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When traveling to Spain, having appropriate health insurance is crucial for covering medical expenses. Here’s a detailed explanation of the requirements and differences between public and private health care, including the use of GHIC (Global Health Insurance Card) or EHIC (European Health Insurance Card) and potential issues with private health insurance.
1. Coverage for Medical Expenses: The insurance should cover medical expenses including hospital stays, doctor visits, and emergency treatments.
2. Repatriation: The insurance should cover repatriation for medical reasons or in case of death.
3. Minimum Coverage Amount: Some policies specify a minimum coverage amount, often around €30,000 to €50,000.
4. Validity: The policy should be valid for the entire duration of the stay.
5. No Co-Payments: Ensure the policy covers the full cost of medical care without requiring co-payments.
- Funded by the government and available to residents and EU citizens with EHIC/GHIC.
- Provides comprehensive medical services, including emergency care, hospital stays, and primary care.
- Typically free or very low cost at the point of use.
- Long wait times for non-emergency treatments can be an issue.
- Available to anyone who chooses to pay for private insurance.
- Offers faster access to specialists and elective procedures.
- Higher standard of comfort and amenities in private hospitals and clinics.
- Costs are higher, and patients without insurance pay out-of-pocket for services.
- Allows EU citizens to receive medical treatment in another member state under the same conditions and at the same cost as residents of that country.
- Covers medically necessary treatments during a temporary stay.
- Does not cover private health care or repatriation costs.
- Similar to EHIC, issued to UK residents post-Brexit for use in EU countries.
- Provides access to necessary state-provided healthcare at reduced cost or sometimes for free.
- Like EHIC, it does not cover private healthcare or non-urgent medical treatments.
1. Pre-Existing Conditions: Many private insurance policies do not cover pre-existing conditions, or they may have waiting periods before coverage starts.
2. Specific Exclusions: Some policies exclude certain types of care, such as mental health treatments, maternity care, or dental care.
3. Policy Limits: There may be caps on the amount payable per treatment or per year, which can lead to out-of-pocket expenses if the limits are exceeded.
4. Administrative Issues: Navigating the claims process can be challenging, especially for non-Spanish speakers, leading to delays or denials in coverage.
5. Network Restrictions: Some policies require treatment to be received at specific hospitals or from particular doctors within a network, limiting choices for the insured.
When traveling to Spain, ensuring you have comprehensive health insurance is essential. While GHIC/EHIC provides necessary state healthcare access, private health insurance offers additional benefits like quicker access to services and better amenities. However, be aware of the potential issues such as exclusions, limits, and administrative hurdles with private health insurance. Always read the policy details carefully to understand what is and isn’t covered.
Each of the 17 regions in Spain is responsible for the provision of healthcare in the region. Central government simply oversees the budget. There are a wide range of clinics, hospitals and surgeries within each region and healthcare is available either free or at a very low cost to those who are enrolled and contribute to the social security system.
Most residents are no more than 15 minutes away from the nearest health centre and there is the facility to be seen at home if needed. In rural areas clinics may only be open on a part-time basis and staffed by professionals from different health centres around the region. Most hospitals have an accident and emergency department and there are smaller accident units at some health centres (centro de salud). Occasionally it may be the case that you need to travel to another area if the facilities for treatment are not available locally. It is normal when needing surgery in Spain to be added to a waiting list although these are generally not as long as the waiting lists in the UK. Many people will have private healthcare insurance for situations where they need surgery in order to avoid waiting, so this keeps waiting lists at a minimum. Spanish medical staff deal only with medical treatment, all other care is expected to be provided by the family or carers.
It is considered that the overall standard of healthcare in the country is good and in most hospitals there are staff who can speak English. If you should need to visit a health centre then they can often arrange for an interpreter if one is needed. The Voluntary interpreting service for the Axarquia health centres is a valuable charity service funded by public donantions and provides on-site interpreters in the Axarquia health centres to those in need. The ASOCIACIÓN DE VOLUNTARIOS INTÉRPRETES PARA LA SALUD DE LA AXARQUÍA website is at www.avisavoluntariosinterpretes.com
The Spanish healthcare system is ranked among the best in the world. Here´s how to sign up to free state healthcare in Spain, or apply for health insurance. If you're living and working in Spain you'll likely have access to Spain's free state healthcare, paid partly by social security payments, which will be deducted from your wage. The Spanish healthcare service is regularly rated among the world´s best, guaranteeing universal coverage and no upfront expenditure from patients apart from paying a proportion of prescription charges. Spain spends about 10 percent of its GDP on healthcare, and is ranked 6th in the EU for the number of doctors with around four doctors per 1,000 people. A 2012 World Health Organisation survey showed that Spanish women outlive all other nationalities (living to 85.1 years) apart from the Japanese, so they must be doing something right.
Spanish healthcare consists of both private and public healthcare, with some hospitals (hospitales) and healthcare centres (centros de salud) offering both private (privado) and state healthcare services (asistencia sanitaria publica). You don´t need to have private health insurance to get medical treatment in Spain but it usually allows you to get faster treatment for non-emergency procedures.
State healthcare is free of charge to anyone living and working in Spain, although in some of the Spanish islands you may have to travel to find a state healthcare provider. As an expat, you are entitled to free state healthcare if you are: resident in Spain and work in employment or self-employment and pay social security contributions, resident in Spain and receiving certain state benefits, resident in Spain and recently divorced or separated from a partner registered with social security, a child resident in Spain, a pregnant woman who is resident in Spain, under 26 and studying in Spain, a state pensioner, or staying temporarily in Spain and have an EHIC card (see below).
If you don´t have the right to state healthcare you have to organise private health cover. If you have been registered on the padron at your town hall for a year, the Spanish government has a state insurance scheme (convenio especial) with a basic monthly fee. This is administered by the authorities in each autonomous region. The state system is funded by social security contributions, with each region of Spain taking individual responsibility for a health budget allocated by central government. As the healthcare system is decentralised, you will need to check the conditions in your own area for using healthcare services. There´s a directory of the regional health authorities within the different regions of Spain on the Spanish health ministry´s website (mainly in Spanish).
If you are not paying social security contributions, then you can choose to take out private health insurance or pay the full amount of any medical costs. How to register for Spain's public health care; First of all, you must register with social security (Direccion General de la Tesoreria General de la Seguridad Social or TGSS), which has offices throughout Spain, to get a social security number. You´ll need to show your passport or ID card, residency certificate and a completed application form. You´ll also need to have registered your details (address etc.) at your town hall. Once you have registered with the TGSS you´ll be given a social security number and a certificate stating that you´re entitled to medical help. You then take the certificate, passport and NIE number (foreigner´s identity number) along to your local health centre. You can then register with a doctor and apply for a health card (tarjeta sanitaria individual or TSI). This will be sent to you in the post, or you will be asked to pick it up personally. The health centre will also be able to arrange for you to get a Sistema de Informacion Poblacional or SIP card. You´ll need to show it every time you visit a clinic, hospital or collect a prescription from a pharmacy.
In an emergency you can go straight to a hospital A&E or ER (Urgencias).
If you want to get any other type of hospital treatment, you´ll need a referral from a doctor. There are public and private hospitals. Only the public hospitals provide free treatment. Some hospitals offer both private (privado) and state healthcare services (asistencia sanitaria publica), so make sure the staff knows which service you want.
When you go to hospital you´ll need to show your social security card or proof of private insurance.
If you are discharged from a hospital and need medication, you have to take the hospital medical report to a pharmacy for the prescription to be fulfilled, as hospital doctors don´t issue prescriptions.
You can take a prescription to any pharmacy (farmacia). Look for a shop with a large green cross sign outside.
Pharmacy opening hours
Pharmacies are usually open Monday to Friday from 9.30am to 2pm and 5pm to 9.30pm, and Saturdays 9.30am to 2pm. There´s usually a notice on the pharmacy window or door with details of the nearest 24-hour pharmacy (farmacia de guardia) or you can find a list of pharmacies online.
In Spain, the cost of prescription medications is subsidized by the public healthcare system (Sistema Nacional de Salud, SNS), with the amount that patients pay depending on their income and employment status. Here is an overview of the current prescription charges:
1. General Employed Workers:
- Income less than €18,000/year: Pay 40% of the prescription cost.
- Income between €18,000 and €100,000/year: Pay 50% of the prescription cost.
- Income over €100,000/year. Pay 60% of the prescription cost.
2. Pensioners:
- Income less than €18,000/year: Pay 10% of the prescription cost, with a maximum monthly cap of €8.23.
- Income between €18,000 and €100,000/year: Pay 10% of the prescription cost, with a maximum monthly cap of €18.52.
- Income over €100,000/year: Pay 60% of the prescription cost, with a maximum monthly cap of €61.75.
3. Unemployed and Social Assistance Recipients:
- Exempt from prescription charges.
Additional Considerations
- Chronic Conditions and Severe Illnesses: Patients with chronic conditions or severe illnesses may have lower co-payment rates or be exempt from prescription charges.
- Children and Young Adults: Individuals under 18 years old are generally exempt from prescription charges.
- Special Cases: Certain medications that are essential but very costly may have additional subsidies to ensure affordability.
Caps on Prescription Costs
For pensioners, there are caps on the amount they need to pay monthly, ensuring that costs do not become prohibitive. These caps vary based on income brackets, as noted above.
Summary
The Spanish healthcare system aims to make medications affordable by subsidizing a significant portion of the cost based on the patient's income and status. Lower-income groups and vulnerable populations, such as pensioners and the unemployed, benefit from reduced rates or exemptions, ensuring equitable access to necessary medications.
In a serious, life-threatening emergency, call the pan-European number 112 free of charge from any mobile/cell phone or landline. The Spanish word for A&E or ER is urgencias.
Other emergency numbers include:
Ambulance: 061
Fire brigade: 080
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