Accessing healthcare in Spain

How to access public and private healthcare

In 2018 a new legislation granting universal access to the healthcare system was passed in Spain. Most residents in Spain have free access to the public healthcare system. However, certain exceptions may apply.

Public healthcare

The Spanish public healthcare system is recognized as one of the most comprehensive, free-of-charge systems in the world and most Spaniards rely on it, leaving private healthcare as the second most preferred option. Public healthcare professionals undergo a strict admission process and Spain spends around 10% of its GDP on healthcare, so the public system constitutes one of the pillars of the Welfare system in Spain.  

Non-residents
EU/EEA/Swiss nationals

These residents can receive free medical assistance by using the European Health Insurance Card. If you are planning to move to Spain on a temporary basis, make sure you apply before travelling, as it will make accessing healthcare a lot easier. Apply to your country of residence, as it is the one that will ultimately cover your medical expenses.

Other nationals

When moving temporarily (without registering for residence in Spain), you may be asked to have private health insurance to be able to travel to Spain. However, certain countries have bilateral agreements meaning citizens do not have this requirement. For this reason, it is recommendable to consult the embassy of your home country while arranging your visa procedures.

Residents

Under the new legislation, all registered residents, so anyone who lives, works and pays social security taxes in Spain may access public healthcare. You can register at the local Health centre with your passport, foreign identity number and social security number. EU and UK pensioners are automatically eligible for public healthcare once permanently living in Spain. For non-Europeans or UK travellers, health insurance is necessary for acquiring a residence permit.   

Applying for public healthcare requires some paperwork, but it will grant you access to general and specialized healthcare in Spain free of charge, so it is worth the hassle.

To get access to public healthcare in Spain, you will be required to follow these steps:

  1. Registration of residency: in Spain, it is known as 'empadronamiento'. It is a certificate that states your official address in Spain, and it can be obtained at your local town hall. You can find some information about how to obtain this document here.
  1. Social security number and card: if you work in Spain, your employer will have you registered in the social security system and therefore you will already have a number. If you are not working, you will have to get your social security number at one of the social security offices. To get a social security card, you will be asked for a valid ID and your residency certificate (certificado de empadronamiento).
  1. Healthcare card: after completing the social security paperwork, you will be issued a certificate that grants you access to the healthcare system. With this document, your ID and your residence certificate you can apply for your healthcare card (tarjeta sanitaria) at your closest healthcare centre (centro de salud). You should receive your health card a couple of weeks after application. In the meantime, you will be provided with a temporary document that will grant you access to healthcare and you will be assigned a doctor. Your healthcare card covers all hospital and doctors visits and 40-60% of the cost of prescription drugs, depending on your income.

Private healthcare

In Spain, locals take out private health insurance for shorter waiting times, as long waiting lists are perhaps the main setback of the public system. This insurance is used either as a supplement or an alternative to public care.

Expats may have to purchase private insurance to fulfil visa requirements, to receive medical assistance in their language or to have easier access to specialists. Dental coverage in the public system is very limited, so purchasing insurance is ultimately a way of reducing the costs of dental visits in Spain.

Compared to other European countries, private insurance in Spain is rather affordable. Insurers typically offer both medical and dental coverage with a discount if you sign up for both. Obviously, prices vary greatly according to the age and sex of the applicant. To give you an idea, the average monthly medical premium for a 30-year old can cost around €30-70.

Medical attention in other languages

For a list of foreign language speaking doctors, the best advice is to consult your embassy or local consulate. They usually make lists of physicians available to their citizens. 

Another option is to get an expat-focused private health insurance with a network of English-speaking doctors. 

Emergencies

In case of an emergency, don't worry about insurance issues, call 112 or head directly to the nearest emergency room (urgencias).

Under Spanish law, any health organization, public or private, is required to treat patients in an emergency situation regardless of their insurance status. However, this case of emergency is defined by its seriousness. For pregnant women and children, they too need to be residents in Spain.

Use the general emergency number 112 if you need an ambulance.

Emergency room assistance is given to everyone without exceptions, but travellers from countries without bilateral agreements with Spain, the European health card or other insurance covers (be this state or private) might be later asked to pay for the medical expenses of assistance given.


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