Health care in Spain for resident and non-resident foreigners
24 Noviembre, 2023
Health care in Spain
In Spain, persons "insured" by the National Social Security System, and their "beneficiaries", are entitled to apply for health care:
- Insured: you can apply if you are working and are affiliated and registered in the National Social Security System, if you are a pensioner or unemployed and have exhausted your unemployment benefit or subsidy and reside in Spain.
- Beneficiaries: you can apply if you are a relative of an insured person, reside in Spain and meet certain requirements.
Foreigners who are not registered or authorized to reside in Spain are entitled to the same protection and health care as persons with Spanish nationality.
Persons who cannot be insured because they do not meet the required conditions may, however, have access to public health care through voluntary insurance with the competent authorities of the Autonomous Community.
How is this health care regulated in Spain for foreigners?
Full health care in Spain for foreigners means that any person, regardless of his or her situation, can be treated in a public health center. However, to control possible abuses that may occur in this regard, a series of measures have been adopted.
These include the need to prove residence in Spain for more than 90 days. In this way, foreigners who have their own medical coverage in their country of origin and intend to make fraudulent use of this service are prevented from accessing the public health service.
However, despite the application of this requirement, undocumented immigrants also have access to health care, for which a report from the social services certifying that they do not have the minimum resources is required.
Regarding the purchase of prescription drugs, this group must pay the same amount as Spaniards with an income of less than 18,000 euros, i.e. 40% of the total.
On the other hand, the regulations on healthcare in Spain for foreigners also regulate organ transplants in order to bring down health tourism. In this sense, in order to be included in the list for this type of intervention, it is necessary to prove a period of residence of more than two years in the country.
But what about the rest of foreigners? In the following situations, they can also receive health care at public expense through the National Health System (NHS):
- Persons in condition of political asylees with authorized residence in Spanish territory.
- Victims of human trafficking, during the period of reinstatement and reflection.
- Persons requiring urgent health care due to serious illness or accident, pregnancy, childbirth and postpartum care.
- Minors under 18 years of age.
In any case, universal public health care in our country is only recognized within our borders, so this right does not mean that it can be enjoyed elsewhere. Migrants residing in Spain on a regular basis must comply with the requirements established by the corresponding autonomous community in order to access healthcare coverage.
Specific cases, residents and non-residents.
Non-residents
- EU/EEA/Swiss Nationals: These residents can receive free medical care using the European Health Insurance Card (EHIC). If you are planning to move to Spain on a temporary basis, be sure to apply for it before traveling, as it will greatly facilitate your access to health care. It should be requested in the country of residence, since it will be the country that will assume the medical expenses that may be incurred during the stay in Spain.
- Other nationalities: For temporary stays (where there is no registration as a resident in Spain), private insurance may be required as a prerequisite to travel to Spain. However, some countries have bilateral agreements that do not require this requirement. For this reason, it is advisable to consult with the embassy of the country of origin when handling visa/permit procedures.
Residents
According to the new legislation, all registered residents in Spain have access to healthcare, regardless of their status in the country. To access public healthcare in Spain, the following steps must be followed:
- Residency registration: in Spain is known as empadronamiento. It is a certificate indicating the official address in Spain, and can be obtained at the local town hall.
- Social security number and card: If you are working in Spain, your employer will register you in the social security system and you will therefore have a social security number. If you are not working, you will need to obtain your social security number from one of the social security offices. To obtain a social security card, you will require a valid identity document and certificate of residence (municipal registration).
- Health System card: after completing the procedure at the social security office, a certificate granting access to the health system will be issued. With this document, an identification document and the certificate of residence, you can apply for a health card at the nearest health center. In about two weeks you will receive the health card. In the meantime, a temporary document will be provided that will allow access to medical care and assign a general practitioner (family doctor). The medical card covers all visits to the hospital and primary care physicians and 40- 60% of the cost of prescription drugs depending on income.
Private Health-care
Foreigners may need private insurance to complete visa or permit procedures, to find health care in their language or as an easier way to access specialists. Dental coverage in the public system is very limited, so dental insurance can help reduce the cost of dental treatment in Spain. Compared to other European countries, private healthcare in Spain is affordable. There are several options among which the following stand out:
- Joining a mutual insurance company: In this case, the employee pays contributions to the Spanish social security system and, at the same time, joins a mutual insurance company. Mutuals have their own network of hospitals, clinics and laboratories. Access to health care is faster than in the public system. Membership in a mutual insurance company is paid for. To benefit from free health care, the insured person must first see a Spanish Social Security doctor who will refer him/her to a specialist (public or private system).
- Affiliation with a private insurance company: In this case, the insured may go to any doctor and any clinic. The health care you receive will be fully covered or reimbursed in accordance with the terms of your insurance policy.
