The Spanish healthcare system is a mixed system, comprising the National Health System (NHS), managed by public entities, and an extensive private hospital network. Nearly 90% of Spaniards benefit from the NHS, while 15% have private health insurance.
To benefit from Spain’s healthcare system, you must legally reside in the country and contribute to the Spanish government to qualify for public service, as it is funded by the government through taxes.
On the other hand, private healthcare in Spain is similar to the Brazilian model, meaning that citizens must pay a monthly fee, which varies depending on the company they use, and thus can access medical and hospital care when necessary.
Public Healthcare System
The National Health System (NHS) is a universal system, meaning that anyone registered with Social Security has access to free healthcare (except for ophthalmology and dentistry), which includes medical consultations, hospitalizations, emergencies, specialized care, and subsidized medications.
Public health services in Spain are classified into two groups: Primary Care and Specialized Care.
Primary Care offers basic services, such as consultations, examinations, pregnancy courses, and emergency care. Specialized Care, on the other hand, provides services in specialized centers and hospitals, on an outpatient or inpatient basis.
As mentioned above; to be eligible for the public healthcare system in Spain, you must be registered with Social Security. Obtaining a Social Security number is quick and free and must be requested before starting any activity or service. It can be requested by the employee or the employer.
Once registered, you must go to the health center nearest to your home to apply for the Individual Health Card (TSI). All individuals duly accredited through their individual health card or other official accreditation document that recognizes their right to care under the Unified Health System, as well as other groups, are entitled to public care.
The National Social Security Institute is the competent body for determining entitlement to healthcare from the public funds of the Unified Health System. Therefore, if a citizen is unemployed or retired, they are guaranteed care if they are registered with Social Security.
For foreigners in Spain, medical or travel insurance with coverage in Spain is a requirement for entry into the country. Otherwise, public services are guaranteed only in cases of accidents, serious illnesses, and for pregnant women in labor.
If an individual is a citizen of one of the European Union member countries, they may receive medical care in Spain’s public healthcare system, provided they present the European Health Insurance Card (EHIC).
Below, we tell you the services it provides in more detail:
- Primary care: This is the first level of contact with the healthcare system. You will be assigned a primary care physician or family doctor at your local health center, who will be responsible for monitoring your overall health.
- Medical specialties: If you need to see a specialist (such as a cardiologist, dermatologist, or gynecologist), you should first see your primary care physician, who will evaluate your case and refer you to a specialist if necessary.
- Emergencies: Public hospitals offer emergency services 24 hours a day, and the service is completely free for residents.
- Hospitalization and surgeries: Hospitalization, including surgeries, is also covered by the public system. This means that if you need to be admitted to a hospital or undergo surgery, you won’t have to worry about large expenses, as these services are funded by the state.
- Medications: Medications prescribed by doctors in the public health system have a subsidized cost, which means you’ll only pay a portion of the total price. These medications can be redeemed at any pharmacy, but you must always carry your Individual Health Card, as it identifies you as a beneficiary of public health care. For example, pensioners receive an even larger subsidy and, in many cases, pay minimal or even nothing for their medications.
Private Healthcare System
As mentioned above, health insurance plans exist in Spain, requiring a monthly payment to access medical and hospital care when necessary. For foreigners working in the country, it is also recommended to purchase health insurance, which can be provided by the company where the individual works or even by the individual themselves.
Therefore, we can say that private healthcare is accessible through private insurance or through direct payment for services.
Advantages of private healthcare:
- Shorter wait times: Although public healthcare offers good coverage, wait times can be long for specialist consultations or non-urgent procedures. Private healthcare tends to offer faster appointments.
- Flexibility: Private centers typically offer greater flexibility in appointment times and more direct access to specialists without the need for a referral.
- Choice of doctor: In private healthcare, you can choose your doctor or surgeon, while in public healthcare, one is generally assigned to you. Many people choose to purchase private health insurance to supplement public healthcare or to avoid using it altogether.
Insurance plans vary in cost and coverage, but typically include:
- Direct access to specialists.
- Hospitalization coverage in private centers.
- Dental, ophthalmological, and cosmetic services, which are often not covered by public health care.
If you decide to use private healthcare without health insurance, it’s important to keep in mind that costs can be high. For example, a consultation with a private specialist can cost between 50 and 150 euros, depending on the clinic and specialty. More complex treatments, such as surgeries or hospitalizations, can be significantly more expensive. For this reason, most people who use private healthcare purchase health insurance to cover some or all of these expenses.
