Anyone relocating to live in Spain long-term will have plenty to learn about – from how to rent property in the country to how the local tax system works. But what about how to get health insurance in Spain? To make things easier to understand, we’ve created this quick guide covering the key points, from who’s able to access free healthcare to what exactly the public system covers.
How the healthcare system works in Spain
Spain’s National Health System, or Sistema Nacional de Salud, provides a comprehensive healthcare infrastructure which is funded by social security payments. How much you have to pay in social security will depend on the nature of your work, your salary, and whether you’re employed or self-employed. Employees usually pay significantly less than the self-employed – that’s because their social security obligations are partly covered by their employers, while self-employed residents have to pay the whole amount themselves. Whatever the amount you’re liable to pay, it will entitle you to access doctors and hospital treatment without paying extra.
If you are looking to get health insurance in Spain, private healthcare is also available. In fact, it’s estimated that almost 20% of the Spanish population has taken out private health insurance, which can provide major benefits like shorter waiting times for treatments and access to services not covered by the National Health System.
What does the Spanish public healthcare system cover?
Any immigrant in Spain who is making social security payments, or receiving state provisions like unemployment benefits, will have the right to freely access the National Health System. This is also true of partners and children under the age of 26 residing in the country. Public healthcare covers a range of services including:
- GP (general practitioner) consultations
- Specialist consultations
- Hospital care
- Emergency care (including emergency dental treatments)
- Physical therapy
- Mental health services
When it comes to prescription medications, Spain operates a co-payment scheme. This means you’ll have to pay up to 60% of the price of medications, depending on your household income.
How to register for public healthcare in Spain
It probably won’t come as a surprise to learn that registering for Spain’s public healthcare system will require a bit of paperwork. An important first step for any new immigrant to the country looking to get health insurance in Spain is to get listed on the padrón, the municipal register which provides official confirmation of your address. This can be done at your local town hall, and you’ll typically have to show your passport, rental contract, recent utility bill, and NIE (foreigners’ identity number).
You’ll also need to apply for your social security (seguridad social) number and a certificate stating you have a right to access public healthcare. The formalities may be handled by your employer, if you have one. Otherwise, you’ll have to visit a local office of the Tesoreria de la Seguridad Social. You can look up the contact information for the most conveniently located office using this official online directory.
You’ll be required to submit a completed TA.1 form and show your passport, visa and residency documentation, NIE, and padrón certification. You may also have to show your employment contract and/or rental agreement, so it’s a good idea to bring these along just in case.
Once you have your social security number and official confirmation of your eligibility for healthcare, you’ll be all set to obtain your unique health card. Also known as the Tarjeta Sanitaria, it will need to be shown whenever you require medical services and treatments in the country. The card can be obtained at your local health centre, or centro de salud. Your autonomous region’s official government website will let you look up which health centre corresponds to your address. For example, a resident of Catalonia can pinpoint the right health centre here.
Do you need private healthcare in Spain?
The National Health System in Spain ticks plenty of boxes, providing world-class care across its network of doctors’ surgeries and hospitals. That said, as we mentioned a bit earlier, a significant proportion of people who want to get health insurance in Spain choose to take out private health insurance which can let you access specialists more quickly, and receive treatment at private health centres and hospitals. You can also expect shorter queues for surgery and other treatments.
The attraction of private healthcare doesn’t just lie in these perks. It’s also worth noting that, with the exception of emergency treatments, dental care isn’t covered by Spain’s public healthcare system. This means that patients have to pay out of their own pockets for routine checkups as well as for treatments like fillings, root canals, and extractions. Getting a private healthcare plan that includes dental care can be a more cost-effective alternative to paying the dentist directly whenever issues come up.
Cost of private healthcare
Of course, prices for private health insurance policies can vary widely depending on your age, personal circumstances, and how wide-ranging the coverage is. The monthly cost can range from around €35 all the way to €300 and beyond, and it’s a good idea to use a price comparison portal, such as Acierto or Rastreator, to compare different packages and providers. Keep in mind, however, that a low price should only be one of your considerations.
It’s equally important to go for a policy that meets your specific requirements. For example, if you’re younger with no pre-existing medical conditions, you may prefer to go for a low-cost package which covers dental care and outpatient consultations and treatments. If your needs are likely to be greater in the months and years to come, you may want to pay more for a policy that will cover hospital treatment, including major operations.
You’ll also want to decide whether you’d like a reimbursement or co-payment policy.
With a reimbursement policy, you’ll typically get full access to treatments provided by health centres and hospitals within the insurer’s own network, and you’ll also be able to pay for treatment by healthcare providers outside the network and have a percentage of these costs reimbursed. For example, a policy may fully reimburse you 90% of medical fees when you go outside the insurer’s network, up to a maximum of €500,000 per year. This flexibility is a key advantage of reimbursement policies, and if your work requires travelling across the country, or even abroad, this kind of insurance may be for you.
Co-payment policies require you to pay certain fees, on top of your monthly premium, for every service or treatment you use. You may have to pay, say, €24 for an emergency home visit by a doctor, or €8 for a physiotherapy session. You’re likely to be restricted to the insurer’s own network of health centres and hospitals, but the main advantage here is that premiums tend to be lower than some of the more flexible and all-encompassing reimbursement policies.