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Date Published: 18/05/2026

Spain's new prescription charge system is now in force: Here's what you now pay for medication

For many people on lower and middle incomes in Spain, the new system works out considerably cheaper

Spain's pharmaceutical co-payment system was updated on May 14, so if you buy prescription medication through the public health system, it’s likely that how much you’ll pay has also changed.

The reform, pushed through by the Ministries of Health and Finance via royal decree, replaces a system that hadn't been updated since 2012 and expands the number of income brackets from three to six, with monthly spending caps introduced for lower earners for the first time.

Minister for Health Mónica García described the changes as a way to make contributions more proportional to income and to reduce the risk of people skipping or cutting back on medication because of cost, something the government's own advisory body had flagged as a real problem under the old system.

The total budgetary impact of the reform is around €265.63 million.

If you're working, here's what you'll pay:

Income up to €9,000: 40%, capped at €8.23 per month
Income €9,000 to €17,999: 40%, capped at €18.52 per month
Income €18,000 to €34,999: 45%, capped at €61.75 per month
Income €35,000 to €59,999: 45%, no monthly cap
Income €60,000 to €99,999: 50%, no monthly cap
Income over €100,000: 60%, no monthly cap

If you're a pensioner, here's what you'll pay:

Pension below €18,000: 10%, capped at €8.23 per month
Pension €18,000 to €59,999: 10%, capped at €13.37 per month
Pension €60,000 to €99,999: 10%, capped at €18.52 per month
Pension over €100,000: 60%, capped at €61.75 per month

Who pays nothing:

Recipients of the Minimum Living Income
Recipients of non-contributory pensions
Unemployed people with no benefits
Minors with recognised disabilities or affected by work accidents and occupational diseases
People receiving the child support supplement

The monthly caps are particularly significant for anyone managing a long-term condition or taking multiple medications, as the previous system had no upper limit for working people on lower incomes, meaning costs could stack up quickly over the course of a month.

It's also worth noting that medication shortages across Spain have been worsening recently, a situation linked in part to the ongoing crisis in the Middle East, so if you're on regular medication it's a good idea to speak to your pharmacist about availability and make sure you're not caught short.

Image: Freepik

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