Everything you need to know about health services in Spain explained

Image - Chaikom/shutterstock

No matter where you live in the world, we can all agree that healthcare and health services are essential. The healthcare system in Spain is ranked as one of the best in the world and, if you reside here, you are most likely eligible for free public healthcare.

The question is, how do you know whether you are eligible, what are your options, and when do you need to take out private healthcare insurance? You’re in luck because the Euro Weekly News answers all of your queries about health services in Spain in this handy explainer guide.

If you live and work in Spain, you will most likely have access to free public healthcare. This is partially covered by social security payments, which are withdrawn from your wages. This explainer article will go through who can access the Spanish healthcare system, how you register, the costs and whether you need extra private health insurance.

Healthcare in Spain

Spain has a high-quality healthcare system that provides universal coverage to all citizens. Healthcare is divided into private and public sectors, with some hospitals (hospitales) and health centres (centros de salud) providing both private (privado) and public (asistencia sanitaria publica) services.

Approximately 90 per cent of Spaniards use the public healthcare system, which is also known as the National Health System. It is, however, highly decentralised, with service delivery managed at the regional level. The Spanish Ministry of Health creates policies, manages the national health budget, and is in charge of the system overall.

Although the Spanish system receives praise for its services, poor accessibility and over-reliance on the private sector are still problematic.

health services healthcare spain
Image – S_L/shutterstock

Who is eligible for state health services in Spain?

Anyone living and working in Spain has access to free public healthcare. However, because of the decentralised nature of the Spanish healthcare system, you will need to research the conditions in your particular region or area before accessing healthcare services.

You can get free state healthcare as an expat if you are:

  • A  resident of Spain who works or is self-employed and pays social security contributions.
  • Living in Spain and receiving government benefits.
  • A resident of Spain who has recently divorced or separated from a registered social security partner.
  • A child who lives in Spain.
  • A pregnant woman who lives in Spain.
  • Under the age of 26 and studying in Spain.
  • A state pensioner.
  • Staying in Spain temporarily and have an EHIC card.

Spain has bilateral agreements with various countries, including Andorra, Brazil, Chile, Ecuador, and Peru, that allows people from these nations to get free emergency medical treatment while visiting Spain for a short period of time. Check with your local Spanish embassy to check if any agreements between Spain and your native country are in place. If you do not have the right to public healthcare, you will need to arrange for private health insurance.

healthcare health services spain
EHIC Card. Image – Ascannio/shutterstock

Private health insurance in Spain

Social security payments cover state healthcare in Spain, which are contributed by all employees and self-employed workers. Workers’ spouses and children are also covered.

Other groups including retirees and people receiving benefits can also register for healthcare if they are a resident of Spain. They can do this even if they haven’t paid into the healthcare system. The ‘convenio especial’ is a discount state contribution system for low-income and unemployed people.

Those who are not protected by state insurance or the EHIC card must get private medical insurance.

Healthcare costs in Spain

Spanish healthcare spending contributes to around 9 per cent of yearly GDP, ranking Spain 13th among EU/EFTA states. Spending amounts to approximately €2,000 per individual, however, healthcare spending has risen in recent years and there is a greater dependence on private sector providers.

Despite this, the majority of public healthcare in Spain is still free. If residents make regular public health insurance payments in Spain, they only have to pay a part of prescription prices, which are usually very low. They must also pay for specialised medical procedures and may require supplementary private insurance coverage.

The Spanish public healthcare system is supported through social security payments. Each area in Spain is responsible for its own health budget, which is assigned by the central government.

Registering for public health services in Spain

First, you need to register with Spanish social security (Direccion General de la Tesoreria General de la Seguridad Social or TGSS), which has offices throughout Spain, to get a social security number.

You will need to provide the following to register:

  • A valid passport or ID card.
  • Your residency certificate or card.
  • Proof that you have registered your address at your local town hall (padron).

After registering with the TGSS, you will be granted a Spanish social security number and a document certifying that you are eligible for medical assistance. After that, you can register for medical care and apply for a health card (tarjeta sanitaria individual or TSI). This will be sent to you by post or you will need to pick it up in person.

health services
Image – Yau Ming Low/shutterstock

Health centres in Spain

In Spain, primary healthcare is provided through GP surgeries (medico de cabecera) and health centres (centro de salud or centro de asistencia primaria or CAP). Health centres are distributed across the country and are staffed by multidisciplinary teams that include general practitioners, paediatrics, nurses, gynaecologists, and physiotherapists.

Health centres typically have six general practitioners. You might not see the same doctor each time you come, however, you can arrange an appointment with a specific doctor at some clinics. There are also a number of specialised health centres that provide specialised care.

In Andalucia, for example, you can use their app to make appointments at your health centre, either in person or telephone consultations, in addition to reordering your prescription medications and consulting the dates of your prescription medicines.

The Spanish Ministry of Health can help you find a health centre in your region.

Pharmacies in Spain

You will most likely have noticed that pharmacies, or ‘farmacias’, are everywhere in Spain! Most of them have a green cross outside which is illuminated. You can take your prescription or health card to any pharmacy to purchase your medication.

Pharmacies are usually open on weekdays from 9:30am until 2pm and 5pm until 9:30pm, and Saturdays from 9:30am until 2pm.

Some cities also have pharmacies that are open 24-hours a day (farmacia de guardia) or that are open until late at night. There is usually a notice on the pharmacy window or door with details of the closest 24-hour pharmacy.

Getting your prescription medications in Spain

For prescription medications, Spain has a co-payment system. Residents must pay a non-refundable portion of their medication expenditures. The amount you pay is determined by your unique circumstances, and the rules are as follows:

  • Working-age people pay between 40 and 60 per cent of costs, depending on their annual income.
  • pensioners with an annual income of less than €100,000 pay 10 per cent of costs.
  • Chronic or serious sickness patients pay 10 per cent of the cost, with a maximum cap on each medicine.

Registered pharmacists can also offer health consultations and advice on medical issues if you don’t think you need to see a doctor.

Hospitals in Spain

In an emergency, you can go directly to a hospital A&E or ER (Urgencias). Any other types of hospital care will require a doctor’s recommendation. Spain has both governmental and private hospitals, and only public hospitals provide free care. Some hospitals provide both private (privado) and public (asistencia sanitaria publica) healthcare services, so let the personnel know which one you need or prefer.

Bare in mind that when visiting a Spanish hospital, you will be required to provide your social security card or proof of private insurance.

Vega Baja hospital in Orihuela (Alicante)
Image – portal.edu.gva.es

Doctors and specialists in Spain

In Spain, doctors operate in either private clinics or health centres. They provide both private and public healthcare, so you must choose which you prefer.

If you wish to consult a medical expert in Spain, you must first obtain a reference from your primary care physician. Keep in mind that waiting periods for highly recommended testing or some expert treatments might be lengthy. If you have private health insurance, you can see a specialist far more quickly than if you use the public system.

Dental treatment and services in Spain

Unless you are under the age of 15 or if you require emergency dental treatment, oral care is not covered by the public health system in Spain. You will need to pay for your dental treatment and bare in mind that you will usually have to pay upfront at the time of treatment.

Emergency telephone numbers that you should keep handy

In a serious, life-threatening emergency, call the pan-European number 112, this is free to call from any mobile or landline. The Spanish word for A&E or ER is urgencias.

Other emergency numbers include:

  • 061 – for an ambulance (ambulancia)
  • 1003 – for an emergency doctor
  • 961 496 199 – emergency dentists
  • 963 600 313 – on duty pharmacy

Thank you for taking the time to read this article. Do remember to come back and check The Euro Weekly News website for all your up-to-date local and international news stories. Remember, you can also follow us on Facebook and Instagram.

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Written by

Laura Kemp

Originally from UK, Laura is based in Axarquia and is a writer for the Euro Weekly News covering news and features. Got a news story you want to share? Then get in touch at editorial@euroweeklynews.com.