Guidance

Healthcare in Spain

Healthcare advice for British nationals planning to live or living in Spain.

Overview

The rules for getting state healthcare in Spain are different from those in the UK. This guide is intended to advise British nationals living, or planning to live, in Spain on the different ways to access healthcare.

There is a short video highlighting the importance of thinking about healthcare before moving to Spain and further information is available on the Healthcare in Spain website.

There will be no change to the rights and status of EU nationals living in the UK, nor UK nationals living in the EU, while the UK remains in the EU.

Healthcare entitlement

If you are registered to work in Spain and make National Insurance contributions then you can get state-run health care on the same basis as a Spanish national. For further information, get in touch with your local TGSS office.

If you registered as a permanent resident in Spain and are not covered for healthcare though any other means, speak to your local INSS office to register for healthcare in Spain. Permanent residents have been registered as residents with extranjería for at least five years.

If you are in receipt of a UK old age state pension, request an S1 form (previously E121) from the Overseas Healthcare Team on +44 191 218 1999. If you are in receipt of an exportable DWP benefit you can request an S1 form the office which pays your exportable benefit.

It is your responsibility to keep the Overseas Healthcare Team or office which pays your exportable DWP benefit up to date with any changes in circumstances which may affect your entitlement to an S1 (E121). When received, register the S1 form with your local INSS office, before you register with your local GP surgery and obtain a medical card..

As from the 1 July 2014, early retirees are no longer able to apply for a residual S1 form based on National Insurance contributions. The NHS website has more information about this change.

If you are a worker seconded to Spain, or the family member of a someone making UK National Insurance contributions, contact HMRC to see if you have entitlement to an S1 form (previously an E106 or E109). Once issued, register the S1 form with your local INSS office, before you register with your local GP surgery.

If you are coming to study or are currently studying in Spain as part of a UK-recognised course, you may be entitled to healthcare paid for by the UK.

In Spain access to healthcare by children and pregnant women is protected by law. Please see the social worker at your local health centre for more details.

If you are covered by the UK for healthcare and you are going on holiday or temporary stay to another EEA country, you will be covered by your European Healthcare Insurance Card (EHIC). To apply for an EHIC, you can do so by calling on (+44) 191 279 0575 or by emailing this S1 renewal application form (MS Word Document, 225KB) to nhsbsa.ehicenquiries@nhsbsa.nhs.uk

Purchasing public health insurance

If you are not covered for state-run healthcare through any other means, the Spanish regional health authorities offer a special pay-in scheme (convenio especial). This is a public health insurance scheme available nationwide where you pay a monthly fee to access state-run healthcare. The scheme is managed by each autonomous region.

Policy holders pay on an individual basis for access to public healthcare, regardless of pre-existing conditions, anywhere in Spain. Children will also need to join the scheme, as long as their parents have sufficient income to be able to pay their subscription. If you have any doubt about your means to pay for your children to join the scheme, you must make an appointment with the social worker at your local health centre.

The basic monthly fee is 60€ for the under 65s and 157€ for those aged 65 and above. However, prescriptions are not subsidised at this rate so you would pay 100% of prescription costs. This form of cover doesn’t give holders the right to an EHIC at this time, so if you wish to travel, you will need to take out private travel insurance. The scheme is now available in:

Visitors to Spain

The UK European Health Insurance Card (EHIC) is valid for holidaymakers and temporary visitors who need to use the state health system while in another EU country. If you are not normally a resident of the UK, and therefore do not have entitlement to a UK-issued EHIC, the Spanish authorities may decide to treat you as a private patient.

If you are a resident in the UK, you should apply for your EHIC before travelling to other European Union Member States. A UK EHIC is usually valid for three to five years – but if you stop being a UK resident, you need to return your EHIC to the Department of Health immediately.

There is a short video explaining how to use the EHIC card in Spain and further information is available on the Healthcare in Spain website.

If you are a UK state pensioner living in Spain and registered for healthcare with an S1, the UK is responsible for issuing your EHIC to use on a temporary stay in the UK and a third EU country. For more information, telephone the Overseas Healthcare Team on +44 191 218 1999.

The EHIC gives you access to medically necessary, state-provided healthcare during a temporary stay in Spain.

When you show your EHIC, you will receive treatment under the same conditions and at the same cost as people insured in Spain.

Be aware that each country’s healthcare system is different. Services that cost you nothing at home might not be free in Spain (for example, prescriptions).

The EHIC is not an alternative to travel insurance. It does not cover any private healthcare or costs such as a return flight to your home country or lost/stolen property.

From 1 July 2014 you will no longer be able to apply for a reimbursement for co-payments made when using your EHIC. The NHS website has more information.

Planned treatment

The EHIC does not cover your costs if you are travelling for the express purpose of obtaining medical treatment. If this is the case you must apply for form S2 from your local NHS Trust.

Oxygen

If you need to receive oxygen therapy during a temporary visit to Spain, you must request it in advance, in writing, from the Spanish authorities. You should send this request at least one month before you are due to travel.

Oxygen therapy needs to be arranged by customers directly with the Spanish authorities. The Healthcare Teams at the British consulates provide a list of contacts and a template letter in Spanish on the Healthcare in Spain website to help you make these arrangements.

Once you have sent the oxygen request directly to the Spanish authorities, it is your responsibility to then follow up with the relevant oxygen provider to confirm your request has been processed.

Prescriptions

Spain uses a co-payment system (information in Spanish) where residents are required to pay a percentage of the cost of their prescription medication. If you are a pensioner and have paid more than you should have for prescription medication, speak with your pharmacists or local health centre to confirm the process in your region to claim a refund.

The table below provides an approximate basic overview of what residents are required to contribute:

Annual income Social situation % of contribution Capped at
Less than €18,000 Working age 40% No cap
  State pensioner 10% €8/month
Between €18,000 and €100,000 Working age 50% No cap
  State pensioner 10% €18/month
Over €100,000 Working age 60% No cap
  State pensioner 60% €60/month

Contact us

If you have a specific question regarding access to healthcare in Spain, please email the Healthcare Team on Healthcare.Spain@fco.gov.uk

Published 2 April 2013
Last updated 1 September 2017 + show all updates
  1. Amended August 2017
  2. EHIC video removed.
  3. Information on changes to EHIC rules from 1 July 2014 added to the guide.
  4. New links provided for a template letter for applying for oxygen therapy in Spain.
  5. Information added about the 'Convenio especial'.
  6. Additional information added on accessing health services for those not entitled to state run healthcare.
  7. Contact details added for the Healthcare Team.
  8. First published.