Spain offers a public healthcare system that ranks among the best in Europe. Foreign residents who meet the requirements can access medical services at little to no cost. Understanding how to register, what is covered, and how private healthcare options fit into the system helps ensure proper medical care while living in Spain.
Public Healthcare Access for Foreign Residents
Spain’s public healthcare system, known as Sistema Nacional de Salud (SNS), is funded through social security contributions. Foreign residents can qualify based on employment, residency, or specific agreements between Spain and their home country.
Who Can Access Public Healthcare?
- Employed and self-employed residents: Workers paying into Spain’s social security system automatically qualify for public healthcare.
- EU/EEA/Swiss citizens: Those holding an EHIC (European Health Insurance Card) can receive temporary medical care, but long-term residents must register in the system.
- Non-EU citizens with residence permits: Residency-based access depends on agreements with Spain or enrollment in social security.
- Pensioners from EU countries: Retired residents from EU nations can use Spain’s public healthcare by transferring their health coverage through the S1 form.
- Low-income, uninsured residents: Those without social security contributions may qualify under the Convenio Especial, a monthly payment plan granting public healthcare access.
How to Register for Public Healthcare
- Obtain a Social Security Number (Número de Afiliación a la Seguridad Social)
- Required for employment or voluntary contributions.
- Can be obtained at local social security offices.
- Register at the Local Health Center (Centro de Salud)
- Present a residency certificate, social security number, and identification.
- Receive a Tarjeta Sanitaria Individual (TSI), the health card used to access public services.
- Choose a General Practitioner (Médico de Cabecera)
- Each resident is assigned a primary care doctor at the local health center.
- Specialist referrals must come through this assigned doctor.
What the Public Healthcare System Covers
The SNS provides a broad range of services, including:
- Primary care: General medical consultations, routine check-ups, and minor treatments.
- Specialist care: Dermatology, cardiology, and other specialty services (requires referral).
- Emergency services: Available to all residents, regardless of registration.
- Hospitalization: Treatment in public hospitals covered by the SNS.
- Maternity care: Prenatal, childbirth, and postnatal care.
- Mental health services: Limited psychiatric and psychological support within public healthcare.
Prescriptions are subsidized, with costs varying based on income and status:
- Working-age residents pay between 40% and 60% of medication costs.
- Pensioners pay 10% or receive free prescriptions.
- Some chronic conditions qualify for reduced-cost or free medications.
Private Healthcare and Insurance Options
While Spain’s public healthcare system is extensive, many foreign residents choose private insurance for additional benefits. Reasons for opting for private care include:
- Faster specialist appointments and procedures
- Access to English-speaking doctors
- Broader hospital choices, including private clinics
How Private Insurance Works
- Standalone private insurance: Many policies cover services beyond public healthcare, including dental and vision care.
- Mixed public-private approach: Some residents use the public system for general care and private insurance for specialist treatments.
- Employer-provided health coverage: Some companies offer private healthcare plans as part of employee benefits.
Emergency Care and Urgent Medical Attention
Public hospitals and emergency services operate 24/7 and do not require prior registration. In case of an emergency:
- Call 112 for an ambulance.
- Go to the nearest public hospital emergency department.
- Use urgent care centers (Centros de Urgencias de Atención Primaria, CUAPs) for non-life-threatening emergencies.
Foreign residents without public healthcare access may receive emergency treatment but could face out-of-pocket costs if uninsured.
Healthcare for Temporary Residents and Tourists
Short-term visitors and non-resident foreigners can use:
- EHIC (for EU/EEA citizens): Covers emergency care during short stays.
- Travel insurance: Recommended for non-EU visitors to cover unexpected medical expenses.
- Out-of-pocket payments: Some non-residents choose to pay directly for private consultations and treatments.
Key Considerations for Foreign Residents
- Public healthcare is high quality but may involve wait times for specialist care.
- Private insurance provides faster access but comes with additional costs.
- Eligibility depends on employment, residency, and agreements with home countries.
- Emergency care is available to all, but non-registered individuals may face fees.
Understanding the healthcare system ensures that foreign residents receive the right medical care while living in Spain. Planning ahead, registering for coverage, and considering private insurance options help navigate the system effectively.