Healthcare guide for expats moving to Spain

For people living in Spain there are three choices in terms of health cover: to be covered only by the Spanish public healthcare system(the SNS), to be covered by the SNS as well as a local Spanish private medical insurance, or to be covered by an international healthcare policy.
This article explains how the Spanish healthcare system works, the different options for an expat and also gives a general idea of healthcare costs in Spain.

Health statistics

* Data from the WHO

  • Total Population: 46,927,000
  • Gross national income per capita (PPP international $, 2013): 31,000
  • Life expectancy at birth m/f (years, 2013): 80/86
  • Probability of dying between 15 and 60 years m/f (per 1 000 population, 2013): 86/40
  • Total expenditure on health per capita (Intl $, 2013): 2,846
  • Total expenditure on health as % of GDP (2013) 8.9
The Spanish healthcare system

The Spanish healthcare system is called the ‘Sistema nacional de salud’ (SNS). Nearly exclusively financed through taxes, the SNS is free for basic healthcare and emergencies. The SNS is largely decentralised and each region applies its own rules.

What does the public healthcare system cover?
Doctors: consultations with SNS doctors are free. In order to see a specialist (except for paediatricians and dentists), you must first be referred by your GP (or by another specialist).
Hospitalisation: healthcare is free in public hospitals. If you need treatment you are generally assigned a hospital near where you live, except for emergencies. In some regions (comunidades autonomas), it is possible to choose the hospital where you would prefer to receive treatment. Ambulance services are also, in general, free and they are linked to public (SNS) hospitals. Rehabilitation is also covered by the SNS if it has been prescribed by an SNS doctor.
Medication: for outpatient medication, you would need to contribute between 10% to 60% of the cost, depending on your situation (e.g. retired) and your income. For certain categories of the population (persons of low income, those who have suffered a work related accident) no contribution is asked.
Dental and optical care: the majority of dental costs are not covered by the SNS except for extractions and certain other treatment. For dental prosthetics it is possible to get financial aid. Those who have suffered from work related illnesses or accidents are covered for dental surgery. Cover for optical care is limited and glasses are not covered by the SNS.

Some hospitals and medical centres (centros sanitarios) offer both private treatment, completely paid for by the patient, and a public SNS treatment service which is often subsidised. It is important to clearly indicate which type of treatment you would like. If you do not have a private medical insurance, the costs of private treatment would not be reimbursed.

Who is allowed treatment on the SNS?
If you work and pay national insurance/social security contributions in Spain you will be covered by the SNS. In order to be covered, you would need to register at your local healthcare centre with your social security number. It is compulsory to sign up to the SNS.
However, if you move to Spain but do not pay taxes (e.g. if you are retired), you must wait 12 months before being entitled to healthcare on the SNS. During this period, you may be able to benefit from the ‘convenio especial’. This system offers access to the SNS for 60€ per month for those over the age of 65, and for 157€ per month for those under 65. Pre-existing medical conditions are covered, but their medication is not. Signing up to the ‘convenio especial’ is not compulsory. You could alternatively opt for a local private medical insurance or an international insurance if you preferred.

The limitations of the SNS:
• The SNS is an effective healthcare system with a large network of hospitals and medical centres throughout the country. However, as in many other European countries, the waiting periods to see a specialist or for a non-urgent hospitalisation can be lengthy.
• Dental and optical care is not covered.
• Your choice of GP is limited to the area where you live, and you can only see SNS GPs. In order to see a specialist, you must first be referred by your GP.

Local Spanish medical insurance

A private medical insurance offers you a more complete medical cover than solely relying on the SNS.

Around 18% of the Spanish population hold a private medical insurance, not only allowing them the choice of whether to be treated in the public or the private sector, but also to cover additional costs such as dental and optical. Please note that subscribing to an international health insurance does not exempt you from signing up to the local health care system.

The waiting periods for treatment are generally shorter in the private sector than in the public sector.

Limitations of local Spanish insurance policies:

  • The local health insurance companies in Spain have networks of doctors, hospitals and medical centres that their clients must adhere to, if the insured person wishes to consult a doctor or be treated in a hospital outside of the network they may be subject to lower reimbursement limits. In order to not be limited to any local network and in order to have the choice of where you would like to be treated, in Spain or elsewhere, you would need to look towards an international policy.
International health insurance

As an expatriate in Spain, you can subscribe to an international health insurance policy. This will allow you to be covered in Spain as well as other countries, enable you to see the doctor of your choice without being limited to an insurer approved network.

If you would like to insure yourself and your family more fully, Expat Assure can also advise you on life insurance and income protection. To find out more, please, read our Protection page.

Which expat insurance should you choose?

We can help you decide which international health insurance or protection plan is best suited to your needs. Don’t hesitate to contact us to request your insurance comparison.

Example medical costs

Healthcare is free in the public sector; below you will find an idea of healthcare costs in the private sector. In Spain, the cost private healthcare is reasonable compared to other European countries.

  • GP consultation: about 60€ – £48
  • Specialist consultation: from 70€ to 110€ – £56 to £88
  • Dental costs : fitting a porcelain crown : about 400€ – £319 (to compare, it would cost around 770€ in the U.K. – approx. £558),
  • Hip replacement: about 7,700€ – £6,136 (to compare, it would cost around 11,000€ in the U.K. – approx. £8,766)
Practical information

Vaccinations

You are not required to have any particular vaccination in order to travel to Spain, however it is recommended to be up-to-date with all your recommended immunisations.

Emergency numbers:

112 or 061 – Ambulance

080 – Fire brigade

091 – Police

098 – Emergency/late night pharmacy

Useful links

Instituto Nacional de la Seguridad Social (INSS) 

Information regarding the regional health authorities

 

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