healthcare for residents in Spain

Spain healthcare system: how to apply as a resident

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All residents in Spain need to register to access healthcare system.

Residents normally access the Spanish national health system in one of these ways:

  • As a permanent resident if they’ve lived in Spain for 5 years
  • If residents are employed or self-employed in Spain
  • Paying directly into the public health insurance scheme according to a special agreement between countries
  • Registering an S1 form with the social security office (British citizens)

If you are a resident in Spain, you are entitled to apply for Spanish state healthcare based on your residency status. Normally the inclusion in the Social Security system is requested by appointment at the Social Security Office.

You can now also apply online. Here’s what to do:

  • Call the Overseas Healthcare Service and ask for a ‘legislation letter’. This tells the Spanish authorities that your home country does not cover your healthcare.
  • Complete the Spanish “Seguridad Social” healthcare application form.
  • Upload both of these documents, along with your passport and your residency certificate to the INSS online application service.

Please note, the application forms are in Spanish.

Remember that if you already receive your healthcare in Spain because you work and pay into the social security system, or you claim a Spanish or UK state pension, this option is not available. If you’re a Pensioner, your home country could cover your healthcare in Spain using an S1 form (for example, if you are British). If you are from a different country, please check your home country government healthcare guidance for more information.

If you are British and have been living in Spain before the end of 2020, your rights to access healthcare in Spain will stay the same for as long as you remain legally resident.

How to get your Covid 19 vaccine in Spain:

Spanish healthcare: Do I have access after Brexit being British?

With the exit of the United Kingdom from the European Union, a multitude of questions arise about the basic services that citizens receive, but one of the most important is: Do I have access to Healthcare in Spain after Brexit?

We will try to simplify the answer, depending on different scenarios:

First of all, you should know that the Public Health Care system in Spain is UNIVERSAL, so if you have a medical emergency you will be looked after at any Public Center. Do not hesitate to go to a Medical Center, regardless of your legal status in Spain.

UK citizens with permanent employment in Spain are entitled to spanish heatlth care?:

Yes. Spanish legislation guarantees health care for all workers registered with the Spanish Social Security system. In this case, the right is automatically recognized, and you do not have to take any steps.

What about family members?

This applies to the worker’s descendants who are under 26 years of age or disabled adults, provided that they are dependent and live with the worker, as well as the worker’s spouse or civil partner.

UK pensioners residing in Spain:

UK pensioners resident in Spain will not be affected in their entitlement to Health Care, which will continue in a similar way to that established in the Community Regulations, as stated in the EU-UK Trade and Cooperation Agreement.

British tourists in Spain:

British tourists are covered by means of the European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC) for temporary stays.

If you are going to be in Spain for more than 3 months, you must register as a resident.

If you are resident in Spain for more than 1 year, you could still join the Social Security System paying a flat fee depending on your age failing to comply with the requirements mentioned on previous scenarios.

Non-residents in Spain

Foreign visitors who do not have a Health Card from the Spanish National Health System or do not provide a document accrediting the health care cover provided by their home country may be charged by the Spanish National Health System for the services provided.

Will they vaccinate me against COVID-19?

One of the main questions asked by expats living in Spain and in the province of Alicante is: will I be vaccinated against COVID-19? The answer is clear and unequivocal: YES.

The Government of Spain states that “the vaccination strategy is a public health strategy and it is important to vaccinate against COVID-19 all persons residing in Spanish territory following, in any case, the prioritization established by conditions of risk, exposure, age and other criteria included in the strategy. Now, with a limited number of doses, all persons included in the priority groups are being vaccinated, regardless of their nationality or type of insurance, so wait for your Health Center to contact you or contact your doctor to find out about the vaccination schedule.

You may rest assured that you are entitled to the COVID-19 vaccine. However, it is important that all your details are registered with the Social Security so they could contact you in the future. If you have not done it yet, you could fill in a online form at the Spanish Social Security website.

The Health situation after Brexit raises many other questions, such as prescriptions and the medical record of British patients in Spain.

What will happen to the information in my medical record?

The holders of the Health Card maintain the same rights and the information in their medical records. In addition, the validity of the Health Cards of British nationals resident in Spain is extended until the 30th of June 2021, as is the validity of prescriptions for medicines issued in the United Kingdom. 

European Health Insurance Card holders (T.S.E)

If you need medical treatment during your stay in another EU country, presenting your European Health Insurance Card will simplify payment and reimbursement procedures.

With a European Health Insurance Card, you can receive healthcare – and claim reimbursement of costs – under the same conditions as nationals of the country where you are staying. If the treatment you need is free for residents of the country, you will not have to pay anything. If the treatment chargeable, you can claim reimbursement from the national body in the country where you are staying and get reimbursement there or claim reimbursement from your insurer when you return to your home country.

Costs will be reimbursed according to the rules and scales of the country where you received treatment. That is, you will either be reimbursed the full cost of the treatment or you will have to pay the patient’s share, depending on the rules of the country where you received care. Your insurer may also decide to reimburse the full cost according to its own rules.

In each EU country there is at least one national contact point that will be able to help you with reimbursement issues.

Without a European Health Insurance Card

If you do not have your European Health Insurance Card with you or cannot use it (for example, in a private hospital that is not covered by the EHIC scheme), you may be asked to pay for the care. You can then claim reimbursement from your health insurance when you return home. This applies to both Public and Private Health Care services. However, the conditions may be different:

  • You will only be reimbursed for treatment to which you are entitled in your home country.
  • You will be reimbursed only for the cost of treatment in your home country, which may be less than what you paid.

If you need urgent treatment, the local health administration in your country can make things easier by faxing or emailing proof of your social security cover to avoid you having to pay upfront.

If you are not sure about what you are entitled to and want to find out before you receive care, each EU country has at least one national CONTACT POINT where they can tell you whether you are entitled to reimbursement and whether certain limits apply.

Health Insurance Spain

If you are travelling abroad specifically for medical treatment, the rules are different.

If you need assistance to register you at the Spanish Social Security or assist you to get private insurance, do not hesitate to contact us.

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