Healthcare in Spain explained

Healthcare in Spain / Online Marketing on Unsplash
Healthcare in Spain / Online Marketing on Unsplash
6 April 2020, Emma Donaldson

If you are an expat or foreigner living in Spain, getting your head around a different health system can be confusing and challenging compared to the system you are used to in your country of origin, and even more so if your Spanish isn’t up to scratch. Let’s have a look at the various healthcare options available in Spain.

Public or private?

The Spanish healthcare system has been ranked as one of the best in the world and consists of both private and public healthcare. The public system provides free basic healthcare to those who contribute to the Spanish social security system and their families, while those who are not eligible and cannot access state healthcare should ensure they are covered by private medical insurance.

As well as paying social security, many Spaniards also choose to cover themselves for private treatment to give them access to wider and above all quicker treatment with figures showing round 19% of the Spanish population have some form of private healthcare cover.

Who can access state healthcare in Spain?

As a general rule, state (public) healthcare in Spain is free of charge to any individual who is a resident, living and working in Spain. Rules and regulations will vary slightly depending on the area of Spain, due to the fact that the Spanish healthcare system is decentralised and controlled by each Autonomous Community.

As an expat, you are fully eligible to access the state healthcare system for free if you are:

  • a working or self-employed resident in Spain and paying Spanish social security contributions
  • living in Spain and receiving certain state benefits
  • a child resident in Spain
  • a pregnant woman who is a resident in Spain
  • under 26 and studying in Spain
  • you receive a Spanish state pension or certain benefits
  • staying temporarily in Spain and have an EHIC card

If you're from the UK and worried about access to healthcare in Spain after Brexit, find out everything you need to know here.

How to register for public healthcare in Spain

The process for registering for public healthcare in Spain is very straightforward. You first of all need to get a social security number. To get this Número de afiliación a la Seguridad Social, you simply need:

  • your passport
  • your NIE or residence permit
  • proof that you’ve registered your address and have the padrón
  • a filled out a TA.1 form in Spanish

Make an appointment online with your nearest local social security office of the General Social Security Treasury (Tesorería General de la Seguridad Social) and after a short appointment, you’ll leave with your social security number. All that is left to do is take this your local centro de salud (health centre) to register and apply for a tarjeta sanitaria (health card).

Health insurance

Health insurance in Spain is covered by social security payments, which, as mentioned, are made by everyone who is employed or self-employed in Spain, also including coverage of immediate family (spouses and children). Those not covered by state insurance or even by the EHIC (European Health Insurance Card) will need to take out private medical insurance. Private insurance for expats is a very popular option and is also very accessible with costs usually between 50 and 200 euros per month, depending on the company and cover plan you choose.

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