Andorra – Elderly Care

How are elderly people regarded and treated in Andorra?

Andorra has a longstanding tradition of honouring and respecting older members of society, consistent with the wider cultural values characteristic of the Pyrenean region. The family unit remains central to how care is organised in practice, with relatives commonly taking an active role in the day-to-day support of elderly parents and grandparents. Nevertheless, as the population grows older and social patterns evolve, formal care services have assumed an ever more important position alongside family-based arrangements.

The wellbeing and quality of life of older people have been recognised as a key priority within Andorra’s public policy landscape, with the Social Department committed to a cross-cutting approach to ageing that encompasses plans for comprehensive care and the promotion of active, healthy ageing. The capital, Andorra la Vella, is a member of the WHO’s Age-Friendly Cities network, which reflects an institutional determination to ensure that the built environment and public services actively support older residents.

Demographers have predicted that the elderly population in Andorra will grow faster than that of any other European nation, driven by rising life expectancy and declining birth rates. In 2022, adults aged 65 and over accounted for 15% of the population, but this proportion is forecast to reach 37% by 2050 — the highest among comparable nations, according to UN projections. This profound demographic shift is driving significant reforms in how the country prepares for elderly care, with a transition away from purely family-centred models towards a more structured combination of community, state, and private provision.

The support framework, which has been strengthened considerably in the wake of the Covid-19 pandemic, encompasses home care, teleassistance, day centre activities, and broader social programmes. The Red Cross plays a prominent role in identifying and reaching isolated elderly people through initiatives such as the Sempre Acompanyats (Always Accompanied) programme, which assists those with limited social networks, alongside teleassistance and housing-related services. This approach broadly echoes the community-care models seen in Nordic countries, where keeping older people connected to their local surroundings is regarded as equally important as clinical treatment.

What state or publicly funded elderly care is available in Andorra?

The cornerstone of public support for elderly residents is the CASS — the Caixa Andorrana de Seguretat Social — a centralised public institution responsible for the administrative, financial, and technical management of the entire social security and health system. CASS operates a co-payment model rather than a fully state-funded NHS-style arrangement: residents contribute to CASS through payroll deductions and in return receive subsidised healthcare and, in due course, a retirement pension.

Under the CASS framework, consultations with general practitioners are covered at 100%; specialist consultations at a minimum of 75%; examinations and diagnostics generally between 75% and 90%; and hospitalisation up to 90%, with no requirement to pay the full amount upfront and then seek reimbursement. This level of subsidy is broadly comparable to the social insurance systems operating in France or Germany, where contributions made during working life build entitlement to healthcare in older age.

A social cohesion threshold (LECS) exists to protect those on lower incomes, and the Ministry of Social Affairs administers the associated social assistance programme. The Andorran government has recognised the need to expand elderly care services and has put in place a range of policies to support the development of new facilities, together with financial assistance for families unable to meet the costs of care unaided.

At the end of 2025, CASS was paying an average monthly retirement pension of €1,222 to 9,304 beneficiaries who had contributed for more than 20 years. The average monthly payment across the entire retirement branch stood at €823.48, a notable increase on prior years. Current rules, in place since 2014, grant retirement benefits after 15 years of contributions at age 65, with early retirement from age 61 available following 40 years of contributions.

Eligibility for CASS-funded support depends primarily on employment history and residency status. Readers should consult the official CASS website (cass.ad) and the Ministry of Social Affairs for current eligibility criteria, income thresholds, and benefit levels, as these figures are subject to change.

What residential, care home, and nursing home options exist in Andorra?

Residential homes represent one of the most widely chosen options for elderly people in Andorra. These facilities offer a broad range of services and activities designed to help residents preserve their independence and maintain a good quality of life, including assistance with activities of daily living such as bathing, dressing, and eating, as well as medication management, housekeeping, and transport services.

Among the recognised residential homes in Andorra is La Font del Ferro. Care homes offer a higher level of support than standard residential homes and are suited to those who require more intensive assistance with daily living; they typically provide nursing care, physiotherapy, and occupational therapy. One of the most notable care homes is the Centre Geriàtric Les Pirenees, situated in the town of Ordino, where staff are committed to fostering a welcoming and supportive atmosphere and delivering a wide range of activities to encourage socialisation and mental engagement.

Elderly patients may also be cared for at the Centre Geriàtric Sant Vicenç d’Enclar, a private geriatric centre with 50 beds. Both El Cedre and Centre Geriàtric Sant Vicenç d’Enclar provide care for elderly and disabled individuals. For those requiring the highest level of clinical support, nursing homes offer 24-hour nursing care and are appropriate for residents with extensive medical needs.

Elderly care services in Andorra are broadly of a high standard, with considerable emphasis placed on creating a warm and welcoming atmosphere for residents. However, the number of elderly care facilities in the country is limited, and as a consequence there are frequently waiting lists for admission. This is an important practical consideration for anyone planning a move to Andorra: the Principality’s small size means that care places are finite while demand continues to grow. Planning well in advance is strongly advisable.

The Servei Andorrà d’Atenció Sanitària (SAAS) is the public body with responsibility for overseeing healthcare delivery in Andorra. SAAS manages the hospital and primary healthcare centres, was established in 1986 with the sole purpose of providing health services to all residents of Andorra, and oversees all public healthcare resources. Inspection and oversight of care facilities falls under the remit of both SAAS and the Ministry of Social Affairs; readers should check both bodies’ official channels for current accreditation information.

How much does elderly care cost in Andorra?

Andorra does not publish a single standardised national fee schedule for elderly care, and costs vary considerably between providers, facility types, and the level of care required. The overall cost of living in Andorra is generally estimated to be around 20–30% lower than in major cities across Western Europe, which may render some care costs more competitive than in comparable European capitals — though luxury establishments and private nursing care can still represent a significant financial commitment.

For home care services — including assistance with daily living, teleassistance, and day centre attendance — costs depend on the number of hours required and the provider involved. State-subsidised home care through CASS or the Ministry of Social Affairs is available to eligible residents and may be provided at reduced or no direct cost, depending on income. Private home care agencies typically charge by the hour or via care packages, and you should request current fee schedules directly from providers.

Residential care homes and assisted living facilities generally charge a monthly fee covering accommodation, meals, and a defined level of personal care. Nursing homes offering full clinical care command the highest fees. While verified published fee tables for Andorran facilities are not centrally collated, anyone without CASS subsidy entitlement should budget substantially for private nursing home care. Always request written fee breakdowns from facilities directly, and clarify what is and is not included — ancillary services such as physiotherapy, specialist nursing, or memory care may attract additional charges.

Around 22% of retirees aged 65 and over in Andorra are considered at risk of poverty, a figure higher than the overall poverty risk of 13% — a reminder that pension income alone may not cover the full cost of residential care, particularly for those who have not made long-term CASS contributions. Financial planning ahead of any move is therefore essential. For the most up-to-date cost guidance, contact the Ministry of Social Affairs (aferssocials.ad) or individual providers directly.

Can expats access elderly care in Andorra, and are there any restrictions?

Access to publicly funded or subsidised elderly care in Andorra depends principally on your residency status and your history of CASS contributions. The distinction between active and passive residency is critical in this regard, as the two pathways carry very different entitlements to care.

The Andorran social security system, known as CASS (Caixa Andorrana de Seguretat Social), functions much like a ministry for social security, overseeing all economic and administrative matters relating to the social security system and the public pension scheme. Passive residents do not contribute to the social security system in Andorra and are instead required by immigration law to maintain a private health and disability insurance policy at all times to cover their healthcare needs. This means that most retirees who arrive on a passive residency permit — the most common route for those not in employment in Andorra — are not enrolled in CASS and consequently cannot access CASS-subsidised care unless they have a prior contribution history.

To qualify for a CASS pension, you generally need to have worked for a minimum of 5 years in Andorra in the period leading up to retirement, provided you remain a resident throughout that retirement period. If you leave Andorra to retire elsewhere, entitlement to a pension will only arise after 15 years of employment there.

Social security agreements with France and Spain specify that individuals are subject to the social security legislation of the country in which they work, regardless of nationality, encompassing salaried and self-employed workers, insured persons without current activity, and public employees whether active or retired. Andorra has also concluded social security agreements with other countries, the most significant being those with France and Spain. If you have contributed to a social security system in another country with which Andorra has a bilateral agreement, some cross-border entitlements may apply — always verify your specific circumstances directly with CASS.

There is no formal distinction in access to public care based on EU versus non-EU nationality as such; what matters is legal residency status and contribution history. Residency in Andorra is open to individuals of all nationalities, with no restrictions based on citizenship. However, non-EU nationals may face additional administrative requirements when demonstrating financial self-sufficiency for passive residency applications.

What private elderly care and international options are available in Andorra?

Given the Principality’s compact size, Andorra’s private elderly care market is more limited in scope than those found in larger neighbouring countries such as France or Spain. Nonetheless, Andorra maintains a strong commitment to delivering high-quality elderly care services, and while the number of available options is modest, the facilities that do exist are staffed by dedicated and highly trained professionals.

The Centre Geriàtric Sant Vicenç d’Enclar operates as a 50-bed private geriatric centre and stands as one of the principal private facilities in the country. Private care homes in Andorra typically maintain a higher staff-to-resident ratio than those reliant on public funding, and many offer a comprehensive range of therapeutic activities, including physiotherapy, occupational therapy, and social programming.

Andorra does not currently have a significant international or expat-focused retirement community sector of the kind found in parts of Spain or Portugal. Those who require care in a language other than Catalan, Spanish, or French may find options limited, and it is worth enquiring directly with individual facilities about their staff’s language capabilities. The Principality’s geographical position — bordering France to the north and Spain to the south — means that some expats choose to access private care or specialist facilities across those borders, particularly for memory care or highly specialised nursing needs, with costs potentially reimbursed in part by CASS where bilateral agreements apply.

A notable characteristic of the Andorran system is that private insurance grants access to the same medical centres used by patients covered under the public health system, with private insurers simply responsible for meeting the patient’s share of the bill. This means the quality gap between public and private care access is narrower in Andorra than in many other countries, where the two streams may involve entirely separate facilities.

What role does health insurance play in covering elderly care in Andorra?

Health insurance occupies a central and, for many expats, legally mandatory role in accessing care in Andorra. The system operates along two parallel tracks: CASS coverage for active residents and workers, and private health insurance for passive residents and others who are not enrolled in CASS.

Passive residents do not contribute to the social security system and are required by immigration law to maintain a private health and disability insurance policy at all times. They are also required to arrange a pension scheme with an Andorran entity as part of passive residency requirements, although this obligation differs for those aged over 65.

The healthcare system in Andorra is built on a co-payment model: individuals visiting a doctor are responsible for paying 25% of the medical bill, with the remainder met by CASS. For those covered by private insurance rather than CASS, the policy pays the patient’s portion of the bill at the same medical centres accessed by CASS-enrolled patients. A well-structured private policy can therefore deliver a comparable standard of access to acute healthcare.

However, long-term residential care — including nursing home stays, assisted living, memory care — is generally not covered in full by standard health insurance policies. When evaluating any private insurance policy for retirement in Andorra, scrutinise carefully for explicit coverage of: residential nursing care, assisted living, dementia care, respite care, and repatriation should you require care in another country. Policies vary considerably, and a specialist expatriate or long-term care insurance broker can assist in identifying policies suited to elderly residents in a small principality. Standard travel or expat medical insurance is unlikely to provide adequate cover for sustained elderly care requirements.

What should expats consider when planning for elderly care in Andorra?

Planning for elderly care as an expat in Andorra calls for careful attention to legal, financial, and practical considerations well before care is actually required. The relatively small care sector and frequent waiting lists make early research and preparation especially important.

1. Understand your residency status and its care implications. Whether you hold active or passive residency determines your CASS entitlement. Your social security obligations vary depending on the type of residency you secure when relocating to Andorra. Clarify your position with CASS or an immigration specialist before making the move.
2. Review your insurance coverage carefully. Ensure that any private health or long-term care policy explicitly covers residential elderly care, not merely acute medical treatment. Request written confirmation of what is and is not included before signing any contract.
3. Research care facilities in advance. There is often a waiting list for admission to care facilities in Andorra. Visiting establishments and registering interest early — potentially years in advance — can be decisive, particularly for nursing home places.
4. Establish legal documents for future incapacity. Andorra has its own legal framework governing power of attorney, advance care directives (known in Catalan as voluntats anticipades), and next-of-kin rights. Ensure these documents are prepared under Andorran law and that the rights of foreign nationals are clearly established. A local notary or solicitor experienced in expat matters is essential.
5. Plan financially for care costs. Pension income — whether from CASS or from overseas — may not be sufficient to cover full residential care costs. Passive residents can receive private or public pensions with tax advantages, subject to the provisions of any applicable double taxation agreement. A financial adviser conversant with Andorran regulations can help structure income and assets to meet care costs in the most efficient manner.
6. Consider language and cultural needs. Catalan is the official language of Andorra, and while the government has modernised many processes, Catalan remains the language of official documentation, requiring translations for formal purposes. Confirm the language capabilities of staff at any care facility you are considering, particularly if you or a family member may eventually experience communication difficulties due to dementia or other conditions.
7. Seek specialist legal and financial advice. The interplay between Andorran law, bilateral social security agreements, and your home country’s rules on pensions, assets, and inheritance can be highly complex. Always consult a local legal or financial adviser with experience of expat situations in Andorra before taking major decisions.

What are the best official sources of information on elderly care in Andorra?

Since fees, eligibility rules, and care facility listings change on a regular basis, it is essential to verify all information through official channels. The following authorities and resources are the most relevant for anyone seeking guidance on elderly care in Andorra.

• CASS (Caixa Andorrana de Seguretat Social): The primary body responsible for social security, health coverage, and pensions. cass.ad — for current contribution rates, pension entitlements, and healthcare reimbursement rules.
• Ministry of Social Affairs (Ministeri d’Afers Socials): The Ministry of Social Affairs administers social assistance programmes throughout Andorra. Visit aferssocials.ad for information on care home regulation, elderly support programmes, and financial assistance schemes.
• SAAS (Servei Andorrà d’Atenció Sanitària): SAAS manages the hospital and all primary healthcare centres, and holds responsibility for overseeing all public healthcare resources in Andorra. It is a key point of contact for enquiries about regulated healthcare and care facility standards.
• Government of Andorra (Govern d’Andorra): The official government portal at govern.ad provides access to legislation, residency information, and links to all relevant ministries.
• Andorra la Vella municipality: As a member of the WHO Age-Friendly Cities network, the capital’s social services department provides community-level support, day centre information, and local welfare services for older residents.
• Red Cross Andorra: Runs social support programmes including teleassistance and the Sempre Acompanyats scheme for isolated elderly people. Contact them for information on community-based support options.

Always confirm specific fees, current eligibility criteria, and facility availability directly with these bodies or with individual care providers, as information changes frequently and no third-party guide — including this one — can serve as a substitute for up-to-date official guidance.

Frequently Asked Questions About Elderly Care in Andorra

Is elderly care in Andorra free for residents?

Elderly care in Andorra is not entirely free, but it is substantially subsidised for those enrolled in CASS. The system operates on a co-payment basis: patients are responsible for 25% of medical bills, with CASS meeting the remainder. Residential nursing care typically involves additional direct charges on top of this. Those on passive residency are not enrolled in CASS and must fund their care primarily through private insurance or personal resources.

Can I access Andorran state care if I have just moved there?

Access to CASS-funded care depends on your residency type and your contribution history. To qualify for a CASS pension, you generally need to have worked for a minimum of 5 years in Andorra in the period leading up to retirement, provided you remain a resident throughout. Newly arrived passive residents will have no CASS entitlement and must rely on private insurance. Check the current rules at cass.ad.

What happens if a family member living abroad suddenly needs emergency residential care in Andorra?

In a medical emergency, the Hospital Nostra Senyora de Meritxell and Andorra’s primary care network will provide acute treatment. However, transitioning into residential elderly care at short notice is difficult given the limited number of places and the frequent waiting lists for admission. It is strongly advisable to research facilities and register interest well in advance of any anticipated need, and to ensure that comprehensive private insurance is in place before relocating.

Are there care facilities in Andorra that cater to residents who do not speak Catalan or Spanish?

Andorra’s official language is Catalan, and most care staff will also speak Spanish and French given the country’s geographical position. However, Andorra does not currently have dedicated facilities specifically catering to other language communities. Challenges in this area include overcoming barriers to seeking help and broadening the range of complementary services available. If language support is a priority, contact individual facilities directly about their staff’s language capabilities before committing to a placement.

What is the quality of care like in Andorran nursing homes?

Elderly care services in Andorra are broadly of a high standard, with a strong emphasis on providing a warm and welcoming environment for residents and delivering a range of services tailored to individual needs. Andorra is committed to high-quality elderly care, and the facilities that operate in the country are staffed by dedicated and well-trained professionals who work to deliver the best possible experience for their residents. Oversight and regulation are the responsibility of SAAS and the Ministry of Social Affairs.

Does Andorra have memory care or dementia-specialist facilities?

Andorra’s geriatric centres provide care for residents with dementia and age-related cognitive conditions within their general nursing home provision. However, given the small number of facilities in the country, highly specialist dementia units of the kind found in larger nations are limited. Some families opt to explore cross-border facilities in France or Spain for specialist memory care, which may in certain circumstances be partially covered by CASS under bilateral agreements. Confirm the available options with CASS and individual providers.

What financial documents do I need to arrange before moving to Andorra for retirement?

Requirements for passive residency include a criminal record certificate duly apostilled, a valid passport (EU/EEA nationals may use a national identity card), a medical examination through the Andorran Immigration Medical Service, and proof of accommodation. You will also need to demonstrate sufficient income — retirement applicants must show annual income equivalent to at least 400% of the Andorran minimum wage and invest a minimum of €600,000 in Andorran assets (as of 2024 — verify current thresholds with the Andorran government). Private health insurance documentation is also a mandatory requirement for passive residents.

Do bilateral agreements between Andorra and other countries affect elderly care entitlements?

Andorra has concluded social security agreements with several countries, most notably France and Spain, generally structured on the basis of reciprocity so that an individual can receive social security care in the other country with the costs charged to the state of the country of residence. If you have contributed to a social security system in France, Spain, or another country with which Andorra has a bilateral agreement, certain entitlements may carry over. This is a complex area; always confirm your specific situation directly with CASS and the relevant authority in your home country.