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There are two types of health insurance scheme available to you in Spain: one public and one private. 

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The state healthcare system in Spain is free and universal: consultations, access to emergency services and drugs are free. The majority of Spanish nationals therefore use the state health insurance called Insalud (Instituto Nacional de Gestion Sanitaria). 
What cover does Insalud provide?
All workers must contribute to the Spanish state healthcare system.
Spanish Social Security doctors are employees who work for the Instituto Nacional de Gestion Sanitaria. They are not paid directly by the patient which means that prices are relatively consistent from one doctor to another. 
Waiting times to see specialists are very long.
Dental and optical care is not covered by Insalud so you must take out private insurance or top-up health cover to keep costs for this type of care as low as possible.
What you need to do:
You must apply to the nearest medical centre to be assigned a doctor. Spanish Social Security chooses the doctor and health centre (usually the closest to your home) which you must attend.
You cannot choose your own doctor but you can however choose to see your doctor in the morning or the afternoon. Once this choice has been made, it cannot be changed.
Your doctor can refer you to a specialist if required.


Joining a top-up scheme
The employee pays into the Spanish Social Security scheme and at the same time is a member of a top-up scheme.
The top-up scheme has its own network of hospitals, clinics and laboratories. Access to care is therefore faster than in the public system.
There is a charge for membership.
To qualify for free care, it is essential to first see a Spanish Social Security doctor who will refer you to a specialist (in either the public or private sector).
Taking out private insurance
The insured can go to any doctor in any clinic. Treatment will be fully reimbursed according to the terms of the insurance policy.
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