1.     The healthcare system in Spain

Spain has an acceptable health care system which consists of a network of hospitals and medical centers all throughout the country. The health care system in Spain consists of both public and private healthcare. Both public and private health care services are offered in hospitals (hospitales) and health care centers (centros de salud). In cases of emergency there is no real distinction between public and private health care but the difference can be noticed in case of non-emergency procedures where private health care is way more faster and easier.

2.     Public healthcare

Spain offers public health care services free for anyone living and working in Spain. In most Spanish cities you will find public health care right next to wherever you are living. However, in some islands of the country you might have to travel a bit to find a free health care provider.

Spanish nationals enjoy full coverage by the state health care system and this is also applicable for people with resident status. As for expatriates there are a few criterions for free health care. These criterions are as stated below:

• If you are a resident in Spain and make social security contributions. To make social security contributions you need to be employed by somebody or you could be self-employed.
• If you are a resident in Spain and have been recently divorced or separated from a partner who is registered with social security.
• If you are a resident in Spain and receiving certain state provided benefits.
• If you are resident in Spain and are pregnant.
• If you are under the age of 26 and studying in Spain.
• A child residing in Spain
• If you are a state pensioner
• If you are temporarily staying in Spain and hold an EHIC card.

The state health care system is funded by social security contributions made by Spanish nationals and residents. The Spanish government creates a national health budget and each region takes individual responsibility for the budget allocated in their portion. The regional government creates health plans and implements to make sure that the health system meets the high standards.
The state health care system in decentralized and different regions have different ways of implementing the health plans. In order to get the best possible service you need to check the preconditions for free state health care in your area. You also need to check the condition and location of health care systems in your area. You can use the Spanish health ministry’s website to check the situation in your region though the website is in Spanish.

If you do not meet the perquisites set to receive free health care you need to organize private health care services. You can also go for the state insurance scheme (convenio especial) provided by the Spanish government by paying a basic monthly fee. The state insurance scheme is administered by the authorities in each autonomous region.

 

3.     Registering for public health care

In order to receive free public health care you need to first register with the social security offices (Direccion General de la Tesoreria General de la Seguridad Sociale or TGSS). You can find the TGSS offices throughout Spain. To register with the TGSS you will need to show your passport or ID card and residency certificate. After showing all the necessary documents you have to fill up an application form. You will also need to register your details at your town hall.

By registering with the TGSS you will receive your social security number and a certificate stating that you are entitled to medical help. The next step in the process is to take the certificate, passport and NIE number to your local health center and register with a doctor and apply for a health card (tarieta sanitaria individual or TSI). The TSI will be sent to you via post or you can receive it personally from the health center. The health center will also arrange for you to get a Sistema de Informacion Poblacional or SIP card. You will need to show the SIP card every time you visit a clinic, hospital or collect a prescription from a pharmacy.

 

4.     European Health insurance card (EHIC)

EU member states issue EHIC cards to help get their citizens the necessary health care when they are going abroad on a holiday or a temporary visit. If you are a non-resident of Spain and have an EHIC card you can access state health care in Spain.

The EHIC card can be used to get any necessary medical treatment you require at a reduced cost or completely free. The course of your treatment will be determined by the doctor you will see and he will prescribe routine or specialist treatment and it will be covered by the EHIC card. You can also get ongoing conditions treated if that cannot wait until you return to your country.

The EHIC card cannot be used if your sole purpose of coming into Spain is to seek medical treatment or to give birth. In this case you should seek advice from the health authorities in your country before leaving for Spain.

However, it is advisable not to totally rely on your EHIC card and you should take out a private insurance if you are in Spain for a prolonged period. There has been cases where an EHIC card has been refused and if it happens to you make sure you get evidence that you presented an EHIC card at your time of need.

 

5.     Bi-lateral Health Agreements:

Spain has bi-lateral agreements with some countries such as Andorra, Brazil, Chile, Ecuador and Peru and this allows the citizens of these countries to obtain free emergency medical treatment when they are on a short visit to Spain.

 

6.     Private healthcare

Over 90 percent of the Spanish population use the state health care system for all their medical needs. Still you will find many people who use private health insurances for improved health care services. If you are not making contributions towards the economy or you want to improve the service of the public health care then you need to take out private health insurance.

Spain has a good health care system and most of the people in Spain use the state health care system. Despite of that many people go for private insurance to cut down on the waiting time and get quick medical assistance. If you want to be on the save side you should go for private health insurances.

There are many health insurance providers in Spain and these companies provide a wide range of packages which cater specifically to your age, health condition and other circumstances you might have. It is advisable to do a little homework before deciding on which health insurance to choose. Do thorough research and get as much advice as you can to make an informed decision. It is absolutely crucial that you find a package that provides the best cover and the best value on your money in order to protect both your health and your finances.

A private health care insurance will give you more freedom in receiving medical care and will enable you to choose what suits you best. The language barrier is a big problem for many expats and a private health insurance can help you eliminate this problem. You can choose an English speaking doctor and get in touch with him without going through the long waiting lines.

HealthcareInsuranceSpain.es is the Premier Agency specializing in affordable medical & health insurance coverage for expats living in Spain. We are agents of Co-Salud, one of the largest health insurance companies in Spain, the flagship of the well renowned company Catalana Occidente. Co-Salud is the only company in Spain which it´s monthly rates are not dependent on the amount of claims you make. For more information feel free to ask us

7.     State insurance scheme (Convenio Especial)

The Spanish health care system offers a state health insurance scheme known as Convenio Especial for those who do not qualify for free health care. Convenio Especial provides medical cover in exchange for a monthly fee. The government has recently announced two packages: a package of EUR 60 for those under the age of 65, while those under the age of 65 must pay EUR 157. This insurance scheme does not cover prescription costs. The scheme is currently being introduced to different regions of the country to make it available throughout the country.

8.     Hospitals

In cases of emergencies you can go straight to a hospital A&E or ER (Urgencias). You will receive super-fast treatment in case of emergencies. In case of any other medical treatment you will need a referral from a doctor. In Spain you will find both public and private hospitals. Only the public hospitals provide free medical care. There are some hospitals that provide both private (Privado) and state health care services (asistencia sanitaria pública). If you are in one of these hospitals make sure the staff knows which you want. Make sure you take your social security card or proof of private insurance. After getting discharged from the hospital take the hospital medical report to a pharmacy to get your prescription filled.

9.     Pharmacies in Spain

You need to take your medical report to the pharmacy (farmacia) to get your prescription filled. Pharmacies can be easily found all over Spain. Look for the shops with a large green cross sign outside. Pharmacies are usually open from Monday to Friday from 9:30 am to 2 pm and from 5 pm to 9:30 pm. On Saturdays the pharmacies are open from 9:30 am to 2 pm. There are also many 24 hour pharmacies (farmacia de guardia). In the normal pharmacies you will find a notice on the pharmacy door with the details of the nearest 24 hour pharmacy. Registered pharmacists receive necessary training to basic medical consultations and guidance on health matters. For more information on opening pharmacies hours click here, you will find all the pharmacies in Spain which are open at night times and at festive days (farmacia de guardia). The map is devided by province and all the open pharmacies will be listed once

10.     Prescription charges in Spain

You have to pay a percentage of the cost of prescription medicines in Spain and these cost is non-refundable. They have created a system where how much your pay depends on your income and age. If you are of working age and your annual income is below EUR 18,000 then you have to pay 40 percent of the total cost of medication. If you are of working age and your income is between EUR 18,000 and 100,000 then you have to pay 50 percent and if you are of working age and your income is over EUR 100,000 then you have to pay 60 percent of the prescription. State pensioners pay 10 percent of the prescription unless their income is over EUR 100,000, then they also have to pay 60 percent of the prescription.

11.     Pregnancy and birth in Spain

Spain provides a very high standard of maternity care. They start taking care of you as soon as the pregnancy occurs, with an initial appointment with a doctor to confirm the pregnancy, antenatal appointments and hospital scans, antenatal appointments and hospital scans. Make sure that you get a medical insurance before the pregnancy if you are planning to give birth in a private clinic.

12.     Visiting the dentist in Spain

Dental treatment is not covered by the state health care system unless it is in an emergency. You must pay for the dental treatment yourself or you need to have private health insurance. For more information on the dental coverage of our insurance please contact us.

13.     Emergencies

In life threatening situations call the pan-European number 112 free of charge from any mobile or landline. The Spanish word for ER is ‘urgencias’.

Other emergency numbers include:

• 060 for an ambulance (ambulancia)
• 961 496 199 – emergency dentists
• 963 600 313 – on duty pharmacy