Spanish healthcare

Five simple steps to getting healthcare in Spain

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If you live in Spain, here’s a step-by-step guide on how to access the Spanish health system and visit a doctor in Spain.

If you are resident or working in Spain and paying social security contributions, you and your dependent family members are eligible for free state healthcare in Spain.

Citizens from the EU staying temporarily in Spain and holding an EHIC (European Health Insurance Card), or those from countries with a bi-lateral healthcare agreement with Spain (check with your embassy), may also use free Spanish state health care. Globality Health provides the steps expats in Spain need to take in order to access Spanish healthcare.

The Spanish healthcare system

Spanish healthcare is decentralised, with each of the 17 autonomous regions taking responsibility for healthcare in their own regions, although the central government controls the overall budget. Thus, you need to check with your regional health authority to find out what services are provided and what are the exact conditions for accessing them in your region. However, there are a few general documents and registrations you need to start the process.

Below is a guide to help you register with the Spanish state healthcare system.

1. Check whether you are eligible for Spanish state healthcare

You can access free Spanish state healthcare – with nothing to pay upfront apart from a proportion of prescription costs – if you are a legal resident in Spain, and are working or self-employed and paying monthly social security contributions. Employees pay a small percentage of their annual salary into the healthcare system, while employers contribute a fair share (approximately 25 percent). Dependents and recently divorced/separated partners are also covered.

You may also be eligible to register for state Spanish healthcare if you are:

  • receiving certain benefits;
  • are pregnant;
  • a student under 26;
  • a child;
  • a state pensioner (you will need documentation from your pension authority).

Until 2014, it was possible for early retirees and unemployed expats to get free healthcare in Spain; this is no longer the case and they must take out private healthcare provision.

If you are not eligible, you can choose to pay for medical treatment, take out private healthcare insurance, or in some regions, you can pay into a government-run health insurance scheme called the convenio especial in order to access free state healthcare in Spain. You need to have been registered on the padrón for 12 months, and pay a basic monthly fee.

2. Register your address on the padrón

If you are resident in Spain you must register your address on the padrón at the ayuntamiento (local town hall) by law and get a certificate of empadronamiento. You will need to take this along when you first register with a doctor in Spain (and in most other situations when you need proof of your address).

To register on the padrón, you will need to take along your passport, NIE number (available from your local police station), residency card, a copy of your rental agreement or deeds to your home, and your last utility bill. Registering is usually free but there is sometimes a small charge.

3. Sign up for social security

You will need to get a social security number to use the Spanish state healthcare system. If you are employed, your employer will issue you with one, if not, you should register with the Spanish social security office, called the Dirección General de la Tesorería General de la Seguridad Social or TGSS. There are TGSS offices throughout Spain; you can find your local office here.

Take along your passport/national ID, residency card and an application form. Dependents may need to show birth/marriage certificates.

Once completed, the TGSS will give you a social security number and a certificate to prove that you are eligible for free state healthcare.

4. Find a primary healthcare doctor

Primary healthcare doctors in Spain may work in a health centre (centro de salud or centro de asistencia primaria or CAP) or in an individual practice as a general doctor (médico de cabecera). Doctors may offer both state and private consultations and treatments, so make sure they know which service you require. In some parts of Spain, for example some of the outlying Spanish islands, you may have to travel to find a state healthcare provider.

You can find a doctor local through a personal recommendation, from your embassy, from the phone book under medicos or from your local healthcare authority (see here for a list).

5. Register with your local health centre or with an individual doctor

You will need to be registered with a local doctor before you can make any appointment, unless it’s an emergency, in which case go straight to the nearest hospital’s emergency department (urgencia).

When you register with a doctor, take along your empadronamiento (which must be less than three months old), your TGSS certificate, passport and foreigner’s identity number (NIE) to apply for your health card (tarjeta sanitaria individual, TSI) and get a Sistema de Informacion Poblacional or SIP card. You’ll need to show this card every time you visit a health clinic, hospital or collect a prescription from a pharmacy.

Dental treatment for those aged 16 years or more is not covered by state healthcare unless in an emergency; generally, you must either pay for it yourself, although it is relatively inexpensive, or take out private insurance. For dental treatment, you don’t need to register with a dentist in Spain; you can just call and make an appointment. Children aged six to 15 years are eligible for free dental treatment under state healthcare.

Read more information about how to find and register with a doctor in Spain.


Globality Health / Expatica

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