Healthcare in Spain

What is the quality of the Health Service in Spain?
The quality of healthcare in Spain is comparable to that of the UK and Ireland. There is a two tier system, The State National Health Service and the private health care sector, which is funded by private health insurance such as BUPA.

What is the cost of private medical insurance?
The costs of PHI (Private Health Insurance) is less expensive than in the UK and Ireland. But before you take up residence in Spain, you should speak to your existing insurer and find out what they will offer you and your partner to maintain your PHI in Spain. This will be particularly important if you have an existing condition for which you have been receiving treatment. Most new insurers will exclude coverage for existing medical conditions.

There has been considerable consolidation within the PHI industry in Spain during the last 7 years, with a few large companies such as Sanitas (owned by BUPA), Previaso, Asisa and Adeslas. now dominating the national market. You will find several smaller companies who concentrate their operations on the Costa del Sol, including some International companies from the UK, Denmark, Holland and the USA.

Prices vary depending upon your previous health condition and your age. As a guideline, if you are under 60 you can expect to pay approximately £48 (€ 74.4) per month as an individual. Family cover, including dental care, can be obtained for approximately £117(€181) per month. This covers a family with three young children. If you are happy to take your health care through the Spanish National Health Service, but you wish to have coverage in case of medical emergencies or accidents, you can obtain a very comprehensive policy from one of the private emergency medical companies who will respond to call-out 24 hrs & 365 days a year.

If you belong to a Society or professional organisation, you will benefit from the special deals offered by the PHI companies. You should also contact the foreign PHI companies who have offices locally such as PPP International, Exeter friendly Society, Columbus HealthCare, and International Health Insurance from Denmark. The policies offered by these companies usually covers repatriation if you wish to be treated back home; although you will have to show that the required treatment is not available in Spain.

Your local Spanish doctor will give you a Form Mod-P10, which you should take to the specialist. There are no additional fees to be paid.

What happens if I become very ill and wish to return home for treatment?
Then we would suggest you take out a comprehensive policy with BUPA or PPP to cover such an eventuality. This policy will cost you around €170 per month, depending on your age and previous medical condition. It will of course cover all your private health needs while you are living in Spain.

Can we get private insurance for Medical Emergencies?
You can take out an annual insurance cover for about €90 per person or €210 per family, with an organisation called Helicopteros Sanitarios. This is an emergency service operating all year round 24 hours a day. They will keep a copy of your records and you can call them to visit your home or if you are involved in any type of accident, including a car accident. We will be happy to introduce you and help complete the necessary documentation.

What about dental care on the Spanish national Health System?
Dental care covers tooth extraction and Maxilofacial surgery only. It is highly advisable to obtain private dental health insurance. Costs vary considerably depending on age and current state of dental health. Our Consultant staff will always be available to advise you on where to obtain the best insurance cover.

If I'm self employed, what is the situation regarding health care on the Spanish national Health system?
If you are self employed, you should first obtain your residence card from the police (Guardia Civil), plus the 'Alta Fiscal' from the Tax office (Hacienda). Take these documents to the office of the Tesoreria de Seguridad Social and ask for the 'Alta de Autonomo and Inscription en la Seguridad Social'. You will then receive a medical card which will entitle you to full medical cover from the Insulad (your local medical clinic). Please do not loose your medical card as you must present it each time you visit a hospital or the local Clinic.

There is free universal health care in Spain. The problem is that to become insured you have to have a social security number. To get one, you generally have to either work for a company or become self employed (in which case you'll pay to be part of the system). That said, you can occasionally "beat the system" with luck and persuasion. An American friend of ours arrived to Spain when she was 76 years old, and managed to convince the people at the social security office to give her a number.

If your country of origin has universal health care, then you may be able to get your country to pay Spain to cover you. For the UK, this is the case for those over 60 and for some people who qualify for the invalidity benefit. You will need the appropriate form (E121 or E106).

If you have a Certificado of Empadronamiento (see Moving), you have the right to emergency care in any public hospital. Once any temporary health care from your country runs out, look into contracting private insurance.

The Spanish Health Care System:
Spain has a public health system so health care is free or low cost if you pay social security (families and retirees are also included). Like many countries, however, the public health service has waiting lists to see specialists and for non-urgent operations.

If you do not qualify for public health care then it is essential that you have private health insurance; you may not be allowed in the country without it. Even if you are under the public health care system it is still advisable (if you can afford) to have private health insurance in order to skip the waiting lists and receive treatment quickly. The most popular private health plans are Adeslas and Sanitas.

Spanish Hospitals:
Generally the larger towns have the best hospitals, which can be found by following signs with a big white 'H' or looking in the Yellow Pages under hospitals.

When attending a hospital (except in the case of an emergency) you must present either a social security card, evidence of private health insurance or proof of ability to pay the bills. If the insurance company does not pay to the hospital directly then you should pay yourself (credit cards are generally accepted) and claim this from the insurance company at a later date.

Spanish Doctors:
The system of educating doctors in Spain is very different from that used in North America. As is common in Europe, medical doctors receive their training as university undergraduates. With public health care, you will usually be assigned a general doctor where you live when issued your social security card. With insurance, you will be able to select a primary care doctor from those affiliated with your plan. There are a number of doctors in Spain who speak English, especially in cities and resort areas, including doctors who received their training in English speaking countries. Embassies and consulates usually maintain lists of such doctors.

Spanish Pharmacies:
Many drugs, including antibiotics, that are available only with a prescription in other countries may be obtained directly from pharmacists in Spain without a prescription. For those drugs where a prescription is required, when given a prescription by a doctor you can pick up the drugs or medicines from a pharmacy which displays the sign of a green cross. Most pharmacies are open from 09:30 until 13:30 and from 16:30 until 20:00 from Monday to Saturday. Outside of those hours a notice will be posted of the nearest pharmacy open after 20:00. There are 24 hour pharmacies in all towns, which pharmacies are indicated by a red light on the pharmacy sign.

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