Spain has a developed health care system that meets the highest European standards. Of course, most of the EU countries are characterized by high-quality health care, but in Spain it is the most effective, and this is where the world-famous medical research institutes are located. Spain’s highly developed public health system is complemented by an excellent private sector, which accounted for approximately 15% of the services provided.

About 93% of the Spanish people prefer to use the public health system, which belongs to the National Health System and decentralized because of a range of rendered services depending on the region. This system is supervised by the Spanish Ministry of Health, which distributes the available state budget and oversees the National Health System.

Quality of Spanish healthcare system

The reports about the level of medical care in different countries of the world or the Health Care Index for Country are published annually by the world’s largest database of cities and countries Numbeo. The experts estimate the overall quality of healthcare systems, the availability of professional equipment in hospitals, the qualifications of doctors and other medical stuff, as well as the cost of service in clinics. Information is based on a survey of residents of the respective countries, and not on the database of national statistical services.

Thus, was compiled a general indicator − a quality of health system index, which comprehensively displays how well or poorly in the country with medicine. The higher this index is, the better the service. The last time, the Health Care Index for Country was updated in the mid-2019. Spain took the prestigious 7th place in this ranking, and the United Kingdom − 13th.

According to the reputable Bloomberg agency and its Healthiest Country Index for 2019, Spain was recognized as the best country in the world on this indicator! For comparison, the UK took only19th place in this ranking. In total, 169 countries with a population of at least 300,000 people were evaluated for factors affecting their general health condition.

The assessment included life expectancy, taking into account risks such as smoking and obesity. Environmental factors, such as access to clean water and sanitation were also taken into consideration.

According to the United Nations, Spain has the highest life expectancy among other EU members and loses only to Japan and Switzerland. The University of Washington’s Institute for Health Metrics and Evaluation predicts the highest life expectancy in Spain by 2040 − about 86 years. Over the past decade, there is also a decrease in cardiovascular diseases and cancer deaths.

Dietary habits of the Spanish people who prefer the «Mediterranean diet» reduce the risk of cardiovascular diseases better than so-called low-fat diets and have a beneficial impact on their health, according to the study of the University of Navarra Medical School.

Today we will try to answer the most common questions about medicine for the British in Spain.

Who has the right to make use of medical care in Spain?

The right to receive access to the Spanish public health care system is for those who are eligible for medical care by The British National Health Service (NHS) after the UK leaved the European Union. This is guaranteed till the end of the year 2020 by an appropriate agreement concluded between the EU and the United Kingdom.

hat assurance provided by the agreement after implementation of BREXIT protect the right of the British citizens to receive medical attention in all EU-members under the same conditions as if they were still EU-citizens, and vice versa.

The British citizen make adventure touring to Spain after BREXIT: what’s about medical care? What documents will be required?

The situation for the British will not change in 2020, the European Health Insurance Card will become a document that allows them to receive medical care while traveling.

The British citizen works legally in Spain: does his family rights for medical assistance?

Yes, the relatives of the British citizen who has the right to reside and actually lives in Spain are entitled to free medical care.
This refers to the employee’s children under the age of 26, and disabled family members, if they are dependent and live with the employee together, as well as to their spouse or common-law partner. For them may be issued separate medical cards.

The British citizen is holding a doctorate/master’s degree/ERASMUS fellowship: will be medical services in Spain available for him?

Yes, he can expect medical assistance if he is EHIC-holder (European Health Insurance Card) and if his research institute/school/university gets him to Spain for a certain period, so he is still under the protection of the British Health System, but should apply S1-form in advance, before his departure in another country.

What medical procedures of the Spanish National Health System are free?

The British citizen who has a Spanish medical card or who proved their right to medical care in the United Kingdom or Gibraltar are not required to pay for health care in the Spanish public health system, since all costs of their medical bears Spain or the United Kingdom by agreement with Spain.

The British citizen lives and works permanently in Spain: whether free medical care is due for him, what steps to take?

Spanish laws ensure medical care to all employees who are protected by the Spanish social security system (el Sistema Español de Seguridad Social). At this point, the above process takes place automatically, and no additional procedures should be required.

A UK citizen will be serviced in health facilities that are a part of the national health system by presenting a medical card provided by the SS (Seguridad Social) in his name at their place of residence.

Medical cards will remain activated until the expiration date and will be fully valid for receiving any medical treatment throughout Spain.

The British citizen is not a Spanish permanent resident: can a medical institution make him pay for medical care?

Foreign guests who do not have a medical card of the Spanish National Health System or do not have a document confirming the health cover provided by British entities may be charged by the Spanish National Health System for the services rendered.

The British citizen’s company is located in the UK, but he is temporally relocated to Spain: is he eligible for medical care?

Yes, as a relocated employee, the British citizen can temporarily work in Spain and any other EU country and remain on providing of the British Social Security System for 2 years. During this time, his rights to social security, including medical care, remain without modification.

The British citizen arrives to work in Spain every day, due to residing in Gibraltar: whether he is eligible to medical care?

Yes, he retains this right.

Those British pensioners who reside in Spain after Brexit: can this fact affect their access to medical care?

Their right to medical care shall not be forfeited, and all the previous conditions will continue to apply until the end of 2020 or until a new relevant agreement between the countries will be signed.

How can the British citizen register with the Spanish public health system?

First of all, he needs to register with the social security system (Dirección General de la Tesorería General de la Seguridad Social or TGSS), which has branches throughout Spain, to get a social security number – el número de seguro social (NSS).
To register for social security, the British will need to provide:

  •  valid passport or id-card,
  • resident card (tarjeta de residente),
  • residence permit (certificado de empadronamiento).

After registering with TGSS, the British citizen will be assigned by a social security number and he will get a document that confirms his eligibility for medical care. Then he can sign up for medical procedures and apply for a medical card (tarjeta sanitaria individual or TSI). This card can be delivered by mail, or it is possible to pick up it personally at the office of the medical institution.

In which cases should the British citizen use private medicine in Spain?

Private health care in Spain works in parallel with the public system, some medical institutions offer both public and private services. Anyone who is not eligible for public health care can purchase private health insurance or pay the full cost of any medical procedure. About 20% of the Spanish people have private health insurance, as it allows them to receive a wider range of medical services and at the appropriate for him time. Private insurance is especially popular among foreigners.

On average, private health insurance in Spain costs about 35-200 euros per month, depending on the chosen insurance plan.
Let’s look at the options in more detail.

Seguro médico sin hospitalización

Usually, it is a low-cost insurance which includes an examination by a general practitioner and analysis of basic health. Other services such as ambulance, hospitalization, and medical procedures are paid separately.

Seguro médico con copago

Medical services for the insured come with a little extra payment. This insurance plan is best suited for those policyholder who are rarely solicited for treating.

At the same time, a certain amount of money (usually 5-10 euros) will be paid for a visit, but you can save on monthly payments, which will be 20-30 percent lower than the normal price.

Seguro médico sin copago

This medical care doesn’t include any additional costs, as «all inclusive» is a full package of services with the assistance of all doctors and any health procedures. Such type of insurance is obligatory for the purpose of obtaining Spanish residence and for students.

Prices for Spanish medical policies in 2020

As we have stated before, the price of health insurance in Spain depends on several factors: the list of insurance services, the age of the insured person and number of all insured persons.

The following prices are commonly found in Spain (monthly payment with an annual service plan):

  • The cost of insurance without hospitalization (basic) for one person under 35 years of age will cost approximately 25-50 euros per month (depending on the company). Full covered insurance is about 40-65 euros;
  • The cost of the basic policy for people over 65 years of age will cost 75-200 euros, full insurance will be at the sum from 100 to 250 euros per month. Please note that not all companies agree to insure people over 65 years of age;
  • Maternity insurance. The basic amount is 35-80 euros per month, the full amount will cost about 50-100 euros;
  • Family policy. The cost of a family insurance, for example, for parents and two children under 10 years will be 90-180 euros (basic) and 160-280 euros (full).

Important: in case of emergency, it does not matter what kind of policies and residency status the British citizen has. He just needs to call the common European number «112», it is free of charge for any mobile/landline phone.

Other useful emergency numbers: 1003 (emergency surgeon), 061 (emergency care), (+34) 961 496199 (emergency dental), (+34) 963600313 (all-night pharmacy).

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