Apply for the Spanish Digital Nomad Visa” and “Legal Rights and Obligations of Digital Nomads in Spain.”
One of the essential requirements to obtain this visa is having healthcare coverage for your entire stay in Spain. This can be achieved in two different ways: by contributing to the Spanish Social Security system or by presenting valid private medical insurance with full coverage.
Do Digital Nomads have access to the Spanish Public Healthcare System?
The answer depends mainly on whether or not you contribute to the Spanish Social Security system:
1. If you contribute in Spain (as a freelancer or employee)
If you register with the Spanish Social Security system, you can access the public healthcare system under the same conditions as any other resident. This includes:
- Access to primary and specialized care
- Emergency services, hospital care, diagnostic tests, etc.
- Coverage for common illnesses, maternity, work-related accidents, etc.
If you plan to register as a self-employed worker (RETA) or as an employee in Spain, you must submit a signed statement committing to register and contribute to Social Security as soon as your residence authorization is approved. This applies whether you’re a freelancer or a foreign employee managing your own contributions in Spain. Once registered, you will be considered an insured individual.
If you choose this route, private health insurance is not required, as you’ll be covered by the public system.
2. If you contribute in your home country and it has a bilateral social security agreement with Spain
If you’re an employee from a country that has a bilateral Social Security agreement with Spain, you can request an A1 certificate from your home country’s administration. This certifies that you will continue paying Social Security in your country during your temporary stay in Spain. Spain maintains such agreements with countries like the U.S., the U.K., Mexico, Argentina, Chile, Australia, Japan, and others.
You must also attach the S1 form, which allows you to register with the Spanish Social Security system and access public healthcare as a beneficiary under your home country’s system.
This certificate:
- Must be issued by the competent authority in your country (e.g., HMRC in the U.K., SSA in the U.S.)
- Must be officially translated into Spanish
- Must explicitly cover the period you plan to reside in Spain
Therefore, if you obtain the A1 certificate and register the S1 with Spanish Social Security, you also don’t need private health insurance, as you’ll be entitled to public healthcare.
3. If you do not contribute in Spain
If you cannot or do not wish to contribute to the Spanish Social Security system, you must have private health insurance that meets the legal requirements for the digital nomad visa to avoid being excluded from the healthcare system. This insurance must meet the following conditions:
- Issued by a provider authorized to operate in Spain
- Full coverage within Spain
- No waiting periods, co-payments, or exclusions that limit access to essential services (emergency care, hospitalization, surgery, etc.)
- Valid throughout the entire residency period
- Must offer benefits equivalent to those of the Spanish National Health System
This is the most common option for those who work as freelancers for foreign clients and are not affiliated with their home country’s Social Security.
The Spanish authorities are very strict in this regard: if the chosen insurance does not meet these criteria, the visa may be denied or renewal rejected. Therefore, it is strongly recommended to purchase insurance specifically designed for resident foreigners, not basic travel insurance.
What if the Digital Nomad moves to Spain with their family?
One of the rights granted to digital nomads is immediate family reunification, without the one-year waiting period required by many other residence permits. However, reunited family members, spouses, children, or dependent parents, do not automatically gain access to public healthcare unless they are also registered with Social Security or covered by an applicable agreement.
In such cases:
- If you contribute in Spain, they can be added as beneficiaries under your Social Security registration.
- If you present the A1 and S1 forms, your relatives must also present equivalent forms to access public healthcare.
- Otherwise, each family member must have their own private health insurance meeting the same requirements, or be covered by the nomad’s insurance policy if allowed.
Am I entitled to a health card as a Digital Nomad?
Yes, but only if you are registered with Spanish Social Security or if you provide a valid international certificate.
In that case, you can apply for the individual health card (TSI) at your local health center after registering your address (empadronamiento) in the municipality where you live. This card gives you access to public healthcare like any other citizen.
Registration (empadronamiento) is mandatory if you stay in Spain for more than 90 days, and it’s often required for other administrative procedures, such as renewing your residence authorization.
To conclude, as you can see, access to healthcare in Spain as a digital nomad depends on your legal and fiscal situation. If you plan to contribute in Spain, you’ll have access to the public healthcare system without issue. If you maintain your affiliation in your home country, you’ll need the proper forms. Otherwise, you must purchase private insurance that meets all legal requirements.
In any case, planning this aspect in advance is essential, as healthcare coverage is one of the key requirements for the approval or renewal of your digital nomad visa in Spain.