Health Insurance - FAQ

Health care in Spain: What are my options?

Spain has both public and private health care system. The provision of Social Security health care is a benefit presently enjoyed by both Spanish and foreign nationals who are employed and self-employed, as they all make the equivalent contribution to the Spanish Social Security system. Public health care includes the provision of medical and pharmaceutical essential services. As well as these citizens, their dependent family members have the same right to public health care.

When is required a private health insurance?

The regulations state that foreign residents must necessarily purchase health insurance with an insurer that operates in Spain to obtain the residence card in Spain or a visa.

Am I entitled to Public Health Care as a foreign national?

In Spain, access to public healthcare is generally available to residents, including foreign nationals. However, entitlement to public healthcare can vary depending on your specific circumstances and immigration status. As a general guideline:

  1. EU/EEA Citizens: If you are a citizen of a European Union (EU) or European Economic Area (EEA) country, you may be entitled to healthcare in Spain through the European Health Insurance Card (EHIC) or the newer European Health Insurance Document (EHID). Additionally, if you are a resident, you may have access to the Spanish public healthcare system.
  2. Non-EU/EEA Citizens: Non-EU/EEA citizens may have access to public healthcare if they are legal residents in Spain. Access is often linked to social security contributions or other specific criteria. In some cases, there may be agreements between Spain and your home country that facilitate healthcare access. It’s important for non-EU/EEA citizens to inquire about the specific requirements and procedures for accessing healthcare based on their residency status. Local social security offices or healthcare authorities in the region where they reside can provide detailed information on eligibility criteria and the steps to take in order to access public healthcare services. Additionally, policies and regulations may evolve, so it’s advisable to consult with relevant authorities for the most up-to-date information.
  3. Tourists and Temporary Visitors: If you are a tourist or a temporary visitor, you may not be entitled to public healthcare in Spain. In such cases, it’s advisable to have travel insurance that covers healthcare expenses.
Do British citizens have access to public healthcare?

In order to qualify for Spanish healthcare as a British citizen, you must:

  • Participate in social security in Spain as an employee or self-employed.

  • Obtain a UK-issued S1 form and register it with the social security office.

  • Lived in Spain for five years and obtaining permanent residency.

  • Obtain an EHIC or GHIC for temporary stays while studying or working.

Otherwise, you are not entitled to Spanish public health care and should consider private insurance.

Over 90-day British residents in Spain need healthcare

Visas are required if you live in Spain or spend more than 90 days there per year. During your first year in the country, you will have to acquire private health insurance if you are under 65. If you go to Spain to work with a work permit visa and pay directly to the Spanish Social Security, after one year registered in the City Council of your place of residence, you can access Spanish public healthcare.

Remember that you must register at the health center in the city where you live, providing your Spanish Social Security number and your residence permit. In your municipality, you can obtain your Social Security number from the General Treasury of Social Security (TGSS). Your health insurance card (Social Security card) will be mailed to you once you have registered. If you have third parties in your charge, their registration will be done separately.

Over 90-day Visas for UK residents in Spain

Non-lucrative visa (NLV)
If you are going to live in Spain with a non-lucrative visa (you are not allowed to work) you will need private medical cover until you turn 65. But you can apply for affiliation to the public health insurance after having been registered in the “padrón” for one year. Affiliation to this scheme involves the payment of a monthly fee that gives you access to the Spanish health system.

Golden visa
If you move to Spain with a Golden Visa, private medical insurance is also required. However, you can also request adherence to the Special Agreement and pay a monthly fee after being registered in the register for one year. Those over 65 who move to Spain will continue to enjoy the same access to Spanish public health as Spanish citizens. This is through the S1 form issued by the United Kingdom. This is a certificate of entitlement to healthcare that UK state pension recipients have access to.

I work in Spain. Does my family have the right to Public healthcare?

Yes, family members of an expat who is working legally in Spain have the right to healthcare, if they are authorised to live and actually live in Spain.

This condition is applicable to the worker’s spouse or life partner, and to descendants of 26 years of age or under, or of any age if disabled, if they are dependent on and live with the worker.

I am legible for Public Healthcare, how do I register?

Register at your local health centre with your social security number. You can get a social security number from your local National Social Security Institute (TGSS) office in Spain. Your children/dependants need to sign up independently.

Once you have signed up, you will obtain a health insurance card. Take it with you whenever you visit a doctor or if you need to purchase medicines in a pharmacy.

I am a UK national and my company is located in the UK, but is sending me temporarily to Spain. Do I have the right to healthcare in Spain?

Yes, the Withdrawal Agreement guarantees that Community regulations will continue to apply. A company may send an employee to another country while maintaining social insurance contributions in the country of origin.

Therefore, a seconded employee may work temporarily in an EU country and continue affiliated to the British social security system for a period of two years, during which time their social security rights, including medical insurance, remain unchanged.

I am a UK national and travel every day to work in Spain from Gibraltar. Will I have the right to healthcare?

Yes, you retain your right.

I am a UK pensioner living in Spain, will my admission to public healthcare be affected following Brexit?

Your right to healthcare will not be affected, the Community Regulations will continue to apply.

If I am a permanent resident

If you are living in Spain or move there permanently before 31st December 2020, you will have healthcare rights in Spain as you do now, provided you remain legally resident. If you have been a resident in Spain for five years or more, you can apply for permanent residency. This will provide you right to use the public healthcare on the same basis as a Spanish citizen.

You may be entitled to state healthcare paid for by the UK if you live in Spain and receive a UK State pension (through an S1 form).

If I live less than a year in Spain

If you have lived in Spain for less than one year and cannot get healthcare cover, you’ll need to buy private health insurance. Anybody aged over 18 years old can purchase health insurance.

What are the advantages of having health insurance?

Private health insurance allows you to have peace of mind. Your health care needs will be taken care of in an timely and appropriate way and you will be protected against unexpected incidents. It includes:

  • Broad medical network: Access to a enormous range of GPs and specialists.
  • Quick care and diagnoses: You can go directly to a specialist without having to obtain a referral from a GP first, which is the protocol in public healthcare. You save time which means that you receive your diagnosis and treatment as fast as possible.
  • Free choice of doctor: you choose the professional that you want to use.
  • Shorter waiting lists: Private clinics and hospitals have less pressure and so waiting times to see doctors, diagnostic tests or surgery are minimum.
  • Flexible schedules: with private hospitals and clinics you can choose appointments at a time that suits you the best.
  • Second medical opinion: you have the choice to seek a second medical opinion with regard to your treatment.
  • Comfortable hospitalisation, for you and your family: you are provided with a single room when hospitalised and it is easy for a relative to stay with you.
  • Additional options: customize your policy to your personal requirements by choosing from an extensive range of extra cover options.
  • Dental Insurance: not covered by public health system, many of the private plans include dental cover or you can add dental cover to your policy if it is not included.
  • Alternative Medicine: some insurers now offer the option to include alternative medicine treatments, such as acupuncture or homeopathy.
  • In the public healthcare system, patients often have to wait a long time for their appointments. Patients with private insurance can avoid these long waiting times. The importance of private insurance might be greater if you visit the doctor regularly.
  • Treatments and physical exams can be more personalized and detailed with private insurance.
  • The private insurance industry often has a better connection with private clinics and hospitals, which often have more advanced technologies and treatments.
  • Private clinics are more likely to have doctors who speak English.
  • In general, private insurance covers more items and acts more quickly than public insurance.
  • Private insurance has more resources to respond quickly to pandemics and sanitation crisis.
How much costs a private health insurance?

The price of private medical insurance varies according to a number of factors:

  • Age: generally, the larger the age of the insured, the higher the cost. Babies and toddlers also have slightly higher prices as they are more likely to need to use services than slightly older children.
  • Location: The location where you are based in Spain affects the premium charged.
  • The type of coverage: The price also depends on the type of cover that you select. For example, a policy which only covers doctors and diagnostic tests will have smaller premiums than a policy which contains hospital treatment and surgical.
  • Co-payments (also called “excesses”): which you pay each time you use a service. If you choose a policy with co-payments then your premiums will be cheaper than a policy without co-payments.
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