Healthcare in Spain

The Spanish are a healthy people - and no wonder. Because of the slow-paced life in Spain, people tend to be less stressed than in many other European countries, and the warm, sunny environment brings a smile to people's faces and boosts their immune systems. In addition to the pleasing environment and laid-back lifestyle of the locals, this country also boasts an excellent healthcare system which expats can also rely on.

Spain’s healthcare system is a mixture of the public and private sectors that are highly regarded as among the best in the world. Each of this country’s 12 regions is responsible for implementing medical services, so expats will soon see that there is a slight difference with the healthcare provisions, depending on their area of residence. Ensuring efficient communication between these regional governments and the Spanish is the responsibility of the Interterritorial Council of the Spanish National Health Service (Consejo Interterritorial del Servicio Nacional de Salud de España, CISNS) who sees to it that all residents of Spain receive quality healthcare.

Generally speaking, private health insurance is Spain is not mandatory since there is a universal healthcare scheme that guarantees coverage and no upfront payments from patients apart from paying a portion of their prescription expenses. Spain also has a bi-lateral agreement with countries such as Ecuador, Peru, Andorra, Brazil and Chile whereas their nationals (under short visits) are entitled to free emergency medical expenses.

The Spanish Public Healthcare Scheme

To qualify for the Spanish universal health coverage, expats must first get a social security number by registering with the Dirección General de la Tesorería General de la Seguridad Social (social security) which has several offices scattered across the country. Applicants must present several documents including their passport, ID card, residency certificate and a duly accomplished application form. Once expats have successfully registered, they will receive a Social Security number and a certificate proving their entitlement to free/subsidised medical services. The certificate must be taken to the local health centre (Centro de Salud) where they will register with a doctor and apply for a health card (tarjeta sanitaria individual or TSI) which they can pick up personally or receive by mail.

All foreign workers, without exception, financially contribute to the local social security system, hence, are fully entitled to register with the national health fund. For EU residents, showing your European Health Card, (replacement of the E-111), will suffice but private doctors and hospital do not accept the EHC. The state healthcare system only covers emergency dental treatments carried out in a hospital. Some extractions are subsidised, but orthodontic treatment is never covered. Children aged between 6 and 15 are entitled to free dental treatment, amounting to an annual check-up and fillings.

Doctors in Spain

To visit any of the public doctors in Spain, a resident of Spain has to be enlisted in his local town hall or Ayuntamiento and have a Spanish social security number. He will then be assigned a public GP or General Practitioner known locally as a medico de cabecera. EU citizens may use their EHIC card when seeking treatment from a public doctor. Those who prefer to consult a private GP can go directly to a hospital or clinic that is in their insurance provider's list. In both cases, everyone has to see a GP first before they can be referred to a specialist as needed.

Hospitals and Medical Services

If you prefer to be treated in a hospital and do not mind spending a few euros every month, then choosing a private health insurance is an option as waiting times to consult a specialist are shorter, plus you will be fully covered for all care including dental and eye care. Note that health insurance companies often won't insure people over 57 years or older.

State hospitals are well equipped and are well managed. Visitors to Spain and foreign residents can use the Spanish National Health system to a certain extent, alongside Spanish nationals. However, there are many situations where the only alternative is private healthcare. Spanish hospitals can sometimes have long waiting times so opting for a Centro de Saluds can be preferable. Most have emergency clinics open during the same hours as the health centre itself, and all large towns have at least one 24-hour emergency centre. Some of the most prominent hospitals in Spain are: