Spain Explained

Are you entitled to health care in Spain?

Last updated on September 13th, 2019 at 09:10 am.

Many people who move to Spain are unclear about what their health entitlement might be when they arrive. This confusion hasn’t gone unnoticed by the official authorities either. Too many people are using the EHIC, European Health Insurance Card, inappropriately or are simply returning to their own countries to get treatment even when they are supposed to be living in Spain.

As a result a website, partly funded by the European Union, has been launched to help those British nationals who are unsure what they should and shouldn’t be accessing and how. The Health Care in Spain website also publicises outreach events when participants can have their questions answered and can be helped with registration.

Why the confusion?

There has always been some level of confusion about entitlement to health care in Spain. Recently, this was increased by the withdrawal of SIP cards ( Sistema de Información poblacional) from some residents. In most cases all that was needed when this happened was for documentation to be shown and they were replaced. However, it has been enough to cause ripples of unease amongst some sections of the foreign community.

Like many countries, Spain is concerned about the bill for its health care and is keen to ensure that only those entitled to it are claiming. However, it must also balance humanitarian considerations with this need to balance the books.  

With so many different nationalities and so many groups with different status, it is not surprising that there is tension between people and services. In this article we attempt to clarify the current position and look at arrangements for:

·      Early retirees who came into the country before 24th April 2012

·      Early retirees coming into the country after 24th April 2012

·      Pensioners receiving a state pension from the UK

Early retirees entering Spain before 24th April 2012

The main query relating to health is usually linked to early retirees who don’t expect to be working and contributing in Spain. However, you may be entitled. You can register here for health care as a resident if you:

·      held a residency certificate before 24th April 2012

·      do not earn more than 100,000€ a year

·      are not entitled to health care through any other means  

According to the Health Care in Spain website, in order to register you will need to go in person to the local INSS office taking with you your residency, padrón and passports. If you don’t submit an annual resident tax declaration in Spain you might also need to prove your taxable income from the UK. In order to do this you should contact HMRC on 00 44 151 210 2222.

Instead of being issued with an EHIC card for when you travel to other European countries, you will be given a Provisional Replacement Certificate which is valid for three months and should work in the same way.

Early retirees entering Spain after 24th April 2012

What about if you are an early retiree but came after 24th April 2012 or are in the process of thinking about moving out here? Private health insurance is always an option, however, you must be aware that if you have existing complaints this will cause a problem and you may not be able to get some health needs covered.

Until now there has also been the option of early-retirees accessing health care for 2 ½ years after they move. This was an additional benefit allowed by the British government in order to help new migrants settle into their new country. Again, applicants must ask for an S1 form to kick start this entitlement.

Unfortunately, this particular benefit looks set to fold. A consultation about the NHS and its scope took place earlier in the year and we can expect legislation that will remove this current opportunity for those looking for health care in Spain before receiving their state pension.  

There will be an alternative. A new scheme has been announced called the Convenio Especial. This is a public health insurance scheme that you will be able to pay a monthly fee to be part of. It will entitle you to health state care and has the advantage that it does not preclude pre-existing conditions.  

The basic monthly fee of the Convenio Especial is currently set at 60€ for the under 65s and 157€ for those aged 65 or over. There will be variations from one autonomous community to another but once part of the scheme you should be able to access healthcare from anywhere in Spain.

Resident pensioners receiving a state pension from the UK

Those retiring to Spain receiving a state pension are eligible for health care here. You need the document S1 which can be obtained from the pension service in your own country.  This allows you to register with Social Security who will issue a Certificate of Registration that you can then take to the Health Centre to obtain your SIP card. The EHIC card is obtainable from your own country rather than Spain.

The consultation into the NHS proposes that pensioners living in Spain will also be eligible to access health services in the UK. Currently they should have de-registered with their GPs and only access health care in Spain.

Everyone is covered

Once the new Convenio Especial is in place, all groups of British nationals who come to live in Spain should have an alternative to private health insurance.

There are many aspects of moving to another country that need very carefuly consideration. Whatever your motives, it looks as though lack of health care shouldn’t stand in your way.

More information

Health Care in Spain:

Foreign and Commonwealth Office, Health Care in Spain:

See all

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