Health in Andorra

The Ministeri de Salut sets health policy, public-health measures, prevention programmes, screening, vaccination and regulation. SAAS provides public and parapublic care through the CAP network, the Hospital Nostra Senyora de Meritxell (HNSM), specialist services, mental-health and addiction care, rehabilitation and other follow-up pathways. Regulated private providers and CASS-contracted services supplement this network. Atenció Primària at a CAP is the usual entry point for examinations, ongoing treatment and referrals. People generally choose a metge referent or paediatrician, and specialist access normally follows a referral through the metge referent, SUM, or an integrated-care specialist. The CASS via preferent system affects reimbursement and access conditions. A personal Targeta Sanitària is used with CASS-contracted providers and does not contain medical data. Andorra Salut with certificat digital can provide access to shared health information, pending referrals, tests and results, and result sharing. CAP appointment arrangements vary by location. Pharmacies support routine treatment, while a farmàcia de guàrdia provides urgent access to medicines outside ordinary opening times. Prevention includes childhood vaccination through paediatricians, CAP services and the Servei de Salut Escolar. The current adult immunization calendar under Decret 35/2026 took effect on 1 March 2026; listed vaccines are free through a CAP appointment and do not require a prescription. Annual influenza and COVID-19 campaigns also take place. School health services conduct periodic screening, examinations for newcomer children and infectious-disease prevention. Consulta Jove provides adolescent sexual and reproductive-health prevention. Public breast-cancer screening currently covers women aged 50 to 74 every two years with a free mammogram and follow-up for abnormalities. The Pla Oncològic Nacional 2026–2030 plans expansion from age 45 and the introduction of cervical screening. For a medical emergency, SUM 116 and HNSM provide continuous emergency service every day of the year. Call 116 for medical emergencies; call 112 for emergencies requiring the unified emergency response, while 110 reaches the Police and 118 the Bombers. Triage determines the urgency of care, so calling 116 before a non-critical emergency visit can help direct the case appropriately. Mental-health care includes SAAS psychiatry and psychology for adults and children or young people, addiction services and community services. CASS reimbursement is based on tariffs and the person’s situation rather than on a universal free-care rule. Under the via preferent basis, the stated reimbursement rates are 75% for visits, 75% for acts, tests and prescribed products, 65% for rehabilitation, 90% for inpatient care and 100% for maternity care. Non-preferent care and non-contracted providers can result in different reimbursement, including a 20% basis of the responsibility tariff for a non-contracted provider. Exact entitlement depends on the service, provider, referral and authorization. If a required specialist service is unavailable in Andorra, cross-border care may be possible after specialist referral and CASS authorization. Grounds can include a waiting time above one week for preferential care or one month for ordinary care, the absence of a local specialist, or a protected prior specialist relationship. Medical transport and accommodation normally require prior agreement from the Area de Control Sanitari; emergencies can receive approval afterwards. Bilateral urgent-care forms exist for Spain, France and Portugal. Patients have rights to understandable information, autonomy, informed consent, refusal, privacy, confidentiality, dignity, a second opinion, advance directives and access to clinical reports and data under Llei 20/2017. These rights apply in public and private care. Patients must provide truthful and complete identity and health information, follow mandatory public-health measures and individual prescriptions, use services responsibly, respect staff and other patients, and provide written refusal where required. Follow-up can involve HNSM, Andorra Salut or HCCA for pending results and referrals, rehabilitation or readaptation, palliative and geriatric services, and El Cedre for continuous stable sociosanitary residence for older or disabled people.