Depends on age mostly. Also, if you have a pre existing condition (for private healthcare) although many have the right to pick and chose and SAY there is no pre existing condition clause, there is. We just dumped Sanitas due to tremendous premium increases. Mÿ wife turned 65 and we were hit with a 30% increase for her and I was charged 22% more and this was our second year with them.we engaged the Convenio Especial, a program that literally buys into the Spanish care system for 60€ a month for me and 157€ a month for my wife. Even when mine goes up to 157€ next year, we will pay a lower cost than private care. But, to qualify for this program there are basic simple conditions to be met. Additionally, we shopped around for other private policies and my wife was noted as uninsurable due to preexisting conditions. Now one can pay 500€ a month and get a premium policy with few limitations. It is interesting to note that if one spends 500,000€ on a casa, they qualify for full state healthcare. Unfortunately we spent less than a third of that and it doesn't matter that we will spend much more than that living here for the rest of our lives.