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

> Health insurance for autonomos in Spain in October 2026: RETA already includes public cover, and in estimacion directa private premiums are deductible up to EUR 500 per person a year. Worked example on the official Sanitas tariff.

Updated: October 2026 · By Jules · URL: https://www.how-to-spain.com/insurance/health-insurance-for-freelancers

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 rate | Tax saving | Net yearly cost |
| --- | --- | --- |
| 30% | EUR 150 | EUR 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.
| # | Situation | Best answer | Runner-up | Why | Ruled out |
| --- | --- | --- | --- | --- | --- |
| 4A-6 | Autonomo, 40, estimacion directa, wants the fastest specialist access | No verified answerNo cheapest verified option. Verified anchor: Sanitas Mas Salud sin copago, EUR 121.13 a month at 40-44 in Madrid | ASISA 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 found | Autonomos in modulos (not eligible for the deduction) |

## Change log

Updated 25 October 2026

- 2026-10-25 Published: health insurance for autonomos in Spain, the EUR 500 deduction and a worked example

## What Should You Read Next?

[### Health Insurance in Spain Routes and insurer-published premiums.](/insurance/health-insurance)[### Business and Autonomo Cards in Spain Cards for the self-employed.](/finance/business-credit-cards)

## 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.

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Source: https://www.how-to-spain.com/insurance/health-insurance-for-freelancers
Last updated: Updated: October 2026
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