Private healthcare in Andorra could become more expensive for some insured individuals: the Health Department is considering withdrawing reimbursement from the CASS (Andorran Social Security Fund) under the 20% plan for private medical procedures included in the analysis. The proposal has not yet been approved and is part of a broader plan that also aims to regulate healthcare referrals abroad.
Key data
- The measure is being analyzed within the Action Plan for the sustainability of the health system.
- During 2023, this bonus represented a public expenditure of 222,500 euros.
- The map of resources and care circuits outside of Andorra is planned for 2026.
- Implementing the change would require amending the Social Security Law.
What has the Health Department announced regarding the CASS reimbursement?
The Ministry of Health is considering modifying or eliminating the 20% reimbursement system for private medical procedures included in the proposal. The stated aim is to reduce public spending and correct the distortions that, according to technical teams, this system can create within the public healthcare system.
The proposal is included in the Action Plan for the sustainability of the health system, a document dated February and presented during the last follow-up meeting of the National Pact for the quality, efficiency and sustainability of the health system.
The measure is currently under review. It has not yet been approved nor formally presented as a finalized reform. Therefore, the current percentage cannot be considered eliminated.
Quick answer: The Health Ministry is considering eliminating the 20% reimbursement from the CASS for certain private medical procedures in order to contain public spending and review the functioning of the healthcare system.
Why is Andorra considering eliminating this coverage?
The main reason is economic. According to published information, this bonus generated an expenditure of €222,500 for public coffers during 2023. The Health Department and the CASS (Spanish Association of Social Services Companies) want to analyze the cost of these actions and the effects of the co-financing system.
The technical teams believe that co-financing private medical procedures could disrupt the functioning of the public healthcare system. For this reason, the feasibility and impact of the reform will be studied, taking into account that it would directly affect users.
The analysis should assess the advantages and disadvantages of the measure, as well as its impact on people who use these services. The source text does not yet specify how the cost would change for each patient.
How does reimbursement currently work for private medical procedures?
The proposal stems from the reimbursement of certain private medical procedures under the 20% tax. The available information does not specify whether all private services have exactly the same conditions or if there are any exceptions.
The 20% data should be interpreted within the context of the measure being studied by the Ministry of Health. It does not allow us to conclude that all private consultations are covered in this way, nor that the potential elimination would affect all medical care indiscriminately.
Insured individuals who need to know their current coverage should request information directly from CASS and consult the conditions applicable to each medical procedure.
What steps are needed for the elimination to be effective?
The Health Department and the CASS have already established a roadmap. The first step will be to conduct a detailed analysis of the costs associated with these private procedures. The study should include the advantages and disadvantages of the measure and its direct impact on users.
If the findings are favorable, a formal proposal would be prepared. Implementing the change would require amending the Social Security Law, so the decision would not depend solely on an administrative instruction.
The source text does not establish a definitive timetable for its entry into force, nor does it specify possible exceptions, limitations, or compensatory measures. These details will only be known if a legislative proposal is submitted.
What impact could this have on those who live or work in Andorra?
The most direct effect would be a potential increase in costs for users of the affected private medical services. The specific impact would depend on the services ultimately included in the reform and the approved conditions.
- Maintenance of the current system: The current refund for the included acts would be retained, subject to applicable conditions.
- Percentage modification: The patient would assume a different portion of the price, depending on the change that was approved.
- Elimination of refund: Users would have to assume the amount corresponding to the affected private acts, unless other coverage was established.
The analysis must also consider that the measure would directly affect users. The source text does not yet confirm whether exceptions would be approved for specific patients, treatments, or income levels.
Andorra is also preparing a map of medical referrals abroad
The second component of the plan involves creating a map of priority healthcare resources and pathways outside of Andorra. This tool is expected to be ready by 2026 and will be used to streamline medical referrals abroad.
CASS maintains agreements with various foreign institutions. According to published information, medical professionals are often unaware of the true cost of tests, which can lead to price differences between centers for the same medical procedure.
The aim is to prioritize healthcare pathways based on the economic cost to each collaborating institution. Available information does not indicate that medical care outside of Andorra will be eliminated altogether.
The map is not yet finalized, and the specific centers that will occupy the top positions have not been published. Therefore, it is not possible to determine which institutions will be prioritized.
How will it be decided which foreign centers will be given priority?
The work will be carried out by a team comprised of representatives from the Ministry of Health, CASS, SAAS, and the College of Physicians. Its members will analyze and compare the rates of collaborating foreign institutions before finalizing the map.
According to the published information, economic cost will be the filter used to prioritize the circuits. The source text does not specify whether other criteria will be applied or how each would be weighted.
The impact of the measure will be evaluated by the percentage of medical procedures successfully redirected to the established channels. This indicator will allow us to measure the effectiveness of the system.
Will the healthcare reform affect foreign residents?
The available information does not establish differences based on nationality. The potential modification would affect CASS users who utilize private medical services included in the reform, according to the approved conditions.
The specific impact will depend on CASS membership, the type of medical procedure, and the final wording of the regulations. No exceptions or specific measures for particular groups have yet been announced.
Individuals requiring private medical services can consult CASS regarding current conditions and the applicable percentage for each medical procedure. Final conditions will only be available once a specific regulatory proposal is presented.
The official information of the CASS It will be the appropriate reference to know the current coverages.
What should patients and residents do now?
- Consult the CASS regarding the applicable reimbursement percentage before undergoing a private medical procedure.
- Ask about the conditions and the necessary documentation.
- Request information from the medical center about the cost of the procedure to be performed.
- Follow the communications from Health, the CASS and the Official Gazette of the Principality of Andorra to be aware of any legal changes.
These measures provide information on current coverage, but do not anticipate the content of a potential reform. Definitive information will depend on the analysis by the Health Service and the CASS (Social Security Administration) and, if necessary, on amendments to the Social Security Law.
Conclusion: a reform still open
The potential elimination of reimbursement under the 20% program is part of a broader review of Andorra's healthcare system. The proposal combines two approaches: examining which private medical procedures should continue to receive funding and prioritizing referrals to foreign institutions through cost comparisons.
The change still requires an economic analysis, an assessment of its impact on patients, and, if the outcome is favorable, an amendment to the Social Security Law. There is no final text yet, nor are any exceptions confirmed.
Users can check their current CASS coverage and follow official communications while the plan is being developed. The final decision will depend on the results of the analysis and any proposed regulations that may be presented.
To plan a move, an investment, or the creation of a business in the country, you can contact Andorra Insiders and receive guidance on residency, taxation, insurance and organizing your arrival.
Frequent questions
Has Andorra already eliminated the CASS 20% reimbursement for private medical procedures?
No. The measure is under study and has not yet been definitively approved or implemented.
How much did it cost CASS to reimburse private medical procedures in 2023?
According to the published information, this bonus generated an expense of 222,500 euros during 2023.
Will it be necessary to change the law to eliminate the refund?
Yes. If the technical analysis is favorable, it would be necessary to submit a formal proposal to amend the Social Security Law.
What is the map of medical referrals abroad?
It is a tool designed to organize healthcare circuits outside of Andorra and to prioritize collaborating institutions according to their economic cost.
Does the potential elimination only affect Andorran citizens?
The available information does not differentiate based on nationality. If approved, the measure would affect CASS users depending on the type of medical procedure and legal conditions.
Sources
- Information published on August 3, 2026 on the Action Plan for the sustainability of the health system and the measures studied by Health.
- CASS: Official information on membership and health benefits.
- Official Gazette of the Principality of Andorra, to consult future regulatory changes.
