Healthcare in Andorra, and what it costs without cover

Andorra runs a public social-security system, CASS (Caixa Andorrana de Seguretat Social), that reimburses care rather than providing it free at the point of use: typically 100% for a GP, at least 75% for specialists and around 90% of a hospital stay, with the patient paying upfront or via a third-party arrangement and claiming the rest back.

No public cover for nomads

The catch for nomads is that the digital nomad permit does not put you into CASS at all. You are required to hold private health insurance instead, so in practice nomads live entirely on private cover and private clinics, most of which work under agreement with CASS.

One hospital, referrals abroad

The whole country is served by one hospital, Hospital Nostra Senyora de Meritxell in Escaldes-Engordany (around 200 beds, +376 871 000), backed by roughly ten primary-care centres and one of the highest pharmacy densities per capita in the world, with a weekend duty rota. Catalan is the official language, though Spanish and French are widely spoken and you will find English in clinics used to international patients, less so in routine public care. The emergency number is 112, with English-speaking operators; ambulance is also reachable on 116. The part to plan for is evacuation: Meritxell handles emergencies, surgery, maternity and intensive care, but highly specialised or complex cases are referred out to partner hospitals in Barcelona, Lleida, Toulouse or Montpellier, and a genuine emergency can mean a helicopter transfer over the border. There is no airport in Andorra, so check your policy covers cross-border medical transport and treatment in Spain and France, not just care inside the principality.

For short visits, US, UK, Canadian and Australian passport holders do not need a visa for Andorra and can stay up to 90 days.

The practical wrinkle is geography: Andorra has no airport and is reachable only by road through Spain or France, both in the Schengen area, so you clear Schengen first and the Schengen 90-days-in-180 clock applies de facto. If you need to re-enter Schengen after your Andorra trip, make sure your status allows it. Andorra does not require visitors to hold travel insurance to enter, but going uninsured in a country with one hospital and helicopter referrals abroad is a poor bet.

A real remote-work route

To stay and work remotely, Andorra has a real route created under Law 42/2022 and its 2023 regulations: a residence permit for people who work entirely through telecommunications and are not tied to a location. You apply via the Ministry of Economy and immigration service, the permit runs two years initially and then renews, and the headline conditions are proof of income of roughly three times the Andorran minimum wage (commonly cited around €4,100 to €4,400 a month, plus more per dependent, so confirm the current figure at application), proof of housing in Andorra, and a commitment to be physically present at least 90 days a year. Crucially for insurance, nomads are not enrolled in CASS and must show private health insurance valid in Andorra; no fixed minimum coverage sum is published for this permit, so buy comprehensive cover that pays for hospitalisation and cross-border transfer rather than a thin policy. Note the practical hurdles too: an annual quota (commonly cited at around 50 permits), an application fee around €2,500 plus a residence-card fee around €500, and approvals that applicants report can be slow. Full detail sits on the Andorra digital nomad visa page.

• One hospital, real evacuations. Serious or specialised cases leave the country for Barcelona, Lleida, Toulouse or Montpellier, so confirm your policy covers treatment and medical transport in Spain and France, not only inside Andorra.
• No public cover as a nomad. The permit keeps you out of CASS, so there is no public safety net; your private policy is the whole of your healthcare cover.
• The Schengen clock. You can only reach Andorra through France or Spain, so your Schengen 90/180 allowance, not Andorra's own rules, is usually the binding constraint on a tourist trip.
• Winter driving. From 1 November to 15 May you must have winter tyres or carry snow chains; the on-the-spot fine is around €180, and mountain roads bring steep grades, tight bends, snow and fog.
• Altitude and terrain. The country sits high in the Pyrenees, with skiing, hiking and mountain sports that drive most injury claims, so check your policy covers your activities and the altitude.