Health in Spain: A guide to state provided healthcare system
The healthcare system has improved considerably over the last few years and is now something the Spanish can be justifiably proud of.
Here’s a guide to insurance, doctors, dentists, pharmacies and emergency treatment.
In Spain the number to call for a medical emergency is 061.
The public healthcare system in Spain is extremely good.
It is not necessary to have private health insurance in Spain, although there are many such insurance companies in the country that are used mainly by people who feel more comfortable with private health insurance.
In 1998 the Sistema Sanitario Público (public health service) brought in an official mandate for both doctors and patients outlining the service to which you are entitled — plus what the health service expects from you.
In any doctor’s office you should find these rights in a leaflet entitled “Carta de Derechos y Deberes” (Charter of Rights and Obligations) – only minimally different, if at all, in various provinces – which tells you everything in detail. Some small practices have posters on the wall containing all the facts you would find in the leaflet, but whatever the case you are entitled to view these rights.
Under a reciprocal agreement between European Union governments, residents of EU countries can receive free medical care when visiting another country. To make sure you qualify, get an E111 form, which is standard for all member states of the EU, before coming to Spain. It is usually available at post offices.
If you are receiving a benefit for a disability or as a pensioner in your home country (within the EU) you should also ask your local Social Security office for a E121 form as this will be required for you to receive free prescriptions.
Tarjeta de Seguridad Social (Spanish medical card)
The EU reciprocal agreement covers you for treatment in Spain until you get an official Medical Card (Tarjeta de SS) from your local Social Security Office (INSS – Oficina del Instuto Nacional de Seguridad Social) in Spain.
If in doubt as to where to go for this you should ask at your doctor’s office.
Applying for the card is not a difficult procedure and you should receive it within a very short time. You will need to show the official your E111/E121 (if you are an EU citizen) and other relevant documents such as your residence card or passport.
If you are not from an EU country and still wish to benefit from the Spanish public insurance scheme you should telephone or visit your Spanish consulate before leaving your home country to enquire as to what forms you may need to take with you.
Local doctors in Spain are as highly qualified as in any other EU country, sometimes more so.
Under the Carta de Derechos y Deberes you may choose your own doctor — it is not necessary to be living in a particular area. And if you do not like this doctor you are entitled to change practices.
You may also choose to go to a Centro de Salud (healthcare centre), which usually has about half a dozen doctors. You may not always get the doctor you first went to, but they do endeavour to give you a sense of regularity.
At a Centro de Salud you must make an appointment, whereas many doctors with their own practices take patients in the order in which they arrive.
You can find the address and telephone number of all the Centros de Salud in your region in the A-Z Listings (www.paginasamarillas.es).
The dental service in Spain is generally very good and efficient, with most practitioners having access to the latest in dental technology.
Unless you have private health insurance which covers dental work, you must pay for treatment at the dentist.
Again it is best to go by a recommendation when choosing a dentist.
You do not have to show any forms when visiting the dentist — simply make an appointment. It is, however, always advisable to take some form of identification with you.
Hospitals are generally very good, with an efficient and fairly rapid service. If it is an emergency you do not, of course, have to be referred by a doctor.
You should ensure you have either your E111/E121 form or your medical card as they will wish to see this. The hospital might also ask for identification, as this is routine everywhere in Spain. Either your passport or residence card will suffice.
You do not have to pay for any service other than prescriptions (if you are not a pensioner).
If you are alone and an ambulance has brought you in for, perhaps, an x-ray to check something is not broken, an ambulance will also return you to your home, even if nothing is found to be wrong.
If you have to stay in hospital and do not speak Spanish, you will find that even in smaller cities there are usually a couple of doctors and a nurse or two who can speak English. But if not, they will do their best to help you.
You can buy many medicines over the counter in Spain that you may not have been able to at home, but if you are a pensioner it would be cheaper and more advisable to see your doctor and to get a prescription from him.
In some countries there is a standard fee for prescriptions, no matter what they may be, but this is not the case in Spain where each item is priced differently. Still, you are likely to find that prescriptions in Spain are a lot cheaper than in many countries.
Pharmacies are usually open from 9.30 am until 2pm and from 5pm until 9.30pm Mondays to Fridays and from 9.30am until 2.30pm on a Saturday.
If you need a pharmacy outside these hours, there is always a local “Farmacia de Guardia”, even the smallest of villages, which is open 24hours a day.
Pharmacists have a more elevated role that perhaps you are used to back home. In Spain, they give medical advice and as such are often the heart of the Spanish community so you can expect lengthy queues when you go to get your medication, even if there is only 1 person in front of you, because people will often go to the pharmacist for minor ailments – coughs, colds, sprains – and describe (or demonstrate) their symptoms.