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Health Insurance Spain: The Expat Healthcare Guide

If you’re heading to Spain – either as a tourist or an expat – it’s critical that you understand how you can access the healthcare facilities on offer. We’ve put together a complete guide to health insurance in Spain to help you ensure that you can get the treatment you need while away…

The reality is that many tourists and expats visiting Spain from another EU country are under the impression that an EHIC (European Health Insurance Card) grants them free and unlimited access to healthcare in Spain.

Sadly, this is generally not the case. Numerous stories exist of disappointed visitors not receiving the standards of care they expected. If you are heading to Spain shortly and are looking to understand how the healthcare system works and whether you need health insurance read on for our detailed explanation of the system as of 2016…

“Free” Healthcare Access

As in most countries there are two broad forms of healthcare on offer in Spain; public, state-funded facilities and privately-run facilities. Interestingly, while the queues in private clinics may be shorter, many expats report similar standards of care whether opting for private or state facilities.

Some expats moving to Spain will be entitled to “free” healthcare if they meet one of the following requirements:

Employed
Self-employed
Retired
Health Insurance for Employed Expats

Those expats who move to Spain in order to work will generally be registered for a social security number and will then pay into the Spanish system. Thanks to these payments working expats will then gain access to the state-run Spanish healthcare system.

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Health Insurance for Self-Employed Expats

Self-employed expats living and working in Spain can also gain access to the public healthcare system. In order to do so you will need to register yourself for local taxation. Under this system you will then receive a social security number and will be entitled to free care at public hospitals.

“Free” Health Insurance for Travellers in Spain

Visitors to Spain from within the EU can make use of an EHIC card in order to gain access to the healthcare system. It should be noted, however, that such a card really only gains you emergency medical treatment (rather than long-term care) and is only suitable for temporary visitors.

Due to the severe limitations of this option, therefore, many travellers exploring Spain opt to take out supplemental health insurance policies offering broader care.

Visitors from outside Europe do not gain access to the same European Health Insurance Card system and so should regard private medical insurance mandatory in Spain.

Private Health Insurance for Expats

SpainExpats who do meet any of the above requirements will not have free or discounted access to the State-run medical facilities.

Instead you will need to make use of two possible alternatives.

The first of these is a “buy in” through the “convenio especial” system. Here you pay into the National Health Service and in exchange gain access to its facilities.

That said, this solution is far from perfect as it has a distinct number of limitations. A good example of this is that such individuals will find their prescriptions are not being subsidized so will need to be paid in full.

The second option is to opt for a fully-featured private health insurance policy for Spain. Such policies are generally recommended as the best option due to the level of coverage provided.

Not only will such a policy grant you access to all the services that you require but they also cover medical repatriation and cost-effective dental care.

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Health Insurance for Self-Employed Expats

Self-employed expats living and working in Spain can also gain access to the public healthcare system. In order to do so you will need to register yourself for local taxation. Under this system you will then receive a social security number and will be entitled to free care at public hospitals.

“Free” Health Insurance for Travellers in Spain

Visitors to Spain from within the EU can make use of an EHIC card in order to gain access to the healthcare system. It should be noted, however, that such a card really only gains you emergency medical treatment (rather than long-term care) and is only suitable for temporary visitors.

Due to the severe limitations of this option, therefore, many travellers exploring Spain opt to take out supplemental health insurance policies offering broader care.

Visitors from outside Europe do not gain access to the same European Health Insurance Card system and so should regard private medical insurance mandatory in Spain.

Prescriptions in Spain

Generally speaking Spain operates a co-payments system for prescriptions. This means that you are unlikely to receive “free” medications while in Spain, though it is likely to be heavily subsidized.

It is interesting to note that unlike the UK where most working adults pay the same fixed fee for prescriptions, in Spain the policy is rather different. Here the level of subsidy you enjoy depends on your taxable income; the more you earn the more you will pay in general. Furthermore while some people’s annual contributions for prescriptions are capped at a maximum, others are not.

Therefore if you expect to need prescription medication while visiting or living in Spain it pays to investigate how the system will work in your case to make budgeting for such eventualities much easier.

Lastly, be aware that as with many other Spanish businesses many pharmacies maintain “Spanish” hours. In other words many drug stores close for much of the afternoon (2-5pm typically) but then re-open after “siesta time” and work late into the evening.

As a result it is wise when requesting a prescription to consider when you’ll be able to collect it. Try to avoid afternoons if possible in all but the most cosmopolitan areas or you may be disappointed to find the pharmacy closed.

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Moving to Spain?


 

Spain is one of the most popular destinations when choosing a new home abroad. With an estimated 800,000 expats living in the Mediterranean country, it has proved to be an attractive home offering a short flight time from other EU destinations, warmer climates and an extensive expat community.

But even though Spain may offer an ideal life for many, some have fallen foul of the potential pitfalls which have made their dream life in the sun an imperfect experience. But the good news is, with the right preparation many of these can be avoided. Here we talk to Stephen Jones, Spanish Consul for the UK Foreign and Commonwealth Office, who offers some invaluable insight for anyone thinking of moving.

“I started my overseas career aged 18 in Spain with a summer season in Magalluf, Mallorca. Since then I have worked all over Spain and the Canary Islands so have fairly extensive knowledge of the area. I am now the British Consul based in Malaga and have been here for almost two years.

Working at the British Consulate is an enjoyable, varied and sometimes challenging role. We are there to assist British nationals, which can include providing help when someone is hospitalised, supporting a partner with the death of a loved one or even visiting a British national in jail. We also issue emergency travel documents to get someone back to the UK. It’s always worth checking your passport every year to make sure you still have validity on it and apply for a new one well in advance of it expiring. Unfortunately, it’s those that don’t do this who desperately regret it (both emotionally and financially) when they need to travel urgently.

 

Popular Locations in Spain

The Costa del Sol and Costa Blanca are the original second home/retirement destinations and through the ups and downs of scandals and bad publicity of land disputes – and despite a rise in competing destinations – they remain two of the most popular places for Brits to buy abroad anywhere in the world. This is likely due to a combination of factors; proximity and ease of travel to the UK, a long standing love of the Costas, the ability to live a semi British life in the sun, good property prices and beautiful scenery – from stunning mountains to some of Europe’s best beaches.

Spain has it all and the British love it. As always research is the best way to find out about the place you want to live. Make sure you really know the area well, talk to the locals and visit www.gov.uk/knowbeforeyougo for more advice and tips before you decide to make the move.

malaga beach view

I personally live in Malaga, and love the beaches of Cabopino (half an hour from Malaga) and eating lunch in one of the many “chiringuitos” (beach restaurants), which serve some of the freshest fish you will ever taste. As for culture, you can’t beat Malaga which was actually a candidate city for 2012 City of Culture. The cathedral is stunning and well worth a visit. About an hour from Malaga you have Ronda with one of the oldest bullrings in Spain or in the other direction is Nerja where the caves are breathtaking.

 

Buying a Property in Spainpexels-photo

Like in many countries, there have been issues over property development in Spain. My advice always remains the same: when purchasing property overseas, get independent legal advice. Do not rely on the agent or developer, however insistent they are that you don’t need a lawyer. A full list of English speaking lawyers can be found on the FCO’s web pages for the country you are intending to invest in. Have a look at www.ukinspain.fco.gov.uk.

When we are contacted by British nationals who are having difficulty we are able to point them in the direction of associations or groups that may be able to help them with their concerns. But some of these problems can be prevented, so remember to research heavily beforehand so you ‘know before you go’.

 

Retiring Abroad in Spain
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We get lots of questions about pensions, and retirees who moved to Spain when the Pound was still strong against the Euro, e.g. £1=€1.5 but are now struggling with day-to-day living costs since the Euro has strengthened. For anyone thinking of retiring abroad, I would make sure that pensioners living here are registered with the local authorities. Registration has a number of benefits including financial discounts on local tax and rates. Being registered may also entitle residents to social security or assistance.

In Spain we have a wonderful relationship with Age Concern which is dedicated to looking after the over 50s. We often put our pensioners in touch with local Age Concern branches who can offer practical advice on financial hardship. This has become a very important subject and I would urge anyone who is thinking of retiring abroad to fully understand their financial position and entitlements – information can be found on the website:www.ukinspain.fco.gov.uk.

 

Healthcare in Spain

The rules for getting state healthcare in Spain are different from those in the UK. The NHS is a residence-based system, which means that all you need to access healthcare in Great Britain is to be ‘ordinarily resident’.

In Spain however, the system is contribution-based, which means that normally you must be paying into the social security system, or in receipt of a Spanish state pension or benefit, in order for you and your dependants to get state healthcare. If you are working, social security contributions can be paid by your employer or by yourself as a self-employed worker. If you are not currently working but have paid contributions into the Spanish system in the past, you may be eligible to pay voluntary contributions, which will also cover you for healthcare. For more information, contact Tesoreria.

If you are not paying into the Spanish social security system you may also get state healthcare if:Doctor

  • You are in receipt of a UK state pension, long-term contribution-based Incapacity benefit or Bereavement benefit;
  • You are an early retiree to Spain and have paid UK national insurance contributions in the last 3 years – apply for an S1 form;
  • You are a posted worker for a UK company;
  • You are a dependant of someone who falls into one of the categories above;
  • You are a temporary visitor to Spain and have a valid UK European Health Insurance Card (EHIC);
  • You will be receiving planned treatment abroad or are in receipt of UK sickness or maternity benefit – apply for an S2 form (previously E112). For more information, please visit the NHS website
  • You are a child under the age of 18 and have no access to healthcare through your own or your parent’s means. This is called ‘La Ley de Minor’ and you apply through the social worker at your local health centre.

In some circumstances you may be asked to provide evidence of your UK income when applying for health care or social security benefits in Spain.

Please remember – if you do register with the state health system in Spain, it is important to de-register with your GP in the UK. Likewise, if you decide to return to the UK, then you must de-register with the Spanish authorities.”

Get your free Spain Health Insurance quote here.

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