Spain has one of the best healthcare systems in Europe, providing high-quality services to both nationals and expats, including expats. The healthcare system here is divided into public and private, and for many expats, it is important to understand the differences in order to choose the right option for their needs. In this article, we will take a detailed look at how the Spanish healthcare system works, what expats need to access services, how to get insurance, and what healthcare services are available in Spain.
1. Basics of the Spanish healthcare system
Spain provides its citizens and permanent residents with free access to healthcare through the public healthcare system, the Servicio Nacional de Salud (SNS). Expats can also access this system under certain conditions. The public system covers essential healthcare services, including GP visits, specialist care, surgical procedures, and emergencies.
- Public System (SNS): Available to citizens, residents, and expats with a work or study permit. It is financed through taxes, making it accessible at no direct cost to patients.
- Private Healthcare: Some expats prefer private health insurance, which provides access to a wider range of healthcare facilities, reduces waiting times and includes a wider range of specialist services.
2. Access to the Public Healthcare System for Expats
To access the SNS, expats must meet several criteria:
- Employment: Foreigners working in Spain are required to pay taxes to the Spanish Social Security Fund. In doing so, they are entitled to healthcare for themselves and their families.
- EU Pensioners: EU citizens who have retired and moved to Spain are also entitled to healthcare. They can obtain an S1 document in their home country, which entitles them to the SNS.
- Students and temporary residents: People with a temporary residence permit must have private health insurance if they are not eligible for SNS. Students may be able to receive health services depending on the conditions of their visa and insurance.
3. How to get a Spanish Health Card (Tarjeta Sanitaria)
To use SNS services, expats must obtain a health card - Tarjeta Sanitaria. This document allows them to access free health care in public clinics and hospitals.
- Procedure for obtaining:
- Visit your local Social Security office (Seguridad Social) with proof of employment or registration as a resident.
- Fill out an application and provide the necessary documents, including your passport, residence permit and proof of registration at your place of residence.
- A health card is issued based on your registration with the Social Security system. It allows you to choose a therapist and use public health services.
4. Private Health Insurance
Private health insurance is becoming a popular choice among expats, especially those who value flexibility and minimal waiting times.
- Advantages of Private Insurance:
- Faster service: Private clinics have shorter waiting times.
- Choice of clinics and doctors: Access to a wide range of medical facilities and specialists.
- International coverage: Insurers that cater to expats often offer plans with coverage outside of Spain.
- Choice of Insurance: There are many insurance companies operating in Spain, offering different levels of insurance. The most popular companies among expats are Sanitas, Asisa, Mapfre and Adeslas, offering packages from basic coverage to premium plans.
- Cost: The average cost of insurance ranges from €50 to €200 per month, depending on age, health and level of coverage. Discounts and extras are also available for families.
5. Healthcare in Spain: What is covered by the SNS
The Spanish public healthcare system provides a range of services:
- Primary care: Visits to a general practitioner are free for anyone with a health card. The general practitioner can also refer the patient to a specialist if necessary.
- Ambulance: Emergency care is available to everyone, regardless of insurance status, especially in life-threatening cases.
- Hospitalisation and surgery: Surgeries and hospital treatment are covered by the SNS. However, there is a waiting list for some procedures, especially in larger cities.
- Medicines: There are partial subsidies for medications prescribed by a doctor. Pensioners and people on low incomes may receive higher reimbursement for medications.
6. Main health centres and clinics in Spain
In major cities in Spain, such as Madrid, Barcelona, Valencia and Seville, there are both public and private hospitals. For example:
- Hospital Clínico San Carlos in Madrid: a large public hospital with a wide range of medical services.
- Hospital Universitario Vall d'Hebron in Barcelona: known for its research and advanced medical technology.
- Quirónsalud is the largest private network of hospitals, providing quality healthcare throughout Spain.
7. The role of pharmacies and buying medicines
Pharmacies are an important part of the healthcare system in Spain. Unlike some countries where medicines are available in supermarkets, in Spain they are sold exclusively in pharmacies. Pharmacists can provide advice, recommend medicines for simple ailments and help with prescriptions.
- Prescription and its importance: Most strong medications require a prescription from a doctor. Cold medicines, painkillers and vitamins are available without a prescription.
- Subsidized medicines: If the medicine is prescribed by a SNS doctor, the patient receives a partial subsidy, making the cost more affordable.
- Pharmacy opening hours: Most pharmacies are open during normal opening hours, but in larger cities there are always pharmacies open 24 hours a day.
8. Healthcare for tourists and temporary residents
If you are temporarily in Spain and are not a resident, emergency medical care is available. EU citizens can use the European Health Insurance Card (EHIC) to cover the cost of emergency treatment. For non-EU citizens, it is recommended to take out international health insurance for the duration of your trip.
- EHIC for EU citizens: Allows visitors to receive emergency healthcare in public institutions in Spain under the same conditions as residents.
- Health insurance for non-EU citizens: It is recommended that non-EU citizens take out temporary health insurance that covers treatment and emergency services.
9. How to avoid bureaucracy and get quality treatment
The Spanish healthcare system can be complicated for new residents. To make the process easier, here are a few tips:
- Get all your paperwork done in advance: Registering with the SNS and obtaining a health card will help avoid delays in the future.
- Consider mixed healthcare: Many expats choose a combination of public and private insurance to get more coverage.
- Learn Spanish: Many doctors speak English, but knowing basic Spanish will make it easier to communicate with medical staff.
Healthcare for Expats in Spain
The Spanish healthcare system offers a high level of medical care and is accessible to both EU residents and expats from other countries. Proper paperwork, choosing an insurance plan, and knowing the available services will help you feel confident and safe in Spain.