Short answer
If you move to Andorra with an employment contract, you are registered with the CASS, the country's social security fund, from your first day. Each benefit, though, has its own waiting period. Work accidents are covered from day 1. Ordinary illness is refunded once you have 25 days of contributions; paid sick leave needs 90 days in the last 6 months, and the birth benefit needs 6 months of registration. After 60 months, medical refunds have no waiting period at all.
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Key facts
- Work accidents and occupational illness are covered from day one, with no prior contributions
- Source: CASS
- Your first refund for ordinary illness needs 25 days of contributions; after that, up to 12 months, 15 days contributed in the previous month
- Source: CASS
- Sick pay for ordinary illness needs 90 days contributed in the last 6 months or 180 in the last 24
- Source: CASS
- The birth benefit needs 6 months of registration and 3 months contributed in the 6 before the birth
- Source: CASS
How the CASS works for a newcomer
The CASS (Caixa Andorrana de Seguretat Social) is not a free health service. You pay the doctor, then the CASS refunds part of the bill. On top of that, it asks for a minimum amount of contribution time before it pays each type of benefit. In Catalan this is the carència; in English, the waiting period.
If you come from a country where your health card works the day you get it, this is the part that catches people out. All the clocks start on the day your employer registers you. They just ring at different times.
| When | What switches on |
|---|---|
| Day 1 | Work accidents and occupational illness |
| 25 days contributed | First refund for ordinary illness, and the death grant |
| 90 days contributed in 6 months | Sick pay for ordinary illness |
| 6 months registered | Birth benefit, with 3 months contributed in the previous 6 |
| 12 months | Refunds need 10 days in the previous 2 months |
| 36 months | 5 days in the previous 3 months is enough |
| 60 months | Refunds from the first day, no waiting period |
Day 1: hurt at work, you are covered
Work accidents and occupational illness have no waiting period. If you are injured on the job in your first week, the CASS treats you like someone who has been here for years.
Tell your employer the same day and keep every medical paper. And remember the limit: flu, or a fall on the slopes on a Sunday, is not a work accident. It goes on the next clock.
Day 25: your first refund for ordinary illness
For ordinary illness, your first refund needs 25 days of contributions. Before that, the GP visit, the pharmacy and any test are on you, and the CASS will not pay them back.
That is the gap at the start. It is short, but it lands right when you are unpacking, getting used to the altitude and maybe arriving at the height of the ski season.
Months 1 to 12: the 15 day rule
Once you clear the first threshold, the CASS keeps checking. Until you reach 12 months of contributions, each refund needs 15 days contributed in the previous month. If you started mid-month, or there is a gap between two jobs, that previous month can fall short.
The bar drops as you build up time:
| Time contributed | What the CASS asks before refunding |
|---|---|
| First time | 25 days contributed |
| More than 25 days, under 12 months | 15 days contributed in the previous month |
| 12 to 36 months | 10 days in the previous 2 months |
| 36 to 60 months | 5 days in the previous 3 months |
| 60 months or more | Nothing, from day one |
How much of each bill comes back is covered in the CASS explained.
Sick pay: 90 or 180 days
Sick pay for ordinary illness has a longer wait: 90 days contributed in the last 6 months, or 180 in the last 24. Arrive in October and the first route only opens well into winter. A work accident has no waiting period.
Until you reach those 90 days, the CASS does not pay your sick days for ordinary illness. What happens to your salary in that time depends on your contract, so ask your employer before you need it. Once granted, sick leave lasts 12 months at most.
Having a baby: the 6 month clock
If a pregnancy is in your plans, there are two separate clocks. Medical costs of pregnancy and birth are paid at 100 % of the CASS tariffs. The birth benefit, which replaces your salary during leave, needs you to be registered 6 months before the birth and to have contributed 3 months in the previous 6.
Arriving pregnant does not leave you without a doctor. It can leave you without the birth benefit if the baby comes before your sixth month of registration.
The death grant
The CASS pays a lump sum to whoever pays for the funeral. It follows the same ladder as refunds: 25 days at first, then 15, 10 or 5 depending on how long you have contributed, and no wait after 60 months. Worth knowing if you move with family.
Five years in: no more refund waiting periods
With 60 months of contributions, medical refunds no longer need any prior days. That is not the state pension. The CASS retirement pension needs age 65 and 180 months of contributions, at least 12 of them in Andorra. If you move here later in your career, run the numbers early.
How to cover the first weeks
The first month is the exposed one. These are the usual options. None is compulsory if you come with a contract:
- Check what cover you carry from home. Some policies or national schemes keep you covered for a while after you leave. Ask in writing until when, and whether it works in Andorra. Our page on the EHIC in Andorra explains why the European card is not the answer here.
- A short private health policy. It bridges the gap until the CASS starts refunding. Ask for the start date and the policy's own waiting periods, because private plans have them too.
- Daily sick pay cover. If losing income worries you more than the doctor's bill, this kind of policy can cover sick days before the CASS 90 day mark.
- A top-up for later. Once inside, the CASS does not refund every bill in full. If you want to cover the difference, see private health insurance in Andorra.
Before you sign, check the insurer is licensed in Andorra on the AFA list. Not sure where to start? The Andorra insurance planner puts what you need in order, whether you come with a job, as self-employed or without work.
Questions to ask any insurer about a bridge policy:
- From which exact day does it cover me?
- Does it have its own waiting periods for visits, tests or hospital?
- Does it cover treatment in Andorra, or only abroad?
- Can I cancel it once the CASS refunds me, and with how much notice?
On the blog you will also find Family on CASS.
Frequently asked questions
What is the CASS waiting period?
It is the contribution time the CASS requires before paying a benefit. Each benefit has its own: 25 days for your first refund for ordinary illness, 90 days in 6 months for sick pay, and 6 months of registration for the birth benefit.
Am I covered if I fall ill in my first week in Andorra?
If it is a work accident, yes, from day one. If it is ordinary illness, the CASS refunds nothing until you have 25 days of contributions.
Does changing jobs reset the clock?
The ladder is measured in time contributed. What can trip you up is the previous month: under 12 months, each refund needs 15 days contributed in the month before. If there is a gap between jobs, check with the CASS.
When can I get sick pay?
Once you have 90 days contributed in the last 6 months, or 180 in the last 24. For a work accident there is no wait.
Do I need private health insurance for my residence permit if I have a job?
No. With an employment contract your cover is the CASS. A private policy for the first weeks is your choice to close the gap, not a permit requirement.
Sources
How we checked this guide
We checked every figure against the official sources listed at the end and reviewed this page on 15 October 2026. Seguros Andorra is not an insurance intermediary: we explain how insurance works, we do not sell it. If something has changed, let us know. Our method is described on how we work (in Spanish).
Keep reading
- The CASS explainedRefund rates of the CASS in Andorra, who is covered and when cover starts.
- Health insuranceHow the CASS and private health insurance fit together in Andorra.
- Private health and top-upCASS top-up or full private health cover in Andorra, and how to choose between them.
- Moving checklistThe insurances a newcomer to Andorra needs, in the order they come up.
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