Expats retiring to Spain will need to consider health care along with property rental or investment decisions. Regular legal-contributor Raymundo Larraín Nesbitt strays again from his usual property themes to give us a general overview on how to apply for healthcare in Spain.

By Raymundo Larraín Nesbitt
Lawyer – Abogado
8^th of November 2014

Emergency Cover vs. Full Healthcare Cover

I have to begin by distinguishing two types of health cover.

• Emergency cover is universal and open to all human beings, whether EU citizens or not. The only requirement for emergency health assistance is that you need to be registered at your local town hall (‘Certificado de Empadronamiento’ or census certificate). This is explained in detail in a section below.
• Access to full health care cover by the Spanish Healthcare System requires a Social Security Number (‘Número de la Seguridad Social’ or SSN for short). This allows you unrestricted access to state-run healthcare. A SSN can be attained by working for a company or else on becoming self-employed (by contributing monthly to a pay-in scheme).

1. Emergency Healthcare Cover

A registered person will have access to public emergency, primary and speciality care for common illness, maternity care during pregnancy, delivery, post-partum etc. It is highly recommended that all foreigners register at their local town hall (known in Spanish as ‘empadronamiento’) for this and many other advantages listed below (and it’s free). Basically the more people that are registered, the more funds the central government allocates to a town hall which – in theory – should benefit everyone.

Step-by-Step Explanation to Attain a Public Health Card (PHC)

A PHC grants you the right to health care (both primary and outpatient) in both hospitals and emergency centres.

1. As outlined, the first step is to attain a Registration Certificate (‘Certificado de Empadronamiento’) from your town hall.  This is a pretty straightforward hassle-free requirement. To register oneself at your local town hall simply follow the below:

• EU members: identity document from your own country, Community card issued by a police station or else your passport. Copy of Title Deeds and a copy of a utility bill (water or electricity).
• Tenants: your rental contract, a copy of a utility bill under the name of the tenant (which must match the tenancy agreement) as well as an identity card or passport.
• Home owners: copy of the title deed and/or a utility bill for the property.
• Under aged: if a child lacks a passport they will require the same documents as an adult except for those born in Spain (a birth certificate or Family Book will suffice in such a case).

2. Find out where your Primary Care Centre (‘Centro de Salud’) is located.
3. Take your passport (and a photocopy) together with your Registration Certificate.
4. Fill in the ad hoc form. After a period spanning normally 2 to 3 months you will be mailed your Personal Health Card.

Benefits of Registering Oneself at Your Local Town Hall (Empadronamiento)

I am digressing a bit here from the article’s topic but I feel compelled to explain the benefits of enrolling in your town hall’s census (‘Empadronamiento’ or Registration Certificate):

• Discounts on IBI tax (akin to the United Kingdom’s Council tax). In some municipalities (i.e. Estepona) this discount may reach up to 80% (!).
• Increased medical attention (more doctors).
• More fire-fighters.
• The right to State education (free, public).
• The right to vote (registered foreigners can vote only on local and European elections).
• Discounts on municipal services.
• Free access to Sports Centres.
• Free access to public libraries.
• Access to Social Services and Leisure Centres (full or partial rebates on social activities i.e. painting, music, theatre, sewing).
• Additional security.
• More ambulances.
• More schools.
• Social assistance.

2. Full Cover Health Assistance

As explained in the article’s introduction, for comprehensive cover you must attain a Social Security Number and be working (legally) in Spain. This can be attained either of two ways:

a) By working for someone else i.e. a company.
b) On becoming self-employed (‘autónomo’ in Spanish).

Either requires that you, or your employer on your behalf, contribute to a monthly state pay-in scheme.

European Healthcare Insurance Card (EHIC)

If you are visiting Spain temporarily, and reside mainly in a EEA member country, the EHIC allows you full access to Spain’s State Healthcare System. You must request information in your home country on how to apply for this card.

The EHIC will not be valid if the holder is mainly resident in Spain. It does not cover you either if you are travelling with the express purpose to seek medical treatment i.e. travel to Spain specifically to give birth.

UK State Pensioner

As a UK pensioner, if you are living in Spain and you receive a UK State Pension or long-term Incapacity Benefit, you may be entitled to state healthcare paid for by the UK.

The UK’s EHIC is only for use outside of Spain on holidaymaking within the EU; it is not intended for those whose main abode is in Spain.

Applying for Healthcare in Spain – Conclusion

Foreigners are entitled to the same healthcare as the rest of Spanish citizens. The only requirement is to be registered at the town hall of your residence.

For full health care cover it is mandatory that you attain a Social Security Number and contribute to a monthly state pay-in scheme.

UK pensioner’s access to the Spanish healthcare assistance is paid for by the UK.

“Tres cosas tiene la vida: salud, dinero y amor” – Cristina and Los Stop.

Popular Spanish pop song from the sixties. Loosely translated as: “Only three things matter in life: health, money and love.”

Related articles

• Healthcare in Spain – Advice by the Foreign & Commonwealth Office (UK Government)
• Health Insurance and Social Security – Angloinfo Expat Network
• How to Apply for Healthcare in Spain – 8^th November 2014

Please note the information provided in this article is of general interest only and is not to be construed or intended as substitute for professional legal advice. This article may be posted freely in websites or other social media so long as the author is duly credited. Plagiarizing, whether in whole or in part, this article without crediting the author may result in criminal prosecution. VOV.

2.014 © Raymundo Larraín Nesbitt. All rights reserved.