healthcare in spain for expats

Spain boasts one of the most efficient healthcare systems in the European Union, making it an attractive destination for those considering relocation. Whether you’re retiring or moving for work, understanding how healthcare in Spain works is crucial. Spain offers excellent public healthcare, accessible to residents contributing to the social security system. Additionally, the Convenio Especial allows non-residents to access public healthcare services for a monthly fee. In this article, we’ll delve into the costs, benefits, and why Spain’s healthcare system is renowned across Europe. Let’s explore how you can ensure seamless healthcare coverage when moving to Spain!

Table of Contents

Health care in Spain

Through the Spanish Health Care system, residents living in this country are guaranteed to have medical attention, immediately and in well-equipped hospitals and with qualified personal. This is a constitutional right in Spain as citizens have the right to be treated in case of a situation that requires medical assistance.

The healthcare system in Spain counts with hospitals, healthcare centers and another type of installations known as state healthcare services. The whole system works under the National Health System, which at the same time is overseen by the Spanish Ministry of Health, in charge of applying yearly budget and guaranteeing the quality of the health services. 
Now, the universal coverage and quality of healthcare in Spain is based on contributions, so the system is basically financed by taxes and payments all citizens and residents do every month, being discounted from their total monthly wage.

how does the spanish health system work?

The healthcare system in Spain is both public and private. Now, more than 90 percent of the Spanish population is integrated in the public health care system, which is free and has the obligation to take care of citizens and non-residents or expats alike, in case they are working and paying contributions in Spain.
But, how is the public healthcare in Spain? Well, public healthcare in Spain can be considered good, but in terms of characteristics the main is this: it is decentralized. This means that even though the general aspects of healthcare are the same for each region, regional authorities regulate budget and resource allocation, and regulate personnel. 
In order to be able to benefit from public healthcare in Spain, residents must live, work and pay taxes in the country, although children, pregnant women, state prisoners and even students under 26 can obtain free medical coverage.

Private healthcare in Spain is a different story, having a more restrictive approach and usually requiring medical insurance for proper treatments. 

Of course, private healthcare in the country plays a huge rule in terms of attention, since in many circumstances non-residents or expats are not eligible to be treated by public healthcare in Spain, particularly when they are not working or not paying contributions.
A clear case is when tourists do not have an EHIC or European Health Insurance Card, in the circumstance of being expired or when the person did not pay for such right of being treated by public healthcare or other EU country for free. So, private medical insurance must be hired.

Spanish HealthCare for Expats and Foreigners

When it comes to expats and non-residents living in the country, such people can enjoy of free healthcare in all Spain thanks to the public hospitals and centers available in all of the cities. Of course, there are a few conditions to fulfill in order to be treated by the public Spanish healthcare system, respecting expats and non-residents.
In details, healthcare for expats living in Spain is covered by the public branch of the National Spanish Healthcare System, when such people are employed or at least self-employed and meeting with their legal duty of paying contributions and taxes.
In this way, healthcare in Spain for non-residents is completely covered, with the same rights a Spanish citizen would have at the moment of suffering a condition, disease or incidental that may involve medical treatment.
On the other hand, there might be cases in which healthcare for retire expats in Spain is not possible, resulting not eligible due to matter of employment status, legal documentation and more. In this case, private healthcare is another option that non-residents have in Spain to enjoy medical coverage, such as insurance policies and other methods.

Healthcare in Spain for UE citizens

Spain offer free healthcare coverage and treatments for citizens of the different countries that are part of the European Union or EU, for short periods of time. However, in case of doubts or regulations and agreements between countries, non-residents can visit embassies in Spain or in the country of origin for more information.
For example, citizens from countries like Brazil, Andorra, Peru, Ecuador and others have the right to receive immediate and free medical treatment in the case of emergency, when they arrive as tourists.

Healthcare for US citizens and tourists in general

US citizens and tourists from other countries arriving to Spain are able to enjoy of free healthcare, at least for a short period of time or while the trip ends. However, in Spain is mandatory to acquire a private medical insurance, so in the case of an incidental or disease visitors can be treated. This is the way the EHIC card is obtained at the moment of traveling to Spain.

Healthcare Costs

Public Spanish healthcare is for free in many cases, only been charged paperwork if health insurance payments are involved. However, being a decentralized system, healthcare in the country is managed differently by the regions and municipalities, and this means budget and other financial affairs.
So, costs may be involve from one region to the other, with expenditures that have been increasing over time, giving as result growing reliance to the private sector of health in Spain.
In hospitals, average expenses per person every year that receive attention in the country is about 2.000 dollars, a similar figure invested by contributors in taxes and state payments that involve social security payments that give the right to be treated by the Spanish health care, including residents and expats.
So, answering the question on how much does healthcare cost in Spain? It is complex to know, but those residents and immigrants paying social security taxes to the state and working should not be worried.
The thing changes when we talk about private healthcare, including premiums of insurance policies and even direct payments in case of immediate attention in clinics, costing hundreds and thousands of Euros in monthly payments and lump sums.

How to register for Spain Public Healthcare

For residents, non-residents and expats in general living in Spain to enjoy of free public healthcare, they must be registered on the social security office in the Iberian country. Such department in Spain is called Dirección General de la Tesorería Social, and there is one of them in every city of the country.
In this way, residents, expats and also citizens can obtain their social security number and enjoy of different benefits the Spanish country has, being one of them the accessing to the Spanish public healthcare system. Here are the steps and documentation you need to obtain the social security number in Spain:
A valid passport, ID card or driver´s license that demonstrates the identity of the person applying for the social security number.
Residency certificate.
Proof of address registration in the city, town or municipality in Spain.
With the social security number, the next step is to apply for a Health Card or TSI that stands for Tarjeta Sanitaria Individual. With these two requirements a person is entitled to receive medical treatment and aid in any hospital in Spain, even being non-residents or expats for that matter.
A thing that actually helps is to issue work permit and employment details, demonstrating economic activities are being performed in the country and duties and contributions are being made.

Understanding the “Convenio Especial” for Residents in Spain

The “Convenio Especial” is a specific arrangement within Spain’s social security system designed for residents who do not fall under the general employment-based social security coverage. This agreement allows individuals, including expatriates and retirees, to voluntarily contribute to Spain’s social security system, ensuring access to comprehensive Spanish health cover and other benefits.

Eligibility and Enrollment

1. Eligibility: The “Convenio Especial” is available to those who reside in Spain but do not have social security coverage through traditional employment or other social security schemes. This often includes self-employed individuals, those with irregular income, and expatriates seeking to secure healthcare in Spain for expats. It also provides an option for healthcare for retired expats in Spain who may not be eligible for regular pension schemes.
2. Enrollment: To enroll in the “Convenio Especial,” individuals must submit an application to the Spanish Social Security Administration. This process involves providing proof of residency and documentation related to one’s current work or income status. For expatriates, this step ensures that their healthcare in Spain aligns with their specific needs.

Contributions and Coverage

1. Contributions: Participants in the “Convenio Especial” agree to make regular monthly contributions to the Spanish social security system. These contributions are based on the individual’s declared income and are essential for accessing Spanish health care insurance and other benefits. The contribution amount is set according to current regulations and is designed to maintain continuous coverage.
2. Coverage: By contributing to the “Convenio Especial,” individuals secure a range of benefits under the Spain healthcare system, including:
   • Healthcare Coverage: This includes access to public health services such as medical consultations, hospital stays, and other essential health services. This is particularly relevant for expatriates and retirees who seek reliable healthcare in Spain.
   • Retirement Pension: Participants can qualify for a retirement pension once they reach the statutory retirement age, assuming they meet the minimum contribution requirements.
   • Disability and Survivor Benefits: The scheme also provides support in the form of disability pensions and benefits for survivors in the event of the participant’s death.

Key Considerations

1. Duration and Renewal: The “Convenio Especial” is valid for a year and requires annual renewal. It is crucial for individuals to keep their contributions up-to-date to maintain Spanish health cover and avoid lapses in coverage.
2. Impact on Other Insurance: It’s important to consider how participating in the “Convenio Especial” might interact with other forms of health insurance or social security benefits, especially for expatriates who may have other insurance arrangements.
3. Professional Guidance: Given the complexities of the Spanish health care system and the specifics of the “Convenio Especial,” seeking advice from a legal or financial expert is highly recommended. This ensures a clear understanding of the benefits and obligations associated with this special agreement.

In conclusion, the “Convenio Especial” provides a valuable option for securing Spanish health cover and other social security benefits for residents, expatriates, and retirees. Properly managing contributions and understanding the terms of the scheme can significantly enhance one’s experience within the Spanish social security system.

In conclusion, the Spanish Healthcare System is one of the best offered in the countries of the EU, with quality and free for those that contribute with duties, being ideal for residents and expats since they do not have any sort of problem at the moment of entering the system or being treated.