What Is the Convenio Especial and Can Students Use It?
The Convenio Especial is Spain’s public healthcare agreement for people without other public cover: it costs €60/month under 65 (€157 from 65) and gives you access to the basic services of the Sistema Nacional de Salud (SNS). The catch: you must have lived in Spain for at least one continuous year immediately before you apply, be registered in the padrón (municipal register) and have no other access to public healthcare. For non-EU students, this means your first year requires private insurance. Whether holders of a study stay (estancia por estudios) are accepted after that is decided by the regional health service.
Through the Convenio Especial, you get GP visits, specialist and hospital care and urgent medical transport without co-payments or waiting periods. Outpatient prescriptions, however, are paid 100% by you. This guide covers who qualifies, how to apply, what is and is not covered, the Year 1 private insurance bridge, and why EU students usually do not need it.
For the full picture on healthcare in Spain, see our Spain Seguridad Social guide and our Spain country guide.
How the Convenio Especial Works
The Convenio Especial is based on Law 16/2003 on the cohesion and quality of the SNS (article 3.3) and regulated by Royal Decree 576/2013. It is meant for people who live in Spain but are not entitled to public healthcare through work, a pension or EU social security rules. You sign it with the health service of the autonomous community where you are registered in the padrón (INGESA in Ceuta and Melilla).
Key Facts
| Detail | Info |
|---|---|
| Monthly cost (under 65) | €60 |
| Monthly cost (65 and over) | €157 |
| Annual cost (under 65) | €720 |
| Residency requirement | 1 continuous year in Spain, immediately before applying |
| Empadronamiento required | Yes — at the time of the application |
| Coverage scope | Basic common services of the SNS (cartera común básica) |
| Co-payments / waiting periods | None |
| Outpatient prescriptions | 100% paid by you |
| Dental covered | Only what the public system covers (limited for adults) |
| Where to apply | Your regional health service |
Who Qualifies?
According to the Spanish Ministry of Health, you can apply if you meet all of these conditions:
- You have lived in Spain for at least one continuous year immediately before the application. Periods of residence in other EU/EEA countries, Switzerland or the UK also count.
- You are registered in the padrón (empadronado) of a Spanish municipality when you apply.
- You have no access to public healthcare by any other route — not through Spanish law (for example a job), EU social security rules or a bilateral social security agreement.
The Ministry describes the Convenio Especial as aimed at economically inactive foreigners who need health insurance to live in Spain. For students on a study stay, the regional health service decides whether they are accepted — ask yours before you plan with it.
Who Does NOT Qualify?
- EU/EEA students covered by their home system — your EHIC already gives you access to necessary care in the SNS
- Employed students — if you work and are registered with the Seguridad Social, you get public healthcare through your job
- Students in their first year — the one-year residence requirement blocks immediate enrollment
The Year 1 Problem: What to Do Before Convenio Especial
This is the biggest hurdle for non-EU students. You arrive in Spain and need healthcare, but the Convenio Especial is not available for at least 12 months. Here is how to bridge the gap.
Private Insurance for Year 1
Private health insurance is mandatory for the Spanish student visa anyway, so you will already have it. Choose a policy that meets the visa conditions and gives you real cover.
| Provider | Price (October 2026) | Annual Cost | Notes |
|---|---|---|---|
| Sanitas International Students | From €41.45/month | From about €497 | Ages 14–35; dental services included |
| Adeslas Welcome | From €660/year | From €660 | Single annual payment; requires a valid NIE |
| ASISA Health Students | Online quote | Online quote | 2–12 months, not renewable |
| DKV Visado | Online quote | Online quote | €0 co-payment for every service |
Visa requirements for insurance: The policy must come from an insurer authorised in Spain, offer benefits comparable to the SNS and be valid for your whole stay. Consulates add:
- No co-payments or deductibles
- No waiting periods
- Cover for the entire stay
- In some consulates: at least €30,000 of cover and repatriation
For a detailed comparison, use our insurance comparison tool.
Can You Switch From Private to Convenio Especial?
Possibly — if your regional health service accepts you after one year of residence. Do not cancel your private policy until the Convenio Especial is signed and you have your health card. Also check with the immigration office (Oficina de Extranjería) whether it accepts the Convenio Especial as proof of insurance for your next extension; private visa policies come with a certificate for exactly that purpose.
Step-by-Step: How to Apply for Convenio Especial
Step 1: Confirm Your Empadronamiento
You must be registered in the padrón of your municipality when you apply. A certificado de empadronamiento from your town hall (Ayuntamiento) is also the most common proof of one year of residence.
Where: Your local Ayuntamiento, its citizen service office (Oficina de Atención al Ciudadano) or the municipal website.
What you need: Your passport or TIE and proof of address, such as your rental contract.
Step 2: Gather Your Documents
The Ministry of Health lists these documents:
- Identity document — NIE, passport or residence card (TIE)
- Proof of one continuous year of residence immediately before the application — for example a padrón certificate or a resident certificate from the police (Dirección General de la Policía)
- Certificado de empadronamiento — registration in a Spanish municipality
- Declaration that you have no other public healthcare cover — a signed declaration (declaración responsable) or a certificate from your home country that your health cover is not exported to Spain. The certificate applies to nationals of countries covered by EU social security rules, the UK, Andorra and Chile.
- Application form — from your regional health service
- Bank details — check with your regional health service how the monthly fee is paid
Step 3: Submit Your Application
You apply to the health service of your comunidad autónoma (autonomous community). The Ministry of Health links to each region’s information page:
| Region | Submit To | Website |
|---|---|---|
| Madrid | Comunidad de Madrid | sede.comunidad.madrid |
| Catalonia | Generalitat de Catalunya (CatSalut) | web.gencat.cat |
| Andalusia | Junta de Andalucía (Servicio Andaluz de Salud) | juntadeandalucia.es |
| Valencia | Generalitat Valenciana | gva.es |
| Basque Country | Basque Government (Osakidetza) | Ask your health centre |
| All others | Your regional health service | sanidad.gob.es lists every region |
Processing time: Set by each region — ask when you apply.
Step 4: Pay the Monthly Fee
The fee is €60 per month under 65 and €157 from 65. Ask your regional health service how and when the payment is collected, and what happens if a payment is missed.
Step 5: Receive Your Tarjeta Sanitaria
After approval, your regional health service gives you an individual tarjeta sanitaria (health card), as a physical and/or digital card. It gives you access to:
- Your assigned health centre (Centro de Salud)
- A family doctor (Médico de Cabecera)
- Hospital services
- Care during temporary stays in other Spanish regions
- Care during temporary stays in the EU/EEA, the UK and Switzerland, with a provisional replacement certificate (Certificado Provisional Sustitutorio) issued by the INSS
What the Convenio Especial Covers
Covered (Basic Common Services of the SNS)
The Convenio Especial covers the cartera común básica — prevention, diagnosis, treatment and rehabilitation in health centres and hospitals, in primary and specialist care, as an outpatient or inpatient:
- GP consultations at your Centro de Salud
- Specialist care — on referral from your GP
- Hospital care — inpatient treatment and surgery
- Emergency treatment — including urgent medical transport
- Diagnostic tests — on referral
- Mental health — care within the public system
- Maternity care — as part of public hospital and specialist care
- Preventive care — vaccinations, screening programmes
- Rehabilitation — in health centres
There are no co-payments and no waiting periods for these services.
NOT Covered — 100% Paid by You
The Ministry of Health lists four services that you pay in full:
- Outpatient prescriptions — you pay the full price of medicines at the pharmacy (the biggest limitation)
- Outpatient orthopaedic products and prostheses
- Dietary products
- Non-urgent medical transport
As in the public system generally, dental care for adults is limited (for example extractions), and glasses and contact lenses for adults are not covered.
The Prescription Gap: How to Manage It
Paying 100% for outpatient medicines is the Convenio Especial’s biggest weakness. Here is how students handle it:
- Generic medicines — ask the pharmacist for the generic version (genérico), which is usually cheaper
- Regular medication — if you take medicines every month, compare their full price with the cost of a private policy before you switch
- Hospital treatment — the outpatient pharmacy rule applies to prescriptions you collect at a pharmacy; ask your doctor how medicines given in hospital are handled
- Private insurance — check what a private policy covers for medicines; Adeslas Welcome, for example, does not cover medicines at all
EU Students: Why You Usually Do NOT Need Convenio Especial
If you are an EU/EEA citizen with a valid European Health Insurance Card (EHIC), you already have access to Spain’s public healthcare system for medically necessary care, on the same terms as people insured in Spain.
EHIC in Spain Covers:
- GP visits at Centro de Salud
- Hospital treatment
- Emergency care
- Specialist referrals
- Prescription medicines, with the same share of the price as people insured in Spain
EHIC Limitations:
- Must be valid for your entire stay — for the EU registration certificate, students can use an EHIC that covers the whole stay
- Only covers medically necessary treatment, not planned treatment
- Must be used at public facilities only
- No repatriation
For longer stays: EU students who stay more than three months register as EU residents; an EHIC valid for the whole stay is accepted as sickness insurance. If you start working in Spain, you are covered through your job instead. Learn more in our EHIC guide.
Convenio Especial vs. Private Insurance: Side-by-Side
| Feature | Convenio Especial | Private Insurance |
|---|---|---|
| Monthly cost | €60 (under 65) | From about €41 (Sanitas International Students) |
| Annual cost | €720 | From €660 (Adeslas Welcome) |
| Available from Day 1? | No (one year of residence first) | Yes |
| GP visits | Public health centre | Doctors in the insurer’s network |
| Specialist access | Via GP referral | Via the insurer’s network |
| Hospital care | Public hospitals | Private hospitals in the network |
| Prescriptions | 100% paid by you (outpatient) | Depends on the policy |
| Dental | Limited for adults | Some policies include dental services |
| Accepted by every region | No — the region decides for study-stay holders | Not applicable |
| Visa requirement met? | Not for the initial visa | Yes, if visa-compliant |
| Bureaucracy | Application to the regional health service | Buy online |
Our recommendation: Use private insurance for Year 1 (mandatory for the visa anyway), then check after 12 months whether your region accepts you. If you are healthy and rarely need prescriptions, the Convenio Especial at €60/month can be good value. If you need regular medicines or dental care, or your region does not accept you, keep your private policy.
University Cities: Where to Apply
Madrid
- Comunidad de Madrid — information and application on the regional e-office (sede.comunidad.madrid)
- Students at Madrid universities apply to the Comunidad de Madrid if they are registered in a Madrid municipality
Barcelona
- Generalitat de Catalunya — the procedure is published on web.gencat.cat
- Once registered, you use your local primary care centre (CAP — Centre d’Atenció Primària)
Valencia
- Generalitat Valenciana — the procedure is published on gva.es
- Once registered, you use your assigned Centro de Salud
Seville and Granada
- Junta de Andalucía — the procedure is published on juntadeandalucia.es
- The Servicio Andaluz de Salud (SAS) runs the health centres in both cities
Common Mistakes to Avoid
- Thinking you can apply immediately. You need one continuous year of residence immediately before the application. There is no exception for students.
- Not registering in the padrón on arrival. Register at the Ayuntamiento soon after you move in. The padrón certificate is the easiest proof of your residence period.
- Not updating your padrón when you move. Update your registration whenever you change address so you can prove a continuous year.
- Forgetting the declaration on other cover. You must declare that you have no other public healthcare cover — and EU, UK, Andorran or Chilean nationals may need a certificate from home.
- Assuming prescriptions are covered. Outpatient prescriptions are not covered. Budget for the full price of your medicines.
- Canceling private insurance too early. Keep private insurance active until your Convenio Especial is signed and your tarjeta sanitaria is issued.
- Assuming your region accepts you. Regions decide whether holders of a study stay can join. Ask before you rely on it.
Frequently Asked Questions
How long does the Convenio Especial application take?
Each regional health service sets its own procedure and processing time. Ask when you apply, and keep your private insurance active until the agreement is signed.
Can I apply for Convenio Especial with a student visa?
Only if your regional health service accepts holders of a study stay (estancia por estudios). You also need one continuous year of residence, padrón registration and no other public cover. Ask your regional health service before you plan with it.
What happens if I leave Spain for the summer?
The requirement is one continuous year of residence immediately before the application. Residence in another EU/EEA country, Switzerland or the UK also counts. If you spend a long time outside those countries, ask your regional health service how it assesses continuity.
Can I use Convenio Especial in all of Spain?
Your tarjeta sanitaria gives you care in your region and during temporary stays in other Spanish regions, Ceuta and Melilla. For temporary stays in the EU/EEA, the UK or Switzerland, the INSS issues a provisional replacement certificate (Certificado Provisional Sustitutorio).
Can I add my partner or family to the Convenio Especial?
The fee is set per subscriber — €60/month under 65 and €157 from 65. Each family member who wants to join must meet the requirements; ask your regional health service how to apply for family members.
What if I start working in Spain?
Once you work and are registered with the Seguridad Social, you are entitled to public healthcare through your job and no longer meet the “no other public cover” condition. Tell your regional health service so the Convenio Especial can be ended.
Can I cancel the Convenio Especial?
Yes. Contact your regional health service to end the agreement — the procedure and notice period are set in your agreement.
Does the Convenio Especial satisfy visa renewal requirements?
For an extension of your study stay you must prove that you have health insurance. Ask the immigration office (Oficina de Extranjería) whether it accepts the Convenio Especial as proof — private visa policies issue a certificate for this purpose.
What happens if I cannot afford the €60/month?
The fee is fixed by Royal Decree 576/2013 — €60/month under 65 — and there is no student discount. Compare it with a private visa policy: Sanitas International Students starts at €41.45/month (October 2026) for ages 14–35, Adeslas Welcome at €660/year.
Related Articles
- Spain’s Seguridad Social for Students: Registration, Tarjeta Sanitaria & Private Top-Up Guide — Complete guide to Spain’s public healthcare for international students
- Spain’s Seguridad Social for International Students: Complete 2026 Guide — The three paths to public healthcare in detail
- EHIC & GHIC: EU Students’ Guide to Health Insurance Abroad — How EHIC works across Europe, including Spain
Next Steps: Plan Your Healthcare Timeline
Before departure: Buy private insurance that meets Spanish student visa requirements. This covers you from Day 1.
Month 1 in Spain: Register at the Ayuntamiento (empadronamiento). This is the easiest way to prove your residence period later.
Month 11: Ask your regional health service whether it accepts holders of a study stay, and gather your documents — including the declaration that you have no other public cover.
Month 12+: If your region accepts you, submit your Convenio Especial application. Keep private insurance active until the tarjeta sanitaria is issued.
Need help finding the right private insurance for Year 1? Use our insurance comparison tool to find plans that meet Spanish visa requirements and cover the gap before Convenio Especial kicks in.
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