ProGestió
Andorra
Understand the Andorran healthcare system: CASS, the preferred pathway, doctors, the hospital, emergencies, care abroad, and private insurance.
Content reviewed by the legal and tax team of ProGestió Andorra — Last updated:
Andorra’s healthcare system is built around CASS, contracted healthcare professionals, health centres, and the Servei Andorrà d’Atenció Sanitària (SAAS), which manages, among other things, the Nostra Senyora de Meritxell hospital.
For a new resident, the main question isn’t just whether a hospital exists. You need to work out your type of cover, the care pathway, the level of reimbursement, and the conditions for accessing facilities in France or Spain.
Working residents are generally registered with CASS. Holders of certain non-working residency permits need to take out compliant private insurance.
| Player | Role |
|---|---|
| CASS | Social security, registration, and reimbursement of benefits |
| SAAS | Public healthcare organisation, hospital, centres, and emergencies |
| Contracted doctors | Professionals signed up to CASS rates and pathways |
| Referring doctor | Entry point for the preferred pathway |
| Supplementary insurance | Covers the remaining out-of-pocket cost, depending on the policy |
| Private residency insurance | Cover required for certain permits without active registration |
Those affected include, in particular:
Registering a spouse or children isn’t automatic. An indirect beneficiary application may be needed, along with family, residency, and dependency evidence.
Someone without an activity shouldn’t assume they’ll be covered by CASS. Their permit may require private insurance covering healthcare in Andorra.
The preferred pathway organises the patient’s journey around a referring doctor. It aims for coordinated care and affects certain reimbursement levels.
The general pathway can include:
1. choosing a referring doctor;
2. an initial consultation;
3. referral to a specialist or a test;
4. using a contracted professional or centre;
5. submitting documents to CASS. Stepping outside this pathway, or consulting a non-contracted provider, can significantly reduce reimbursement. CASS notes, for example, reimbursement limited to 20% of the reference rate for certain procedures carried out with non-contracted foreign providers.
Percentages vary depending on the procedure, the pathway, the provider, and the condition.
CASS publishes, in particular, reimbursement levels for the preferred pathway, enhanced cover for certain conditions, and mechanisms that can reach 90% or 100% in specific cases.
Before a significant procedure, it’s worth checking:
The percentage is often applied to a reference rate, which can differ from the price actually billed.
Andorra has contracted private practitioners and primary care centres across several parishes.
The centres provide, in particular, local care, prevention, follow-up, and referrals. The SAAS website publishes up-to-date contact details and opening hours.
The referring doctor can be chosen from among professionals taking part in the scheme. This choice makes it easier to access the preferred pathway.
The Nostra Senyora de Meritxell hospital is the Principality’s only hospital. It handles emergencies, hospitalisation, critical care, specialist consultations, and various medical services.
For an emergency, the service is available 24 hours a day. SAAS recommends, where the situation allows, calling 116 before travelling, to be properly directed.
Certain highly specialised care may require a referral to a partner centre in Spain or France.
CASS organises cover arrangements for planned care or emergencies abroad, particularly in countries linked by agreements.
Before planned medical travel, it’s necessary to check:
For an emergency during a temporary stay in Spain, France, or Portugal, specific procedures apply. Documents need to be requested and kept.
These two products don’t serve the same need.
Supplementary insurance works alongside CASS to cover part of the remaining out-of-pocket cost, depending on the policy.
Private insurance required by certain permits needs to provide cover meeting immigration criteria, particularly for illness and, depending on status, other risks.
Before subscribing, it’s necessary to check:
A family needs to organise cover before relocating. It’s necessary to check, in particular:
Financial benefits linked to maternity or paternity follow contribution conditions separate from simple medical cover.
1. Identify your status: employee, self-employed, dependant, or private insurance.
2. Check the start date of your cover.
3. Register family members.
4. Choose a referring doctor.
5. Compare supplementary cover based on your needs.
6. Keep useful prescriptions and medical records.
7. Check the procedures for care abroad.
8. Save emergency numbers and CASS contact details.
Does CASS reimburse 100% of care? Not automatically. The level depends on the procedure, the care pathway, the condition, and the provider.
Can you see a specialist directly? It may be possible, but the preferred pathway and reimbursement may require a referral.
Is care in France or Spain covered? Yes, in certain situations, particularly through contracted centres or emergency procedures, subject to the required steps.
Is a passive resident covered by CASS? Not automatically. They generally need the private insurance required by their permit.
To go further: Active residency, Passive residency, Moving to Andorra with family, Administrative management.
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