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Health Insurance for Autonomos in Spain (2026): The EUR 500 Deduction

Jules

Editor

Updated: October 2026 | Found helpful by 7 others

Registering as an autonomo (RETA) already gives you public health cover. If you add a private policy and pay tax in estimacion directa, the premium is a deductible expense up to EUR 500 per person a year for you, your spouse and children under 25 living with you (EUR 1500 with a disability), as of October 2026. Because it lowers taxable income, the saving is that amount times your marginal rate: EUR 150 a year at 30%.

What Can an Autonomo Deduct?

Autonomos in estimacion directa can deduct health insurance premiums as a business expense: their own cover and that of a spouse and children under 25 living with them, up to EUR 500 per person a year (EUR 1,500 per person with a disability).

The rule is for estimacion directa only; autonomos taxed by modulos cannot use it.

What Does It Save on a Real Premium?

Example: Sanitas Mas Salud sin copago, Ages 40-44, Madrid, at EUR 121.13 a month on Sanitas's official tariff, or EUR 1,453.56 a year. Only EUR 500 of it is deductible:

Saving = EUR 500 x marginal rate; net cost = yearly premium minus saving, October 2026.
Marginal rateTax savingNet yearly cost
30%EUR 150EUR 1,303.56

The research gave a net cost of about EUR 953 a year for this example by subtracting the full EUR 500; a deduction lowers taxable income, so only the tax on it is saved.

Which Policy Fits Your Situation?

Worked scenario, October 2026.
#SituationBest answerRunner-upWhyRuled out
4A-6Autonomo, 40, estimacion directa, wants the fastest specialist accessNo verified answerNo cheapest verified option. Verified anchor: Sanitas Mas Salud sin copago, EUR 121.13 a month at 40-44 in MadridASISA Completa (from EUR 48.70; your quote depends on profile)The EUR 500 deduction lowers the net cost of any policy; cheaper insurer-published prices for this profile were not foundAutonomos in modulos (not eligible for the deduction)

Frequently Asked Questions

Can autonomos deduct private health insurance in Spain?

Yes, in estimacion directa: premiums for yourself, your spouse and children under 25 living with you are deductible up to EUR 500 per person a year, or EUR 1500 with a disability (Ley 35/2006 art. 30, October 2026).

How much does the deduction actually save?

The deduction lowers taxable income, so it saves EUR 500 times your marginal rate: EUR 150 a year at 30%. On a EUR 1,453.56 policy that leaves EUR 1,303.56.

Do autonomos need private health insurance at all?

No. RETA registration includes public health cover; private insurance is optional, for faster specialist access.

Sources

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