Andorra – Doctors

How does the healthcare system in Andorra work, and does it cover expats?

Andorra’s healthcare structure is built around a co-payment framework that draws on both public and private elements, all administered through the Caixa Andorrana de Seguretat Social (CASS), the country’s official public health institution. Unlike a fully state-funded model such as the NHS in the United Kingdom, or an entirely private arrangement, CASS functions as a social insurance mechanism — broadly comparable in principle to Medicare in Australia — under which residents contribute monthly and receive subsidised rather than free care.

The Andorran Social Security Fund (CASS) sits at the heart of the Principality’s social protection framework. Founded in 1966 and subsequently modernised under Law 17/2008 on Social Security, it operates on a contributory and solidarity-based foundation to guarantee medical, employment, and retirement protection for employees, the self-employed, and pensioners alike.

Any person carrying out a professional activity in Andorra is required to be affiliated with CASS. This obligation applies to employees registered through their employer, self-employed workers enrolled in the Economic Activities Register, and company directors or active partners who exercise genuine management responsibilities.

Passive residents — those living in Andorra without engaging in employment — fall outside the CASS framework and must instead hold a valid private health insurance policy. This distinction is critically important for expats: eligibility for public healthcare in Andorra is determined by your residency type and employment status, not simply by your physical presence in the country.

Health insurance is a legal requirement for everyone residing in Andorra. The government mandates that all residents hold cover either through the national social security system or through a private medical insurance arrangement. For current, authoritative information on eligibility, consult the official CASS website at www.cass.ad.

Andorra has one hospital and approximately 12 health centres, sufficient for its small and geographically contained population. The Hospital Nostra Senyora de Meritxell in Andorra la Vella is the country’s principal hospital, providing a broad spectrum of services including emergency care, surgical procedures, diagnostic facilities, and maternity services.

How do you find and register with a doctor in Andorra?

A defining characteristic of Andorra’s health system is the concept of the “referring doctor” (metge referent). Every resident is required to nominate a general practitioner who acts as their primary point of contact, manages referrals to specialists, and maintains an ongoing overview of the patient’s health. This model is conceptually similar to the GP gatekeeping arrangements found in countries such as France and the Netherlands, where a registered primary care physician coordinates access to further care.

Since September 2018, the CASS framework has operated on a referral basis: patients must be registered with a general practitioner, who determines whether onward referral to a specialist is appropriate. Patients who follow this coordinated pathway benefit from a higher reimbursement rate, with the overall aim of improving access, efficiency, and continuity of care.

Every person registered with CASS must select either a doctor or a paediatrician to serve as their referring practitioner. This arrangement provides personalised general healthcare and enables continuity of health monitoring over time.

Once you have settled in Andorra, it makes practical sense to select a doctor situated close to your home parish, thereby reducing the need to travel significant distances when you are unwell. While there are no rigid catchment boundaries preventing you from choosing a practitioner in a different parish, proximity is a sensible consideration in a compact country.

To register as an active resident with CASS and designate your referring doctor, follow these steps:

1. Obtain your residency permit and your Andorran NIA (Número d’Identificació Administrativa) — your personal administrative identification number in Andorra.
2. To register with a local doctor in Andorra, you will need to provide your social security number and proof of residency.
3. Register with CASS either in person at a CASS office or through the CASS Online portal. All procedures can be completed via either channel. Employers must register their employees from the first day of work; self-employed individuals must register before commencing their activity.
4. Browse the directory of CASS-affiliated doctors — accessible through the CASS online portal — and contact your preferred GP to confirm that they are currently taking on new patients.
5. Formally nominate your chosen practitioner as your metge referent through the CASS system.
6. Once registration is complete, you will receive a medical card, which you must present at every subsequent appointment.

It is not unusual for practitioners to have closed their lists to new patients. Some doctors also prefer to meet prospective patients before accepting them onto their records. It is therefore advisable to contact several practices near your parish when you first arrive. For the most up-to-date directory of CASS-affiliated practitioners, visit the official CASS portal at www.cass.ad.

How do you pay for a doctor’s appointment in Andorra?

Healthcare in Andorra is delivered on a co-payment basis: CASS meets a portion of the total cost, with the remainder falling to the patient. In most instances, the patient settles the full amount at the point of care, and CASS subsequently reimburses the subsidised portion by bank transfer or a comparable method. This is a notable departure from fully publicly funded systems where payment flows directly to the provider — in Andorra, you typically pay upfront and reclaim later.

For patients accessing care via the recommended referral route — through their registered referring doctor — CASS covers 75% of outpatient and specialist consultation costs, leaving the patient responsible for the remaining 25%. For inpatient hospital stays, CASS covers 90% of the costs, so the patient’s share is limited to 10%. Costs arising from workplace accidents or occupational illnesses, and the costs of childbirth, are met in full with no patient contribution required.

For a standard consultation with the referring doctor, the patient’s 25% share typically amounts to approximately €5–7 (as of the date of that source — consult the CASS website for current tariffs, as these are subject to periodic revision). The overall process has been designed to be straightforward and largely digital: you book an appointment with your doctor or chosen specialist, and you must have a referral from your metge referent. Depending on whether the facility participates in the third-party payment scheme, you either pay the full cost at the clinic and claim reimbursement, or pay only your 25% share directly. The clinic provides a stamped form which you upload to the CASS portal to initiate the reimbursement process.

Where a patient cannot afford to meet the 25% or 10% co-payment, an independent CASS commission assesses the circumstances on a case-by-case basis and may authorise full cost coverage.

Once enrolled in CASS, expats are subject to exactly the same co-payment rules as Andorran nationals — there is no separate pricing tier for foreign residents. If you seek treatment from providers not authorised by CASS and the Andorran authorities, reimbursements are reduced to 33% of the amount incurred. To receive the standard reimbursement rates, always use CASS-affiliated providers. For the most current schedule of fees and reimbursements, refer directly to www.cass.ad.

Do you need private health insurance to see a doctor in Andorra?

Whether private health insurance is necessary depends entirely on your residency category. If you relocate to Andorra as a passive resident, you do not contribute to the social security system, and immigration law therefore requires you to maintain a private health and disability insurance policy at all times to cover your medical needs in the Principality.

Expats intending to live in Andorra should put comprehensive health insurance arrangements in place before they move. Those who will be working and contributing to the public system will be covered by CASS, though many expats also choose to hold private health insurance to access a wider range of services or to benefit from faster care.

Even for those already covered by CASS, supplementary private insurance is widely taken out. Although private cover is most directly relevant to passive residents who are ineligible for social security, holding it alongside CASS membership offers additional advantages: it opens the door to private clinics and broader medical provision, and it bridges the gap left by the CASS co-payment.

Private insurance is also recommended as a means of covering services excluded from the public plan, such as dental treatment, optical care, and procedures undertaken abroad. The CASS-managed public system provides only limited support for dental and vision care. Basic emergency dental treatment may attract partial reimbursement, but routine dental work and most optical services lie outside the scope of public cover.

An important point for anyone arriving from an EU country: the European Health Insurance Card (EHIC) carries no validity in Andorra. Although the Principality is geographically bordered by Spain and France, it is not a member of the European Union or the European Economic Area — the territories for which the EHIC is valid — and it cannot therefore be used for healthcare services in Andorra, whether by residents or visitors.

For up-to-date requirements regarding private health insurance for passive residents, verify directly with the Andorran immigration authority, the Govern d’Andorra. Private health insurance premiums in Andorra vary, but as a general guide, individuals can expect to pay in the region of €30–110 per month, depending on age and medical history.

How do you transfer your medical records to a doctor in Andorra?

Andorra does not participate in any centralised cross-border digital health record exchange system of the kind being developed across EU member states. Nonetheless, your new metge referent will want a clear picture of your medical background from the outset, particularly if you have ongoing conditions or established medication requirements.

Before leaving your home country, request a full medical summary from your current doctor. In the majority of countries, patients are entitled by law to access their own health records. A GP summary letter, patient discharge document, or clinical referral letter is the most practical form of record to bring with you. Ask your doctor to make it as comprehensive as possible, covering current diagnoses, medications, allergies, vaccination history, and relevant test results.

Andorra’s official language is Catalan, and most medical professionals also work in Spanish and French. While a good number of practitioners have some command of English, having your medical records translated into Catalan, Spanish, or French prior to arrival is strongly advisable, particularly for complex medical histories where precision matters. A certified translation is not always obligatory for a routine handover, but it is good practice for significant documents such as specialist reports or accounts of surgical procedures.

The CASS online portal gives registered users access to contribution certificates, employment records, benefit information, and medical reimbursement history. Once you are enrolled, your healthcare interactions within the CASS network are tracked digitally through this platform, and appointments can be booked either directly or via the portal.

For specific guidance on accepted documentation and the process for transferring ongoing prescription requirements, contact CASS directly or raise the matter with your new metge referent at your first appointment, as they will be familiar with onboarding new residents who arrive with established medical histories.

What should expats know about language barriers and finding doctors in Andorra?

Catalan is the official language of Andorra, but the country’s small size, internationally diverse population, and close ties to both France and Spain make multilingualism a common feature of medical settings. Healthcare professionals in Andorra frequently speak several languages, with English, Spanish, French, and Catalan all widely used in clinical practice.

The majority of doctors are able to consult in English, Spanish, and Catalan. This is especially true in Andorra la Vella and the more heavily populated commercial parishes, which tend to attract higher concentrations of international residents. In smaller or more rural parishes, you may find fewer practitioners who are fully comfortable consulting in English, and Spanish or French may serve as more reliable common languages.

Even where English is spoken, having a working knowledge of Spanish or French can be a real asset when navigating medical appointments. This is particularly the case in pharmacy settings, at specialist clinics, and when handling administrative paperwork, much of which is produced in Catalan.

To locate a multilingual practitioner, the CASS online portal lists all affiliated doctors, and it is entirely reasonable to contact a practice in advance to enquire about the languages a particular doctor uses in consultations. Expat networks and community groups — especially those operating on social media platforms serving Andorra’s international community — often compile informal directories of practitioners who consult in specific languages. Your country’s embassy in Madrid or Paris (which serve as the nearest diplomatic missions for most nationalities) may also be able to provide recommendations for doctors who work in languages other than Catalan and Spanish.

There is no formal public interpretation service built into the CASS-funded primary care system for routine appointments. If you anticipate needing interpretation support for a complex or sensitive consultation, it is worth making arrangements in advance — whether through a private interpreter, a bilingual companion, or by selecting a practitioner who consults in your preferred language.

What do expats need to know about prescriptions and medication in Andorra?

CASS covers up to 75% of the cost of prescription medicines (as of 2025), meaning that patients are responsible for the remaining 25% at the pharmacy counter when collecting their medication. This applies to drugs prescribed by a CASS-affiliated doctor. As with consultation costs, reimbursement rates are subject to periodic revision — always check www.cass.ad for the latest information.

Prescriptions issued in other countries are not generally accepted directly by Andorran pharmacies. If you arrive carrying an ongoing prescription from abroad, your new metge referent will need to review your medication and issue a local Andorran prescription before it can be dispensed and reimbursed by CASS. Bring a sufficient supply of any essential medication to bridge the period between your arrival and your first GP consultation.

If you are travelling to Andorra with medication, it is advisable to check with your home country’s embassy or consulate regarding applicable rules on medication allowances and any restrictions. You may be required to carry a signed letter from your GP and a copy of your prescription in your hand luggage.

Pharmacies are plentiful across Andorra and maintain high standards. Most operate standard hours of approximately 9:30am to 1:30pm and 4:30pm to 8:00pm, Monday to Saturday. A number of pharmacies operate around the clock, and these are typically identified by a red light displayed outside.

With respect to medication pricing, costs in Andorra tend to run around 10% lower than equivalent prices in Spain, a reflection of the country’s lower rate of value-added tax. This can make managing ongoing prescription needs cost-effective for residents, provided they are enrolled in CASS or hold supplementary private insurance to offset their share of costs.

For detailed information on which medications are eligible for reimbursement, applicable coverage thresholds, and rules governing controlled substances, the Andorran Ministry of Health (www.govern.ad) and the CASS website are the authoritative sources. Pharmacists in Andorra are generally well informed and approachable, and can advise on locally available equivalents if a specific brand is not in stock.

Frequently asked questions

What should I do in a medical emergency in Andorra?

Emergency services in Andorra are accessible to all individuals, including those without insurance cover. The number to call for a medical emergency is 116. The Hospital Nostra Senyora de Meritxell in Andorra la Vella operates a round-the-clock emergency department. CASS contributors will have their emergency treatment costs handled at the standard co-payment rates. Those without insurance cover will be liable for the full cost of treatment.

Does CASS cover pre-existing medical conditions?

CASS functions as a social insurance scheme and does not impose the kind of pre-existing condition exclusions that private insurers sometimes apply. Once registered and contributing, your existing health conditions should be covered at the standard co-payment rates. For complex conditions requiring specialist intervention or treatments not available within Andorra, agreements with hospitals and medical centres in Spain and France allow for cross-border referral. In such cases, the Andorran resident is referred by their GP, the appointment is arranged through CASS, and the corresponding percentage of costs is reimbursed.

How long does it take to register with CASS and get a doctor?

In most circumstances, healthcare access becomes available as soon as contributions commence. CASS registration is typically processed once a residency permit and NIA are in place. Nominating a metge referent is a direct process — once your preferred doctor confirms they are accepting new patients, the nomination can be finalised promptly through the CASS online portal. Allow a few days for administrative processing, and keep your CASS card on your person once it has been issued.

What happens to my healthcare cover if I stop working in Andorra?

CASS entitlement is tied to active contributions. If you leave employment or cease self-employment and move to passive residency status, you will no longer qualify for CASS cover and will be required to hold private health insurance as a condition of lawful residency. It is essential to arrange private cover before your CASS contributions come to an end, so as to avoid any interruption in healthcare access. Contact CASS directly for advice tailored to your individual circumstances.

Can my family members be covered by my CASS registration?

A single CASS contribution extends to cover financially dependent family members, including minor children, students up to the age of 25, and spouses with no independent income of their own. This provides reassurance for the whole household and broadly mirrors the family-based coverage models found in other European countries, where one working member’s contributions encompass dependent relatives.

Is it possible to see a specialist directly without going through a GP first?

The system does permit patients to choose both a primary care physician and a specialist without necessarily obtaining a GP referral first. However, the CASS reimbursement pathway favours patients who access specialists via their referring doctor, offering a higher rate of reimbursement for those who follow this route. Attending a specialist without a referral is allowed but may result in a reduced CASS reimbursement. Always verify the implications with CASS before booking a direct specialist appointment.

Does Andorra have any agreements that let me use my CASS cover in neighbouring countries?

Andorra has concluded bilateral social security agreements with Spain (1982) and France (2000). These treaties prevent double contributions and allow for the aggregation of contribution periods relevant to pensions and disability benefits. By virtue of these agreements, along with a further arrangement with Portugal, Andorran residents can access healthcare when visiting those countries. Before travelling, you can visit a CASS office or log into the online portal to download a certificate confirming your cover while abroad.

Do I need to re-register with a new doctor if I move to a different parish within Andorra?

Andorra is a very small country comprising seven parishes, and there are no rigid catchment area rules that compel you to change your referring doctor simply because you have moved. That said, once you are settled in a new parish, selecting a practitioner closer to your new home is sensible and will spare you unnecessary travel when you are unwell. Any change to your metge referent is handled through the CASS online portal. Consult www.cass.ad for the current procedure.