Key Takeaways
- Active residents pay into CASS — roughly €480–590/month as a self-employed director.
- CASS reimburses 100% of GP visits, at least 75% of specialists, 90% of hospital stays.
- Passive residents are not in CASS and need private insurance (~€100–200/month per adult).
- One contribution covers a non-earning spouse and children.
- Complex care is referred to partner hospitals in Barcelona or Toulouse with cover.
Andorra’s public healthcare runs through CASS, the social-security fund. Active residents pay into it — roughly €480–590 a month as a self-employed director — and it reimburses most care: 100% of GP visits, at least 75% of specialists, 90% of hospital stays. Passive residents do not join CASS and must hold private insurance. Quality is high; for some complex care residents use hospitals in Barcelona or Toulouse.
How CASS works
CASS (Caixa Andorrana de Seguretat Social) is Andorra’s single social-security system, covering healthcare, pensions and benefits. It operates on a reimbursement model: you pay the provider, then CASS pays you back a set percentage.
| Care | CASS covers | You pay |
|---|---|---|
| GP consultation | 100% | 0% |
| Specialist consultation | At least 75% | Up to 25% |
| Hospitalisation | 90% | 10% |
| Prescription medication | 40–100% by type | Rest (chronic-condition drugs are near-free) |
Many residents take out a top-up (mutua) policy for €40–100 a month to cover the co-payment portion, which makes most care effectively free at the point of use.
Who is in CASS — and who isn’t
- Active residents register with CASS as self-employed workers. The contribution is a percentage of a chosen base (minimum: the national minimum wage), landing around €480–590 a month. New businesses can get reduced rates in the early years.
- Employees pay 6.5% of gross salary; the employer adds 15.5%.
- Dependents — a non-earning spouse, children under 18, students to 25 — are covered on a single contribution.
- Passive residents are not eligible for CASS. They must carry private health insurance covering them in Andorra for the whole permit, typically €100–200 a month per adult.
The reality of using it
Day-to-day care in Andorra is good: modern clinics, short waits, English- and Spanish-speaking doctors are common. The country has one main hospital, Hospital Nostra Senyora de Meritxell in Escaldes-Engordany, plus private clinics. For highly specialised treatment — complex oncology, rare conditions, certain surgeries — CASS has agreements with hospitals in Spain and France, and residents are referred across the border with cover.
Pensions and the wider system
CASS contributions also build a state pension entitlement. If you move to Andorra mid-career, years contributed elsewhere in the EU can often be aggregated under coordination rules — worth checking with an advisor if retirement is on the horizon.
Frequently asked questions
How much does healthcare cost in Andorra?
Active residents pay roughly €480–590 a month into CASS as self-employed. Passive residents pay €100–200 a month per adult for private insurance. CASS then reimburses 75–100% of most care.
Do passive residents get Andorran public healthcare?
No. Passive residents are not in CASS and must hold private health insurance for the duration of their permit.
Is Andorran healthcare good?
Yes for routine and most specialist care, with short waits and multilingual doctors. Complex cases are referred to partner hospitals in Barcelona or Toulouse with CASS cover.
Are my children covered?
Yes. One CASS contribution covers a non-earning spouse and children (under 18, or students up to 25).
Last reviewed: 3 September 2026. General information, not medical, legal or financial advice; CASS rates and coverage change and this page may become out of date. Speak to our team.
Suggested Reading
The Real Cost — and Reality — of Living in Andorra (2026)
Retiring in Andorra: Pensions, Healthcare and the Passive Residency Route
The Best Parishes to Live in Andorra: A Guide to All Seven
