Andorra Healthcare System: A Guide for Residents

Coverage Levels and Reimbursement

CASS covers health costs at rates between 75% and 100% of expenditure, depending on the type of service. The coverage structure is designed to make essential care affordable while requiring some patient contribution.

For general practitioner consultations, CASS covers 100% of the cost. Specialist consultations receive a minimum of 75% coverage, with patients responsible for the remaining 25%.

Hospitalization is covered at 90% of expenses, making even major medical events manageable financially. Expenses from workplace accidents, occupational diseases, and childbirth are covered at 100%.

For non-affiliated services or when accessing care through the non-preferential route, patients pay higher copayments of 33% to 40%. CASS also covers 75% of the cost of two dental cleanings per year.

The reimbursement process is automated. When CASS receives notification of a health service, the system processes payment automatically and reimburses the covered portion by bank transfer within 2 to 5 business days.

Hospitals and Medical Facilities

Hospital Nostra Senyora de Meritxell is the only hospital in Andorra. Built in 1993 across 12 levels, it features 192 single-bed rooms with private bathrooms, ensuring patient comfort and privacy.

The hospital provides first-level healthcare services with excellent care from highly qualified physicians and medical staff. Facilities include a cafeteria, large terrace area, and vending machines to make patients and visitors comfortable.

The hospital's facilities and staff treatment are of excellent quality. However, for specialized treatments not available in Andorra, patients may be transported by helicopter to either Barcelona or Toulouse for advanced care.

The Servei Andorrà d'Atenció Sanitària (SAAS) manages the hospital and provides comprehensive medical services. The facility handles routine care, emergencies, and many specialist services for the Andorran population.

Private Health Insurance Options

Many residents opt for complementary private insurance to cover the copayment percentages that CASS does not subsidize. This eliminates out-of-pocket costs for medical services and provides additional peace of mind.

Private insurance policies in Andorra typically cover the gap between CASS reimbursement and full cost. They may also provide access to additional services, faster appointments, or coverage for treatments not included in CASS.

International expatriates and travelers should note that the European Health Insurance Card (EHIC) and Global Health Insurance Card (GHIC) are not valid in Andorra. Visitors must take out comprehensive travel and medical insurance before arriving.

Private insurance costs vary based on coverage level, age, and pre-existing conditions. Policies are available from both local Andorran insurers and international providers with operations in the principality.

Access to Healthcare in Spain and France

Andorra has bilateral healthcare agreements with both Spain and France, allowing for healthcare coverage in those countries in specific situations. This extends the reach of Andorran healthcare beyond the principality's borders.

These agreements are particularly valuable given Andorra's small size and limited specialist facilities. Residents can access advanced medical care in Spanish or French hospitals when necessary, with CASS coverage applying.

For specialist treatment not available at Hospital Nostra Senyora de Meritxell, patients are referred to facilities in Barcelona or Toulouse. Emergency helicopter transport is available when immediate specialized care is required.

The proximity to both Spain and France, combined with formal healthcare agreements, ensures Andorran residents have access to the full range of modern medical treatments without sacrificing their CASS coverage.

Requirements for Passive Residents

Passive residents face different healthcare requirements than active residents or workers. If you have passive resident status, you are required by law to take out private health insurance.

Passive residents cannot enroll in CASS through standard employment-based contributions. Instead, they must arrange private health insurance at a minimum cost of approximately EUR 2K per year.

The private insurance must meet specific coverage standards set by Andorran immigration authorities. This ensures passive residents have comprehensive healthcare access despite not contributing to CASS through employment.

Passive residents should select insurance policies that provide coverage comparable to CASS benefits, including hospitalization, specialist care, and emergency services. Many international insurers offer Andorra-compliant policies for passive residents.

Quality and International Standing

Andorra's healthcare system is highly regarded for its quality and accessibility. The combination of modern facilities, qualified medical professionals, and comprehensive coverage ensures residents receive excellent care.

Hospital Nostra Senyora de Meritxell offers care comparable to facilities in neighboring countries, with modern equipment and well-trained staff. The hospital maintains high standards across emergency care, routine procedures, and specialist services.

The CASS system's high reimbursement rates make healthcare financially accessible to all residents. Combined with the option to choose any physician or specialist freely, patients enjoy both quality care and personal choice.

Access to Spanish and French healthcare systems through bilateral agreements further enhances the quality of care available to Andorran residents. This network ensures access to cutting-edge treatments and highly specialized care when needed.