Sanitas vs Adeslas vs Asisa: Best Health Insurance in Spain for UK Expats (2026)

Choosing private health insurance in Spain involves three names that come up constantly: Sanitas, Adeslas, and Asisa. Between them they cover a large share of the Spanish private health market. Understanding the real differences between them, rather than the marketing version, helps you choose the right one for your situation.

I have spoken to dozens of British expats who have used all three. Here is what they actually say.

A Quick Overview of Each Provider

Sanitas is owned by Bupa and is probably the best-known private insurer in Spain for international residents. Strong brand, extensive hospital and clinic network, good app, and English-language customer service options.

Adeslas (formally SegurCaixa Adeslas) is the largest private health insurer in Spain by number of policy holders. Very wide clinic network, competitive pricing, predominantly Spanish-language service.

Asisa is a medical cooperative rather than a traditional insurer, owned by its member doctors. This gives them a slightly different structure. Strong in certain regions, more variable elsewhere.

Network Coverage: Where Can You Be Treated?

This is often the deciding factor and it varies significantly by region.

Sanitas has a national network but it is strongest in major cities and established expat areas (Madrid, Barcelona, Costa del Sol, Alicante). In smaller provincial towns and rural areas, the Sanitas network can be thin.

Adeslas has the broadest network of the three, by a significant margin. In almost any Spanish city or large town you will find Adeslas-affiliated GPs and clinics. For people who move around Spain or live outside major expat hubs, Adeslas often has the better practical coverage.

Asisa is strong in certain regions (particularly Castile, Valencia, and parts of Andalusia) and weaker in others. It is worth checking the Asisa network specifically for your area before signing up.

Practical test: Before choosing any provider, search their clinic finder (cuadro medico) with your specific town or postcode. What matters is not national coverage statistics but what is actually available within a 20-minute drive of your home.

Does It Meet NLV Requirements?

All three providers have policy options that can meet the Non-Lucrative Visa requirements. The critical point is selecting the right product within each provider’s range.

The NLV requires a policy with no co-payment clause (sin copago). Some policies from all three providers include small copays; you must specifically confirm you are getting a no-copago version and obtain documentation stating this clearly.

Sanitas is the most experienced at producing visa-compliant documentation for expat applicants. Adeslas also offers suitable policies but the documentation process can be slower. Asisa is the least consistent in my experience of what expats report.

For NLV applications specifically, I tend to recommend Sanitas or Feather over Adeslas or Asisa, primarily because of the documentation process rather than the coverage itself.

Get a Sanitas quote for NLV applications

Pricing Comparison

Pricing depends heavily on age, the specific product, your area, and whether you add dental or other extras. These are approximate monthly premiums for a healthy individual:

Age 35:

• Sanitas Más Salud: €55 to €75
• Adeslas Completa: €45 to €65
• Asisa Salud: €40 to €60

Age 50:

• Sanitas: €90 to €120
• Adeslas: €80 to €110
• Asisa: €75 to €100

Age 65:

• Sanitas: €170 to €250
• Adeslas: €150 to €220
• Asisa: €140 to €200

Adeslas tends to come in cheaper than Sanitas at most age groups, particularly for older applicants. Asisa is generally the cheapest of the three but with more regional variability.

For families, Adeslas can offer meaningful savings over Sanitas when you are adding multiple people to a policy.

Customer Service: The Real-World Experience

This is where Sanitas earns its premium most clearly.

Sanitas: Offers English-language customer support through some channels. App is modern and functional. Online appointment booking works well. Claims processing is generally faster than competitors.

Adeslas: Almost entirely Spanish-language. The app and online portal are functional but not as polished. If your Spanish is limited, Adeslas customer service interactions will require patience or a Spanish-speaking friend.

Asisa: Variable. Some Asisa clinics have excellent English-speaking staff; others do not. The central customer service is Spanish-language. Regional inconsistency is a real issue.

For UK expats who are not yet confident in Spanish, the service language question is material. A medical situation is not the moment to be struggling with language barriers.

What Each Provider Does Well

Choose Sanitas if:

• You want the most English-friendly service experience
• You are in a major expat area where the Sanitas network is strong
• You value brand reliability and Bupa backing
• You are applying for the NLV and want straightforward compliance documentation

Choose Adeslas if:

• You are living outside the main expat areas and need the broadest network
• Price is a significant factor and you are comfortable with Spanish-language service
• You are adding multiple family members and want competitive family pricing

Choose Asisa if:

• You are specifically in a region where Asisa has a strong network (check first)
• You want the cheapest of the three options and the regional network suits you
• You have good Spanish or a bilingual partner to help with service interactions

What About Feather and Cigna?

These two providers serve different niches from the big three Spanish insurers.

Feather is aimed specifically at expats, with English-language service and documentation structured for visa applications. Better for NLV applicants than any of the Spanish providers on the service and documentation front. Tends to be competitive on price for under-50s.

Cigna Global suits expats who travel extensively, want worldwide coverage rather than Spain-only, or have complex international health needs. Premium prices, premium coverage.

Compare Feather’s expat health plans

My Recommendation

For most UK expats moving to Spain and applying for the NLV: start with a Feather or Sanitas quote. They are the two providers I hear the fewest complaints about from English-speaking expats in terms of service and documentation.

Once you have lived in Spain a few years, have better Spanish, and understand the local healthcare landscape, switching to Adeslas for better pricing at renewal makes sense for many people.

Always check the cuadro medico (clinic network) for your specific area before signing. A nationally praised provider that has no clinics near you is worthless.

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Frequently Asked Questions

Which is the biggest health insurer in Spain?
Adeslas has the largest number of policy holders in Spain. Sanitas is the most used by international residents in Spain.

Does Sanitas cover the whole of Spain?
Yes, Sanitas has national coverage, but their network is stronger in major cities and key expat areas than in rural or smaller provincial towns.

Is Adeslas good for foreigners in Spain?
Adeslas offers good coverage but their service is predominantly in Spanish. For expats with limited Spanish, the day-to-day service experience can be frustrating compared to English-friendly alternatives.

Which health insurer is best for the NLV?
For the NLV application specifically, Feather or Sanitas are the most straightforward to work with in terms of producing the correct documentation. Both have experience with expat visa applications.

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*Affiliate disclosure: Some links in this article are affiliate links. If you purchase through them, I may receive a commission at no extra cost to you.*

*See also: Feather Insurance Review | Spain Private vs Public Healthcare | Health Insurance for NLV Applications*