Overview

Key points

• The Ministry of Health is responsible for the planning, regulation and management of the health system. The Andorran National Health Service (Servei Andorrà d’Atenció Sanitària, or SAAS) manages the only hospital in Andorra, 12 primary care centres, emergency care services, institutional mental health care, and residential long-term care in one of four nursing homes.
  
• General practitioners (GPs), some specialists and some allied health professionals (such as physiotherapists, speech therapists and clinical analysts) operate as self-employed providers and sign agreements with the Andorran Social Security Fund (Caixa Andorrana de Seguretat Social, or CASS).
• The CASS is responsible for the public funding of health services. It pools public funds centrally, provides social and sickness benefits, and pays health care providers for their services based on signed agreements.
• Population coverage of the social health insurance scheme is extensive, covering over 98% of residents in 2023.
• The benefits basket is comprehensive and includes some cross-border care in France and Spain (based on agreements with these countries), but there are substantial co-payments (such as 10% of hospital care costs). Nevertheless, Andorra has one of the lowest shares of health spending derived from out-of-pocket (OOP) payments in the WHO European Region, amounting to 11.0% in 2023.
• This low share is due to the very high share of current health spending that is derived from voluntary health insurance (VHI), amounting to 17.9% in 2023, higher than in any other country in the WHO European Region. Private health insurance is largely complementary, covering the cost-sharing required in the social health insurance system.
• In 2023 (the latest year with available data), 2.1% of households experienced catastrophic spending, placing Andorra in the lower range of countries in the WHO European Region.
• The Andorran health system has fewer nurses but more doctors per population than the WHO European Region on average. In 2023, all doctors working in Andorra were trained abroad, a share that was 42.2% for nurses.
• Between 2016 and 2023 life expectancy at birth in Andorra increased from 83.4 to 84.6 years, one of the highest in the WHO European Region.