Healthcare in Spain

Who can access the Spain healthcare system?

The public Spanish healthcare system can be used by anyone who is paying into the social security system. That means anyone who works in Spain or who is self-employed. If your spouse is employed or self-employed Spain and you are not, you can also be added to their social security and have access to healthcare. Many people thinking of moving to Spain ask is healthcare free in Spain and the simple answer is yes it is, but only if you’re paying into the social security system or a dependent of someone else who is. What about healthcare in Spain for EU citizens? The same situation regarding social security payments applies whether you’re an EU citizen or a non-EU citizen such as those from the UK.

In order to register for the public system you will need your social security number and to be registered on the padrón (similar to census) with your local town hall. You can take both these certificates and your ID number such as NIE or TIE (foreign identity numbers) to your nearest health clinic and they will be able to register you and give you a public health card. The cards are slightly different depending on what region of Spain you choose to live in.

EHIC and GHIC

EHIC stands for European Health Insurance Card, while GHIC stands for Global Health Insurance Card. Both cards are only to be used during temporary trips that are a maximum of three months and only when absolutely necessary, they were never designed for those moving abroad.

The EHIC is what EU citizens can use when they travel within Europe to be able to access free healthcare in an emergency when abroad. If you are receiving a UK state pension and started living in the EU before January 1st 2021 you will also be able to use this card as you will be covered under the withdrawal agreement.

The GHIC allows British nationals medically necessary state healthcare in Europe at a reduced cost or sometimes for free. Again it’s to be used if you’re travelling in Spain temporarily or here on holiday, not if you move here.

Remember, you can’t simply get a GP appointment with these cards for example, they are more for emergency care. If you intend to move to Spain to retire, you will need to either have access to the national healthcare system or get private health insurance. 
 

Health insurance for the public system

If you are not paying social security, there is a way that you can access the public system through what is called the convenio especial or special agreement. It enables foreigners in Spain to pay a monthly fee to be able access the Spanish national health service instead and have all the same benefits and cover as Spanish nationals. The only things that aren’t covered as prescriptions, prosthetics and dietary medicines. It costs a total of €60 per month if you are under 65 and €157 per month if you are over 65.

The only caveat to this is that you must have been living in Spain for one year before you’re eligible to apply for it, so you may have to get private healthcare for the first year. It’s important to be aware that you will generally need a good level of Spanish if you want to go this way as the majority public healthcare doctors in Spain don’t have a good enough level of English in many regions across the country, even in big cities like Barcelona. 
 

Healthcare costs

The cost of healthcare in Spain, depends on how you are covered. If you have public healthcare, almost all your costs are covered by the state and prescriptions are subsidised. If you require private healthcare, costs can range from around €50 to €200 per month, or more if you get a family package.

If you aren’t covered by either, costs can vary immensely. For example, it can be fairly affordable to pay for privately for blood tests or even scans, but for any surgical procedures it could set you back thousands. It’s always best to be covered and in many cases your visa won’t actually be approved if you don’t have healthcare. Bear in mind that sometimes the public healthcare system can be slow, so it’s worth knowing that you can pay for some things privately to speed up tests and results. 
 

Women and children’s healthcare in Spain

Pregnant women and children under the age of 18 can receive free public healthcare in Spain. Be aware though, they may still need to prove that they have private healthcare for certain visas.

Private healthcare

While the quality of healthcare in Spain is generally good, private healthcare can offer several benefits and can surprisingly be quite affordable compared with many countries. In fact, according to the latest data available 11.6 million Spaniards have private healthcare.

One main advantage of private healthcare over public healthcare is that waiting times are drastically reduced. Since the Covid-19 pandemic the public health system in Spain has been suffering with huge backlogs and there are long waiting lists even to see GPs, let alone to see specialists which could take months. Another great aspect of the private healthcare in Spain is that you can often book to see a specialist directly, without having to wait to be referred by your doctor.

There are many different types of private healthcare companies in Spain that offer many policies and coverage. Some of them even have their own hospitals. It’s important to shop around to see which one best fits you and your needs, if they will cover your pre-existing conditions and if they require you to make co-payments or not.

Do UK citizens need private healthcare?

Healthcare in Spain for UK citizens depends on various factors similar to those above. If you are a UK citizen and are planning on retiring to Spain and are not working, you will not be paying into the social security system and will therefore not be eligible for public healthcare. This means that you will need private healthcare or to pay for the convenio especial to access the public system, but not until after one year of living in Spain.

If you’re retired and receive a UK State pension, you can also get public healthcare by getting an S1 form, meaning that your healthcare in Spain is covered by the UK government. The S1 system is still active even though the UK has left the EU, unfortunately though, it is only available to those who are covered by the Withdrawal Agreement and were resident in Spain before January 1st 2021, meaning that this type of healthcare in Spain after Brexit is no longer possible for new arrivals.

Healthcare emergencies

If you have healthcare emergency in Spain, you will be seen at the emergency room either at a local clinic, public hospital or a private hospital, depending on what type of cover you have and the severity of the problem. Emergency healthcare is generally good in Spain, but be aware you will most likely have to wait to be seen, and this time depends on how many other people are in the ER at the same time and the severity of your condition. If you have public healthcare and need an ambulance you can call 112, other private healthcare companies may have their own emergency numbers. Your regional public health system may also have an emergency number you can call to speak to a healthcare professional and be assessed over the phone. 

Conclusion

If you’re thinking about moving to here, it’s important to know how your healthcare in Spain is going to be covered whether that’s just for a check-up or for an emergency. If you’re not covered by the public healthcare system, because you’re retiring, then don’t worry, there are plenty of other ways you can get covered, including many good private companies.