A Guide to the National Healthcare System in Spain

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As in the UK, Spain has a free state healthcare system that is paid for by social security payments deducted from your wages. If you have residency or are working in Spain you will have access to the healthcare system which is ranked among the best in the world. Managed by the Spanish Ministry of Health, the national health system works alongside the private healthcare system and provides doctors, medical specialists, hospitals and healthcare centres (centros de salud).

Who is eligible for free Spanish national healthcare?

Around 90% of Spanish nationals use the public healthcare system. Expats may also be eligible for free state healthcare in Spain is any of the following points apply:

  • If you are a resident in Spain, working or self-employed and paying social security contributions
  • If you live in Spain and receive state benefits
  • If you are a resident in Spain and are separated or divorced from a partner who is eligible for social security
  • If you are a spouse of a worker making social security contributions
  • If you are a child or pregnant woman resident in Spain
  • If you are studying in Spain and under the age of 26
  • If you are a state pensioner
  • If you are an EU resident visiting Spain and registered for EHIC.

You can also get short term or emergency care from the Spanish state healthcare system if you are a resident of a country with a bi-lateral agreement with Spain. These include citizens of Andorra, Brazil, Chile, Ecuador and Peru. If none of these apply, you will need to arrange for private health insurance to cover any treatment.

Cost of Spanish Healthcare

Spain spends around 9% of annual GDP on its healthcare providers, making it one of the biggest spenders on healthcare in the EU. It consequently has a very high-quality medical system. For those who are eligible, most healthcare is free although a contribution towards the cost of prescription charges may be applied in some cases, as in the UK.

Registering for Spanish State Healthcare

When you move to Spain and become a resident, you should register with the nearest social security office (Dirección General de la Tesorería General de la Seguridad Social or TGSS) and obtain a social security number and certificate showing you are entitled to state healthcare. You will need to provide a passport or ID card, your residency certificate and proof that you have registered your address with your local town hall.

Once you have a social security number and eligibility certificate you can apply for a TSI health card (tarjeta sanitaria individual) which will be mailed to you or you can arrange to collect it.

Private healthcare in Spain

Those who are not eligible for free state healthcare or who want access to private medical facilities will need to take out private health insurance to cover the cost of any claims. Private healthcare costs between 50 and 200 € per month depending on the level of coverage, age and health of the applicant, and the amount of deductible you choose to make towards any claim.

There are several main companies offering private health insurance in Spain including Aetna, Cigna, Bupa and Allianz. It’s a good idea to get several quotes before choosing a company and make sure they operate at a hospital close to where you live.

Where to find doctors

In an emergency, anyone can go straight to A&E at a local hospital or ER (Urgencias) and receive free treatment. If it is a life-threatening situation, call the European emergency number 112 free from any mobile or landline.

Other emergency phone numbers to note are:

Ambulance                    – 061 or 112

Emergency doctor       – 1003

Emergency dentist       – 961 496 199

On-duty pharmacist    – 963 600 313

Usually you will need to show your social security card or healthcare insurance policy details.

Most GPs and medical specialists work in private practices, GP surgeries (medico de cabecera) or health centres in Spain. Health centres will include a wide range of staff including several GPs, nurses, pediatricians, physiotherapists and gynecologists. You can find your nearest healthcare centre on the Ministry of Health website. Many of them offer both private and state healthcare, so make sure you are clear about which type of healthcare you need.

You can choose your own family doctor but to see a consultant or specialist you must be referred from your doctor. Waiting times can be lengthy for some more popular treatments so you may want to use private health insurance to see a specialist sooner.

You need a prescription for birth control pills although condoms are available over the counter at pharmacies. STD tests and advice on sexual health are free. Since 2010, abortion is legal during the first trimester of any pregnancy. After that it is only permitted in extreme circumstances such as a serious threat to life.

Healthcare for children

Children under 15 get free state healthcare via their parent’s healthcare coverage and public services for children are good. Vaccination programmes includes protection against Hepatitis B, polio, tetanus, MMR (measles, mumps and rubella) and diphtheria.

Spanish dental care

Dental care in Spain is not free as part of the state healthcare system except for those aged under 15 or requiring emergency treatment. You need to pay for any dental care or take out insurance to cover any dental treatment.

Alternative therapies

According to Spanish law, alternative medicine can only be offered by those with full medical qualifications. This includes homoeopathy, acupuncture, reflexology and chiropractic treatment and they are not covered by state healthcare. Usually you need to pay an extra fee to add these services to your private healthcare plan.

If you need medical treatment in Spain and do not speak Spanish fluently, it may be wise to take an interpreter or a Spanish dictionary with you.

The full article by Expatica provides full information about Spanish healthcare for expats.

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