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The rules for getting state healthcare in Spain are different from those in the UK. This guide is intended to advise British nationals living, or planning to live, in Spain on the different ways to access healthcare.
If you are registered to work in Spain and make national insurance contributions then you can get state-run health care on the same basis as a Spanish national. For further information, get in touch with your local TGSS office.
If you registered as a resident in Spain before 24 April 2012, have an annual income of less than €100,000 and are not covered for healthcare though any other means, speak to your local INSS office to register for healthcare in Spain as a resident.
If you are in receipt of a UK old age state pension or long term sickness benefit, obtain an S1 form (previously E121) from the International Pension Centre on +44 191 218 7777. Once issued, register the S1 form with your local INSS office, before you register with your local GP surgery and obtain a medical card.
If you are an early retiree and have recently made national insurance contributions in the UK, contact the Overseas Healthcare Team on +44 191 218 1999 to see if you have entitlement to a residual S1 form (previously E106) for a limited time. Once issued, register the S1 form with your local INSS office, before you register with your local GP surgery.
If you are a worker seconded to Spain, or the family member of a someone making UK national insurance contributions, contact HMRC to see if you have entitlement to an S1 form (previously and E106 or E109). Once issued, register the S1 form with your localINSS office, before you register with your local GP surgery.
If you are coming to study or are currently studying in Spain as part of a UK-recognised course, you may be entitled to healthcare paid for by the UK.
If you are not covered for state-run healthcare through other means, the Spanish government recently announced guidelines for regional health authorities to offer a new special scheme (convenio especial). This is a public health insurance scheme available nation-wide where you can pay a monthly quota to access state-run healthcare.
The scheme will be managed by each autonomous region which will have the option of including different services over and above the basic package announced by the government. Policy holders, including children, will pay on an individual basis and be able to receive access to public healthcare, regardless of pre-existing conditions, anywhere in Spain.
The announced basic monthly fee is 60€ for the under 65s and 157€ for those aged 65 and above. However, prescriptions are not subsidised at this rate so you would pay 100% of prescription costs. We expect to receive news of the launch of the convenio in each autonomous community in the near future.
The UK European Health Insurance Card (EHIC) is valid for holidaymakers and temporary visitors who need to use the state health system while in another EU country. If you are not normally a resident of the UK, and therefore do not have entitlement to a UK-issued EHIC, the Spanish authorities may decide to treat you as a private patient.
If you are a resident in the UK, you should apply for your EHIC before travelling to other European Union Member States. A UK EHIC is usually valid for three to five years – but if you stop being a UK resident, you need to return your EHIC to the Department of Health immediately.
If you are a UK state pensioner living in Spain and registered for healthcare with an S1, the UK is responsible for issuing your EHIC to use on a temporary stay in the UK and a third EU country. For more information, telephone the Overseas Healthcare Team on +44 191 218 1999.
The EHIC gives you access to medically necessary, state-provided healthcare during a temporary stay in Spain.
When you show your EHIC, you will receive treatment under the same conditions and at the same cost as people insured in Spain.
Be aware that each country’s healthcare system is different. Services that cost you nothing at home might not be free in Spain (for example, prescriptions).
The EHIC is not an alternative to travel insurance. It does not cover any private healthcare or costs such as a return flight to your home country or lost/stolen property.
The EHIC does not cover your costs if you are travelling for the express purpose of obtaining medical treatment. If this is the case you must apply for form S2 from your local NHS Trust.
If you need to receive oxygen therapy during a temporary visit to Spain, you must request it in advance, in writing, from the Spanish authorities. You should send this request at least one month before you are due to travel.
Oxygen therapy needs to be arranged directly with the Spanish authorities. The Healthcare Team at the British Consulate can provide a list of contacts and a template letter in Spanish to help you make the arrangements. Send an email to firstname.lastname@example.org to request the information.
Once you have sent the oxygen request directly to the Spanish authorities, it is your responsibility to then follow up with the relevant oxygen provider to confirm your request has been processed.
Spain uses a co-payment system (information in Spanish) where residents are required to pay a percentage of the cost of their prescription medication. If you are a pensioner and have paid more than you should have for prescription medication, speak with your pharmacists or local health centre to confirm the process in your region to claim a refund.
The table below provides a basic overview of what residents are required to contribute:
|Annual income||Social situation||% of contribution||Capped at|
|Less than €18,000||Working age||40%||No cap|
|Between €18,000 and €100,000||Working age||50%||No cap|
|Over €100,000||Working age||60%||No cap|
If you have a specific question regarding access to healthcare in Spain, please email the Healthcare Team on Enquiries.Social-Sec.Spain@fco.gov.uk or by calling 902 109 356 (in Spain) +34 913 342 194 (outside Spain).