In a previous newsletter, we wrote about Spain being the healthiest country in the world according to the Bloomberg Healthiest Country Index as well as having the longest average lifespan in Europe. There are a number of contributing factors but undoubtedly having a healthcare system generally considered one of the best in the world is one of the main ones.
Public Health Service
What’s even better is that the public health service is virtually free, or at least very inexpensive, for anyone who is resident and working or self-employed in the country and paying social security contributions, anyone who is in receipt of social welfare payments or the state pension, anyone under the age of 26 and studying in Spain and any resident pregnant woman. If you fall into none of the above categories there are ways you can still avail of the health service – but we’ll get to that a bit later.
How does it work?
Assuming you’re already empadronado/a (registered) with your local ayuntamiento (town hall), the first step is to register with the Dirección General de la Tesorería General de la Seguridad Social (TGSS) to get a social security number. Once you’ve been allocated a number you bring it to your local health centre, or CAP (Centro de Asistencia Primaria) along with your NIE and passport, apply for the health card and you will be assigned a doctor. The cost of prescription medication in Spain is already generally less than in northern countries and once you have your health card this cost is further subsidised. In Catalunya, your health card will look like this:
There’s a CAP in just about every town so no matter where you are you shouldn’t far from one. If you think you’d find that whole application procedure a bit daunting, you know who to get in touch with; callCarlos are old hands at this stuff!
Private Health Insurance
If you do not meet any of the requirements mentioned in the above paragraph and are not entitled to free public healthcare, you will need to take out private health insurance. If you are registered with your local town hall as having been resident in the country for a year or more but have never made social security contributions, you can apply for the convenio especial (a state-run insurance scheme). There are a range of different types of convenio especial for different purposes and the scheme is run individually by each autonomous region in Spain. There are also differences between regions, so we won’t go into the details here.
Alternatively, you can take out your own private health insurance with any one of a growing number of companies. As always, callCarlos are happy to do the legwork to help you find the one most suitable for your needs.
European Health Card
If you are not resident in Spain but spend some time here – or anywhere in the EU for that matter – it is a good idea to get yourself a European Health Insurance Card (EHIC). You need to apply for this card in your country of residence and it entitles you to avail of public healthcare should something happen to you while temporarily in Spain (or any other EU country). It does not apply if you come to Spain with the specific intention of using the health system here but in the event that while here you require treatment that cannot wait till you return to your home country you will receive free or at least reduced cost, healthcare.
If you are a resident in Spain, remember that you should, therefore, get a Spanish Tarjeta Sanitaria Europea – the same thing but for residents of this country when they are travelling elsewhere in the E.U. Of course if some accident should befall you while abroad, your EHIC (or TSA) will only cover your basic medicare so you should still take out travel insurance to cover any other eventualities.
Seeing a doctor
To see a doctor you need to make an appointment through your local CAP, either in person or over the phone. Depending on your location there may be a wait of a few days or even a couple of weeks if on public healthcare while those on private usually have shorter waiting times. If you wish to see a specialist or if you require (non-urgent) hospital treatment you will also need to go through your doctor. Although the majority of patients go through their local CAP there are some doctors who have their own practice, but you’ll need to check whether they offer a public or private service, depending on what cover you have. Some of these private GPs (médicos de cabecera) may not accept foreign patients who do not speak Spanish unless they bring an interpreter whereas in a CAP, especially on the Costa Brava, there is a better chance of there being someone to assist in your language.
For more urgent matters you can present to Urgencias, the equivalent of E.R. or A&E. On the Costa Brava there are hospitals with emergency departments in Palamós and Blanes as well as Girona and Figueres a bit further inland. As in every EU country, the number to call in case of an emergency is 112.
Unfortunately, visits to the dentist or the optician are not covered under the healthcare system in Spain, so unless you have a private health insurance that covers these you just pay as you go.
We hope this has been useful in giving you an overview of how the Spanish healthcare system works for foreigners, whether living here or just visiting. It is not intended to cover every aspect or eventuality but if you have any queries or if there is anything you are unsure of, do not hesitate to get in touch with callCarlos and we’ll find the answers you need.