⚠️ Confirm before you switch
RD 1155/2024, art. 64.2.c requires you to have maintained, and to continue, health insurance ("un seguro de enfermedad") to renew. The regulation and the Ministry of Inclusion's renewal information sheet do not say whether the convenio especial meets this requirement. Confirm with your case manager how your Oficina de Extranjería treats it before cancelling any policy, and never leave a gap in cover.
What the convenio especial is
Under Real Decreto 576/2013 (BOE-A-2013-8190) and Ley 16/2003, art. 3.3, people resident in Spain who are not covered by the public health system can obtain public healthcare by paying a monthly fee under a convenio especial. You sign it with the health service of the region where you are registered on the padrón — or with INGESA in Ceuta and Melilla. It gives access to the basic common portfolio of services of the national health system. It is individual: each family member signs their own.
Who can sign one
RD 576/2013, art. 3 requires all three of the following:
- Effective residence in Spain for a continuous period of at least one year immediately before you apply (the Ministry of Health and several regions also count periods in other EU/EEA countries, Switzerland or the UK).
- Registration on the padrón in a municipality of the region where you apply.
- No access to public healthcare by any other route — under Spanish law, EU social security rules or a bilateral agreement.
It is not limited to EU pensioners, and your nationality and income source do not matter. Pensioners whose pension state covers their healthcare (for example with an S1 form) are excluded because they already have that access. Because of the one-year residence requirement, the convenio is not available for your first NLV application.
What it costs and covers
- Fee (RD 576/2013, art. 6.1): €60 a month if you are under 65; €157 a month if you are 65 or over. Regions may charge more only if they add complementary services.
- Coverage: the basic common portfolio of public healthcare. According to the Ministry of Health, outpatient prescriptions, orthoprosthetics, dietary products and non-urgent transport are paid 100% by the patient.
- If it ends: if the convenio is terminated for non-payment, voluntary withdrawal or breach, you cannot sign a new one for a year (art. 7.3).
How to apply
- Apply to the health service of the region where you are registered on the padrón (INGESA in Ceuta and Melilla). Each region publishes its own form and procedure.
- Typical documents: identity document, proof of at least one year's residence, a current padrón certificate and, where relevant, a certificate showing you have no other public-healthcare entitlement.
- The administration has 30 days to decide; if it does not answer, the application is approved. You then have three months to sign the convenio, and cover starts on the day you sign (RD 576/2013, art. 4).
Using it at renewal
Your renewal is filed at the Oficina de Extranjería in the province where you live — the consulate is not involved, and there is no change of visa "category". If you plan to rely on the convenio especial for the health-insurance requirement, confirm first how your office treats it, keep your existing cover until the convenio is signed and active, and keep proof of continuous cover for the whole period of your current authorisation (art. 64.2.c).
Sources: RD 576/2013 (BOE-A-2013-8190); Ley 16/2003, art. 3.3 (BOE-A-2003-10715); RD 1155/2024, art. 64 (BOE-A-2024-24099); Ministry of Health — convenio especial. Checked 17 October 2026.
Frequently Asked Questions
What is the convenio especial?
It is a paid agreement that gives access to Spain's public health system (the basic common portfolio of services) to people who live in Spain but have no right to public healthcare by any other route. It is signed with the health service of the region where you are registered on the padrón (INGESA in Ceuta and Melilla), under Real Decreto 576/2013 and Ley 16/2003, art. 3.3. It is a healthcare agreement only — not a visa or a residence category. Your residence authorisation stays the non-lucrative one.
Who can sign a convenio especial?
Under RD 576/2013, art. 3, you must have lived effectively in Spain for a continuous period of at least one year immediately before applying, be registered on the padrón in the region, and have no access to public healthcare by any other route (Spanish law, EU social security rules or a bilateral agreement). Nationality and the source of your income do not matter.
Is it only for EU pensioners?
No. Nothing in RD 576/2013 limits it to EU pensioners. Pensioners whose pension state covers their healthcare (for example with an S1 form) are excluded, because they already have access to public healthcare through that route.
How much does it cost?
RD 576/2013, art. 6.1 sets a monthly fee of €60 if you are under 65 and €157 if you are 65 or over. Regions may charge more only if they add complementary services. Outpatient prescriptions are not covered — the Ministry of Health states the patient pays 100% of outpatient pharmacy, orthoprosthetic and dietary products and non-urgent transport.
How do I apply?
You apply to the health service of the region where you are registered, with proof of identity, of one year's residence, your padrón certificate and, where relevant, a certificate showing you have no other entitlement. The administration has 30 days to decide (no answer means approval), you then have three months to sign, and cover starts on the day you sign (RD 576/2013, art. 4).
Can I use the convenio especial for my NLV renewal?
No official source we have found says either way. RD 1155/2024, art. 64.2.c requires you to have maintained, and to continue, "un seguro de enfermedad" (health insurance) for the renewal, and the Ministry of Inclusion's renewal information sheet does not mention the convenio. The Ministry of Health describes the convenio as aimed at economically inactive foreigners who need health insurance to reside in Spain, but it does not refer to the non-lucrative renewal. Before you cancel any private policy, confirm with your case manager how your Oficina de Extranjería treats the convenio — and never leave a gap in cover.
Can I use it for my first NLV application?
No. The convenio requires a year of residence in Spain and padrón registration before you apply, so it is not available for the initial visa from abroad.
Planning your renewal?
Our specialists check your health cover, financial evidence and residence record before you file, so your renewal goes in complete.