Health Coverage Options for Expats in Spain
There is free universal health care in Spain. To become fully insured, however, you have to have a social security number. To get one, you generally have to either work for a company or become self-employed (in which case you’ll pay to be part of the system). If you have a Certificado de Empadronamiento (see the section Registration), however, you have the right to emergency care in any public hospital. This is incredibly easy to get and you don´t need to be a resident, or even have legal status in Spain!
You may not need to buy health insurance if you are legally employed in Spain. Your employer is obligated to pay approximately thirty percent of your salary into a health fund that covers you and all of your dependents. This fund covers all of your doctor’s visits, medications, eye tests (but not the cost of glasses), emergency and elective surgeries.
It does not cover dental, (although some companies do include dental in their company insurance plan) and you may also want to choose a doctor outside of your geographical area, or choose your own hospital for elective surgery. If this is the case, you will need to buy your own insurance. There are a few health insurers who service Spain, but Sanitas is really the only one that has English-speaking doctors in their clinics. (See below)
Additionally, if your country of origin has universal health care, then you may be able to get your country to pay for Spain to cover you. In some cases, you may want to keep your universal health care provided by your home country, especially if you intend to be back and forth between Spain and home. In this case, it is recommended to purchase additional health or travel insurance from a home-country insurance provider that supplements your universal health care for the duration of your stay in Spain. In Canada, for example, you will need to continue paying for your provincial health care and notify them of your extended absence from the country to ensure continued coverage. This is a requirement of getting private health or travel insurance anyway.
Health Insurance Companies in Spain
- Sanitas: https://www.sanitas.es/
- Asisa: http://www.asisa.es/
- FIATC: http://www.fiatc.es/
- Asistencia Sanitaria: http://www.asc.es/
Prices for private insurance start at about 30 €/month for a 30 year-old male, plus an initial fee of 30 euros, but you can sometimes negotiate (or avoid) the initial fee if somebody with that insurance company recommends you.
However, most expatriates living in Spain will need to or want to get an international health insurance plan that will cover them in Spain, but also globally including or excluding the USA.
If you’re a retired EU citizen you should apply for a form E121 from the UK Pensions Service before you go to live in Spain. Once you arrive you must register the form at the local social security office and they will issue you with a social security card which must be produced when you go for treatment either at your local surgery or hospital. Until you have your card (and it may take some time to arrive), you should be able to show that you have applied for a card and want to be treated under EEA rules.
If you’re going to live in Spain but won’t be working and have not yet reached retirement age, you may still be able to get free or low-cost state healthcare for a limited period of time, depending on your circumstances. If you’ve been paying social security contributions in the UK up to the point of departure, you should apply for form E106 from the Pensions Service in the UK. They will send you a claim pack and let you know whether you’re entitled to this limited cover. Ask if you can include any family members in your claim. If they decide you’re entitled to claim, they’ll send you to form E106 which you must then complete and register with the social security authorities in Spain. Until you register you won’t be entitled to free healthcare, so make sure you’ve got health insurance cover as a back-up.
Once you start working in Spain and paying social security contributions through the normal channels, you’re no longer entitled to use your E106 or your European Health Insurance Card.
You can get the forms you need from The Department for Work and Pensions. Contact them at: https://www.dwp.gov.uk.