Health Care In Spain
Spain has the 7th best health care in the world according to WHO. Spain has a centralized (national) health care system; patients have no choice of provider, and there is almost no cost sharing, which often results in significant waiting times for major procedures. While the quality of Spain’s public health care is of a high standard, some residents opt for private care to avoid the sometimes lengthy waiting times. Nonetheless, the health care system in Spain is very good. Spanish hospitals are modern and well-equipped and doctors are also excellent.
Nurses in Spain’s national system are well-trained and efficient, but they do not carry out tasks related to personal care and feeding. Generally speaking, the patient’s family takes over, which is why hospitals allow one companion to be with the patient 24 hours a day.
In general, non-EU retirees will not be able to access the Spanish health care system and will have to take out private insurance. Overall costs aren’t extremely high, so some expats choose to “go naked” and pay as they go. A popular company with expats is Sanitas (part of BUPA); note that your zip code in Spain will affect the monthly dues as, of course, will your age. If you choose to pay-as-you-go, a typical fee for a family doctor is about 60 euros (rising to 80 for an initial consultation with a specialist).
A special government pay-in-program—the convenio especial—has been launched in parts of Spain for residents who do not qualify for Spanish health care. At the moment, that program is only available in Valencia, Murcia, Galicia, and Castilla y Leon—but not in Catalonia. When it is launched, applicants, who must have been resident for 12 months, will pay a basic monthly fee of 60 euros for under-65s and 157 euros for those over 65. The scheme does not cover prescription costs.
Once you have been formally registered with the social security system in Spain, you will receive a document entitling you to medical assistance. This form can then be used to apply for a health card at your closest state health center: Tarjeta Sanitaria Individual (TSI). To do so you’ll need to present your social security and national insurance certificates, as well as your passport.
For minor problems take advantage of the excellent farmacias (pharmacies), where highly trained pharmacists will provide advice, as well as recommend remedies, some of which would require prescriptions back home.
If you move to Spain as an employee or are self-employed, the situation is different. You will pay social security contributions to the General Social Security Fund (Dirección General de la Tesorería General de la Seguridad Social—TGSS). You will be issued with a social security number which will entitle you to health care, sickness, unemployment benefits, as well as government pensions. It also means you will be exposed to Spanish taxation.
Many people who are eligible for state health care, both expats and locals, combine social medicine with private insurance. It is acceptable and common to use them in tandem.