Many Brits arrive in Spain thinking that they will be covered for healthcare both in Spain and by the NHS back in the United Kingdom. Both countries have universal healthcare systems. However, many Brits living in Spain are discovering – to their horror – that they may not be covered by the health system of either country, especially in the case of serious or terminal illness.
How does the system work?
If you are moving from the United Kingdom to Spain before retirement age (60 for Women, 65 for Men) you should apply for an E106 form. For British Citizens, this form provides for up to two years of healthcare in Spain funded from the UK NHS. The exact amount of time depends on your historical tax and NI contributions.
If you and/or other family members are above retirement age, you should make an application for an E121 form. Based on your status as European Union citizen, you receive health entitlement on the same basis as a Spanish person.
You might have heard of an EHIC (European Health Insurance Card), which is the replacement for the E111. This card is issued by the social security agency of the EU country you are resident in and is for the cover of emergency medical treatment for when visiting another EU country. The EHIC is not meant to cover ongoing medical treatment in another EU country.
These forms should be applied for from the DWP (Department of Work & Pensions) more information here: http://www.dwp.gov.uk - You can apply for a EHIC card at a Post Office branch: http://www.postoffice.co.uk.
What happens if I run out of cover?
The E106 form provides health cover for a specified period of time. So, what happens if you are diagnosed with a health problem during your cover with the E106, and the situation persists beyond the end of the period of cover? The simple answer is you will find yourselves billed for all costs!
In this sort of situation, a very normal reaction is to consider returning to the UK. Ho wever, if you have been out of the UK for more than three months and have applied for and been issued an E106, you are no longer eligible for free healthcare in the NHS system. You will need to prove that you are repatriating to the UK; a typical proof might be taking out a mortgage or taking other similar actions which can prove you mean to permanently relocate back to the UK. It can take 6 months for this process to be completed.
How to I get healthcare in Spain?
Like in the UK, there are two options: public or private healthcare. To qualify for the public healthcare system (Insalud), you need to complete the administrative steps of becoming resident in Spain. This can mean having a permanent address, being registered at the town hall, getting a NIE and getting registered in the social security system, in addition to starting to make contributions to it. If you are self-employed or starting a business, you might get a bit of a shock in that you will need to make payments even if you are not earning anything. Please note you cannot just pay your contributions, you have to be working.
As in the UK, many people opt to get private health insurance to complement or substitute public healthcare. Many people do not realize that it can be impossible to get cover for a condition after it has been diagnosed. So the best advice is to make sure you get insurance when you are fit and healthy.
What should I do?
Find out what forms you need to complete and how long you will have coverage for.
Make sure you understand how you will get into the Spanish Social Security System and whether and when you will be covered.
- Consider how long it will take to get established in your new home. Remember that navigating through all of the bureaucracy can take a while and it is important that you do not get into a situation where you are not covered.
- Think about whether and when you will be working. If you are starting a business or are going to be self-employed, do some figures. You might not want to be paying social security contributions at the beginning if you can avoid it; but you also might not want to not have health cover!
- Get informed about what coverage different private health plans might give you and find out how much it will cost. You might be surprised!
By Susan Warner – Sanitas Agent 17517
"I have been advising British expatriates in Spain about health insurance for the last 3 years and have helped over 700 families make sure they have the healthcare cover they need. I understand how complicated health cover first appears and am more than happy to talk and advise people on their options with no obligation. Don’t assume private health insurance will be too expensive for you – there is cover to suit all budgets."
Tel: +34 952 815 446 - Mob: +34 615 655 348 -