Co-Payment Prescription Charges In Spain

If you live in Spain or are in the process of moving to Spain, it is important that you are aware of any prescription charges that you may have to pay.

The co-payment system means that most people, including UK pensioners, are required to pay a percentage of their prescription costs when visiting a Spanish pharmacy. The percentage that will need to be paid will be included in your prescription.

The scheme is handled by each autonomous community, meaning that the process may vary slightly between the different regions.

The payment percentage will differ from person to person, as it will be calculated on each individual situation and on declared annual income. This percentage will be taken from information about your income obtained from the annual resident tax declaration (IRPF).

If you have not made an annual resident tax declaration in Spain, there will be no indication on the prescription of how much you must pay. This means that blanket charges will be made of 40 per cent for non-pensioners with low incomes and 10 per cent for pensioners. It is, however, important to remember that no income information means no cap on your monthly contribution if you are not a pensioner.

Your rate of payment is recorded against your health card record as a pharmacy contribution code (TSI), set from your resident tax declaration. This makes it difficult to obtain a discount if you have not presented a tax return in Spain, even a zero one.

Obviously, we would all prefer that prescriptions were free, but drugs and medicines do remain a substantial drain on the economy. Because of this, the 2012 reform also meant that some treatments have to be paid for in full, as they are no longer available on prescription in Spain. If you are unsure of anything, speak to your pharmacist, who will be able to give you more information about this and will be able to discuss all options that are available to you.

The Spanish government are trying to keep the payment scheme as fair as possible. That is why they are using this means of testing to ensure that people's contributions are administered fairly.

Below is a guide of the charges which are correct as of May 2026 (Real Decreto-ley 11/2026).

Pensioners

Pensioners with an income below €18,000 will have to pay 10% towards the cost, up to a maximum of €8.23 per month. (Valenciana region is exempt from the 1st of January 2016)

Pensioners with an income above €18,000 but below €60,000 will have to pay 10% towards the cost, up to a maximum of €13.37 per month. Pensioners with an income of €60,000 or more but below €100,000 will have to pay 10% towards the cost, up to a maximum of €18.52 per month.

Pensioners with an income above €100,000 will have to pay 60% toward the cost, up to a maximum of €61.75 per month.

Non-Pensioners

Non-pensioners with an income below €18,000 will have to pay 40% toward the cost, up to a maximum of €8.23 per month below €9,000 and €18.52 per month from €9,000 to €18,000. (In the Valenciana region, people on unemployment benefit, minors and other listed groups with an income below €18,000 are exempt through the Generalitat's co-payment aid.)

Non-pensioners with an income above €18,000 but below €60,000 will have to pay 45% toward the cost, capped at €61.75 per month below €35,000 and with no maximum above that. Non-pensioners with an income of €60,000 or more but below €100,000 will have to pay 50% toward the cost with no maximum.

Non-pensioners with an income above €100,000 will have to pay 60% toward the cost with no maximum.

** Note that all prices are based on the Consumer Price Index (CPI) and are adjusted each January.

** Since 14 May 2026, pensioners who receive the minimum-pension supplement (complemento a mínimos) are exempt from co-payment charges. Pensioners already exempt on incomes below €5,635 per year (€11,200 if not obliged to file a tax return) keep the exemption under a transitional rule.

Exclusions

There are a number of groups that are currently excluded from paying prescription charges. These are:-

• Those who have had an accident at work or have contracted an occupational disease
• Unemployed who have lost their entitlement to unemployment benefits
• Those affected by toxic syndrome or those with certain levels of disability
• Those currently receiving 'social integration' benefits
• Those receiving a non-contributory pension
• Pensioners receiving the minimum-pension supplement (complemento a mínimos)
• Minors with a degree of disability equal to or greater than 33%
• Those receiving the Minimum Vital Income (IMV)
• Those receiving social security benefits for a dependent child or minor in permanent foster care or guardianship for adoption purposes.

Valenciana Region Exemptions

Please note that from the 1st of January 2016, pensioners and those in receipt of state welfare with an income less than €18,000 per annum are exempt from all prescription payments. Children under the age of 18 with a disability of 33% or more and adults with a disability of 65% or more are also covered by the regional aid.

Pharmacy Insurance Cover

At Health Plan Spain, we offer a pharmacy option as an add on to any of our policies.

This option provides reimbursement of 50% of your prescribed drugs and medicines up to a maximum of €200. So for example, If your annual prescription costs were €400, you would receive a reimbursement of €200 for the year.

This additional cover can only be added on the contraction or renewal of the health insurance plan you decide to purchase.

There are no waiting times or exclusions with this option. The option is chosen per person, so it can be added for everyone on the policy or just the people who want it, and costs from €4,30 per person, per month.

Please contact us for further information or to get a quick quote on any of our plans you can visit Healthplanspain: Sanitas health plans

Not sure what you pay? Read our guide to how copayments work in the Health Library.