How much does healthcare cost in Andorra in 2026?

Active workers enrol in the Caixa Andorrana de Seguretat Social (CASS) with employment or an approved self-employed base. Guides that track current rates put the combined social-security take near 22% of gross pay, with about 6.5% on the employee side and 15.5% on the employer side. Self-employed filers often pay the full 22% on a declared base, with lower bases available when income qualifies.

At the point of care, you usually pay first and reclaim. Inside the via preferent (the preferred pathway that starts with your referring GP), CASS typically reimburses about 75% of its reference tariff for many consultations and about 90% for hospitalisation, with maternity often at 100% when you stay on pathway. Jump to a specialist without that pathway and reimbursement can fall toward about 33% for some acts. Hospital Nostra Senyora de Meritxell in Escaldes-Engordany is the main inpatient hub people name when they plan serious care.

Passive residence (residència passiva) does not put you on CASS through a job. Immigration expects private health insurance that covers care inside Andorra, not a tourist travel policy: Apply for a residence permit. Published planning bands for full private cover often sit near several hundred euros a year for a healthy adult, and higher for families, but quotes move with age and scope.

People already on CASS often buy a local top-up so the residual 25% consultation share or 10% hospital share, plus charges above CASS tariffs, do not hit the card every visit. Bank-linked products such as Creand Salut and similar domestic top-ups commonly land in a few tens of euros per person per month in lifestyle guides. Keep that line next to rent, not as a surprise after your first specialist invoice: Monthly budget.

Cross-border care in Spain or France only helps when your policy and CASS bilateral rules actually cover it. Do not assume a Barcelona private hospital bill is “basically free” because Andorra feels close on the map: How expensive is Andorra.