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If you’re travelling to Spain or living or working there, it’s important to know how to access healthcare, what you are entitled to and what costs you may face.
Healthcare for people travelling to Spain for leisure or work on a temporary basis
European Health Insurance Card
The first thing you should know about the Spanish healthcare system is that you will need an up-to-date European Health Insurance Card (EHIC). This travel essential will entitle you to receive healthcare provided by the state in Spain during a temporary stay there, either at a reduced cost or for free. You will need to present it every time you visit a hospital or health centre for assessment or treatment.
EHICs are valid up to 31 October 2019 when the UK is expected to leave the EU. At present, it is unclear what will happen after this date.
If you are travelling on or after 31 October 2019, you are advised to have sufficient travel insurance in place to cover any healthcare costs.
You also need to be aware that an EHIC will not cover you for certain types of treatment, including private healthcare, flying back to the UK or mountain rescue services. It is not valid on cruises.
Therefore, you are strongly advised to purchase travel insurance to cover any additional costs, even if you are travelling with an EHIC to a destination within the EU. In this case, make sure you keep any receipts and paperwork relating to your healthcare to help you claim a refund.
How to find and access healthcare in Spain
Spain has one of the best healthcare systems in the world, currently ranked at number seven by the World Health Organization, so rest assured that you will be in safe hands when accessing medical attention while travelling.
Note that in some remote parts of the country and on Spain’s islands, you might have to travel to find a medical facility. It’s a good idea to familiarise yourself with where healthcare providers are located when you first arrive, just in case you need to use their services.
Some facilities offer both private and state funded healthcare. Please note that if you are asked to pay for your medical treatment upfront, you are not being treated in a state healthcare facility.
You will need to tell them which kind of healthcare you want to access when you arrive. These terms may be useful:
- Health centre – Centro de salud
- Hospital – Hospital
- Private healthcare – Asistencia sanitaria privada
- State-provided healthcare – Asistencia sanitaria pública
You will also need to be clear about which type of service you want to use if a hotel or travel company arranges healthcare for you.
Health services are organised by region in Spain. You can access information about a region’s healthcare system on this website [link: http://www.mscbs.gob.es/en/organizacion/ccaa/directorio/home.htm]. Click on the relevant region on the map and go to “Servicio de Salud” (Healthcare Service) to find more information.
Anyone can receive emergency healthcare in Spain if their needs are urgent. Please note that you are likely to be charged in full if you are not the holder of a European Health Insurance Card.
The number to call if you find yourself in a health emergency in Spain is 112. This is a free number which you can use anywhere in Spain, and will give you access to the ambulance and paramedic service. The operators generally speak both English and Spanish, but you may want to know some basic vocabulary:
- A&E Department – Urgencias
- I need an ambulance – Necesito una ambulancia
- I am in pain – Tengo dolor
- There has been a car accident – Ha habido un accidente de coche
If you see a doctor in Spain and they then recommend that you receive further healthcare in a hospital, you will need to go to a state hospital to be able to use your EHIC and avoid fees.
Unlike the UK, if you’re an inpatient you’ll find that there are no restrictions on visiting times, though visitors may be expected to help with basic tasks such as washing and dressing.
If you need to see a GP in Spain, you can do so at your nearest health centre. Many will have English-speaking staff, or can arrange for an interpreter if necessary. Note that many centres will offer both private and public healthcare, and there will be separate surgery times for each category.
Your EHIC card won’t cover you for dental treatment in Spain as it’s not covered by state healthcare, except in an emergency. (Though if you do need to visit a private dentist, you may well find that prices are cheaper than in the UK.) You can access emergency dental healthcare in an emergency department or health centre.
If a doctor writes a prescription for you, you can simply take it to a pharmacy to receive your drugs or treatment. Note that prescriptions are subject to non-refundable charges but your EHIC will give you a discount of between 10 and 50 per cent, depending on your working status.
If you need a prescription fulfilled upon discharge from hospital you will need to take your medical report to a doctor who will then write you a prescription.
Giving birth while on holiday
While there are restrictions on pregnant women travelling by air or sea to another country after a certain number of weeks, sometimes a baby does make his or her appearance long before their due date. In these circumstances, your EHIC will cover you for routine maternity care, the birth itself and healthcare related to the birth. You will also need a maternity S2 form. You can get in touch with Overseas Healthcare Services on the following numbers:
- If you’re calling from the UK: 0191 218 1999
- If you’re caling from outside the UK: +44 191 218 1999
Taking out extra travel insurance to cover costs such as an extended stay if you have to delay your trip home is the safest course of action.
What if I don’t have my EHIC with me?
If you travel without your EHIC, you can obtain a provisional replacement certificate (PRC) which proves that you are entitled to an EHIC and its benefits. You will need to phone Overseas Healthcare Services on the following numbers between 8am and 6pm UK time (Monday to Friday) to get one of these:
- From the UK: 0191 218 1999
- From outside the UK: +44 191 218 1999
What happens if I need to bring medicine to Spain?
If you need to bring drugs or other treatment with you, you will also need a letter from your GP explaining what they consist of and why you have been prescribed them. Make sure your GP includes the drug’s generic name as well as brand name. It’s a good idea to have the letter translated into Spanish. Make sure that you organise collecting the right amount of your medication in plenty of time before your trip.
You will need to check whether your medication is a controlled drug. If this is the case, you will have to ensure that you comply with the rules on exporting drugs from the UK and will have to apply for a Spanish import licence at a Spanish consulate in the UK.
When taking your medication or other treatment with you to Spain, make sure that it complies with the following:
- It hasn’t gone past the expiry date
- It is in its original packet
- The label is clear and accurate
- It is packed in your hand luggage along with the explanatory letter and the prescription
- It is in an insulated bag if it needs to be at a cooler temperature
What will happen after Brexit?
We don’t yet know what Brexit will mean for healthcare when travelling in Europe.
If you are planning to travel on or after 31 October 2019, make sure you have sufficient travel insurance in place to cover any healthcare costs.
The government is negotiating with Spain about what happens to healthcare for travellers after this time, but the results are yet to be finalised.
What are my rights if I live permanently in Spain, but I am a British citizen?
If you pay national insurance contributions in Spain you will be entitled to receive state provided healthcare. To do this, you will have to register with your nearest Treasury of Social Security Office (Tesoreria General de la Seguridad Social) to get a social security number. Then you will need to go to your local health centre with your registration certificate, which will enable you to apply for a “tarjeta sanitaria” or public health card and then register with a GP at a health centre. You will need to take this card with you every time you go to the doctor or hospital. Once the UK leaves the EU, you will still be entitled to state-provided healthcare under this system.
If you are working in Spain but have been sent there by your company based in the UK, you may be eligible for health cover paid for by the UK. You will need to check this with the National Insurance Contributions and Employer Office in the UK by telephoning:
- From the UK: 0300 200 3500
- From outside the UK: +44 191 203 7010
Maternity care in Spain
State-funded healthcare covers a range of maternity services, but you will need private insurance if you are planning to give birth in a private or specialist unit.
Note that if you are topping up your state-provided healthcare with private insurance, you will need to have held a policy for a certain period of time before being able to take advantage of it. So if this is the case, it’s best to plan ahead and have an insurance policy in place before you fall pregnant.
Rest assured that both private and public maternity care in Spain is considered to be of excellent quality. You can access maternity services through your local health centre or GP practice.
Once you embark on a course of maternity care, you will have an introductory appointment with a doctor/midwife to confirm your pregnancy, then a series of antenatal appointments and scans in a hospital. You are likely to see your community midwife once a month for regular checks for the first 32 weeks, then at fortnightly intervals. You will have regular blood and urine tests, and three ultrasound scans as standard, one during each trimester.
Home births are rare in Spain, with most births taking place in hospital. Gas and air are not used in Spain, but pethidine and epidurals are. Note also that there is a higher rate of caesarian sections here.
You are likely to stay in hospital for five days after the birth, and during this time your newborn will receive a series of checks, including the Apgar score immediately after birth to rate his or her health. After you have left hospital, your baby will have a blood test at one week to check for certain conditions.
Pensioners and healthcare in Spain
If you receive an exportable UK pension or a different kind of exportable benefit, you could be eligible for state-provided medical care funded by the UK. To make this happen, you will need to get an S1 certificate. This can be used up until the UK exits the EU.
You can contact the International Pension Centre, part of the Department for Work and Pensions on:
- From the UK: 0191 218 7777
- From outside the UK: +44 191 218 7777
What happens after the UK leaves the EU?
If you have lived in Spain for more than five years without a break, you could be eligible to apply for permanent residency. This will mean that you can receive state medical care in the same way that Spanish citizens do.
However, if you have lived in Spain for less than five years, but have been registered with your local town hall for a year at least, you may be eligible to use the “Convenio Especial” scheme. This allows you to buy health insurance to access the Spanish healthcare system. Please note it does not include the cost of prescriptions.
If you have been registered with your local town hall for under a year, you will need to purchase private health insurance to access medical care in Spain.