Living in Spain as an American: Health, Banking, Voting, Passport

Living in Spain as an American means taking on Spanish administration while several US obligations stay in place: your passport, your vote and your tax return keep working through US channels, and your health cover, bank account and address registration move to Spain. This page covers each, using the government source that sets the rule.

Health care: a Spanish route or private insurance

Your route depends on your status, and the full breakdown is in healthcare in Spain for expats. The one that fits many non-working Americans is the convenio especial, a public-system subscription. The Ministerio de Sanidad requires one year of effective residence in Spain, registration at a Spanish town hall, and no access to public health protection by another route. It costs €60 a month under 65 and €157 from 65.

Until you qualify, visa holders buy private insurance. The non-lucrative visa asks for a policy with no deductible, copay or waiting period (see the insurance guide).

Registering where you live: the padrón

Article 15 of the Ley 7/1985 says every person who lives in Spain must register in the padrón of the municipality where they habitually reside. It is free, and it is a record of residence, not an immigration status. A non-EU citizen without long-term residence must renew the registration every two years, according to Valencia’s procedure. The padrón guide lists the documents and the renewal rules.

Banking

Any bank in Spain must identify you with an official document and needs your tax number, the NIE, to open an account. If you legally reside in the EU and a bank refuses, Real Decreto-ley 19/2017 gives you a right to a basic payment account. The banking guide covers documents, the fee cap and how to complain.

Opening a Spanish account has a US consequence: Americans must report foreign accounts to the US Treasury and the IRS above set thresholds. Those rules are in US taxes for Americans in Spain.

Voting in US elections from Spain

Most US citizens aged 18 or older living abroad can vote absentee in federal elections, according to the U.S. Embassy in Spain. The process:

1. Register and request a ballot with the Federal Post Card Application (FPCA), which does both. The embassy says to submit a new one each year, every time you move, and whenever you change your address, email or name.
2. Return it by mail, or by fax or email if your state allows it.
3. Verify your registration with your local election officials.
4. Your state sends a blank ballot 45 days before the November elections, by email, fax, mail or online download, depending on the address on your FPCA. For primaries, special and run-off elections, ballots usually go out 30 days before.
5. Return the ballot before your state’s deadline.

The embassy sends voters to FVAP.gov, whose online assistant walks you through the FPCA, and to its Voting Assistance Guide for state-by-state rules.

Renewing your US passport in Spain

The U.S. Embassy in Madrid renews most adult passports by mail, without an appointment (form DS-82). Fees from the embassy’s page:

Service	Fee
Adult passport renewal (DS-82), book	$130
Adult passport card, added to a renewal	$30
First-time adult passport or lost, stolen or damaged (DS-11)	$165
Minor passport (DS-11)	$135

The consular section takes only online payment, and you print the payment confirmation and include it in the package. In April 2026 the embassy said processing took 4 to 5 weeks. Children’s passports are valid for 5 years, not 10, and children under 16 apply in person with their parents. For urgent travel the Madrid embassy can issue an emergency passport to walk-in applicants, with proof of travel.

Social Security: the US-Spain totalization agreement

The agreement covers the Spanish general social security system for disability, old age, death and survivors, and several special systems including the self-employed. The SSA’s rules:

• Self-employed: a person who resides in Spain is assigned Spanish coverage, and one who resides in the US is assigned US coverage. Someone who transfers a business to the other country for five years or fewer stays under the original country.
• Combining credits: to count Spanish credits toward a US benefit, you need at least six US credits (about 1.5 years of work). To count US credits toward a Spanish benefit, you need at least one year of coverage under the Spanish system.
• Where to claim: from Spain you can contact the Federal Benefits Unit at the U.S. Embassy in Madrid or any Spanish social security office, and ask for the application to count as a claim in the other country.

Taxation of your benefits is a separate question, covered in the tax guides.

What things cost

The cost gap depends on the category, and surveys of spending are not price lists. On the official surveys, per person: groceries are about the same (€2,301 in the US in 2024, €2,255 in Spain in 2025) while transport is about three times higher in the US (€4,924 against €1,611). The comparison, with its limits, is in cost of living: Spain vs USA.