The Spanish Healthcare System remains one of the most highly respected healthcare systems in the world and is ranked comfortably higher than other western countries’ healthcare systems including those of the UK, Norway, Portugal, Netherlands and Germany.
• Ranked as the 7th best in the world according to the World Health Organisation (WHO), the system remains one that many countries look at with envy. To put it in perspective, the UK – with its highly acclaimed NHS – is ranked 18th while Germany, the country with the largest economy in Europe, sits even further down in 25th.
• With more than 750 hospitals, 1.21 million beds and nearly half a million doctors and nurses, Spain’s healthcare system is reassuringly good and modern …and as with the UK, there are two types of healthcare services: free and private.
• Spanish healthcare for expatriots … As an expat – or would-be expat – deciding on which healthcare plan you need for your stay or residency in Spain, can be a real headache. Before deciding which healthcare plan is best for them, expats must first of all consider one thing – are you going to be living and working in Spain, or just living in Spain? After all, there is a big difference.
• If you’re going to live and work in Spain permanently and wish to qualify for free Spanish healthcare, the rules are pretty straight forward: you must obtain a social security number. To obtain this you must either be working for a company in Spain or working for yourself from Spain, meaning you’ll be contributing to the system.
• Once you’re contributing to the system only then are you entitled to free medical care in Spain – and it’s worth noting that while social security payments are high, the level of service is excellent and the system remains mostly free of the under-financing problems that the UK’s NHS suffers from.
• If you’re going to Spain as a posted worker and will be working there for a period of two to five years, you can get access to Spanish state healthcare via the S1 form (previously the E106). In this case, your healthcare will be paid by the UK as you will still be making NI contributions to the UK.
• Go private? … The other option is of course to go private. Private healthcare works in the same way that it does in other countries, in that the cost will vary depending on the type of cover you require. As is the case in the UK, the cost of going private will be affected by variables such as age, health and type of cover (e.g. family cover).
• Private healthcare in Spain is excellent and retirees who have private health insurance can often transfer it to a Spanish policy – often for similar or even lower premiums. This will cover them in the same way that it does in the UK. It’s also worth noting that some health insurance schemes also cover repatriation for treatment in your country of origin, though these will come at an additional premium.
• The expat community in Spain is so large that there are now specific schemes aimed at expats living and working in Spain. Insurance companies such as Sanitas Health Plan Spain are just one example of this, offering expats a wide range of healthcare plans including dental insurance schemes.
• For expats just living in Spain, and strictly not working, the options will vary depending on whether you’re over retirement age or not. Early retirees may apply for healthcare via the S1 (previously E106) form. The length of time you’ll be covered depends on your contributory record in the UK, but you would usually get cover lasting up to two-and-a-half years from the day you stop working. During this time, you’ll also be entitled to NHS treatment in the UK. However, after this period, if you don’t qualify for an S1 form you should arrange private health insurance or explore other available options.
• On the other hand, if you’re over the retirement age and are in receipt of a UK State Pension or long term incapacity benefit and intend to live in Spain permanently, you can get access to Spanish state healthcare via the S1 (previously E121) form.
• Having registered with the Spanish authorities, the S1 form in this instance gives you and any dependants the same healthcare cover that Spanish nationals get, but as this may not be the same cover you received on the NHS.
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• When it comes to registering your S1 with the Spanish authorities, there are a couple of things you must take care of first. The first thing is to obtain your certificate as a Local Resident (Certificado de Empadronamiento), available from the local Town Hall. The next step is to obtain your Certificate of Residence in Spain (Certificado de Residencial Numero de Identificacion Extranjero), available from your nearest police station. A valid passport is essential when registering these forms.
• What does the future hold? … In the meantime, despite how highly rated the Spanish Healthcare System currently is, the future of it remains unclear as the Spanish government has plans to part-privatize the public healthcare system as the country continues to experience tough times economically.
The reform plans have sparked angry demonstrations across Spain this year, with many feeling the plans are politically motivated rather than attempts to cut costs.
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Article by David Johns