Guidance

Healthcare in Spain, including the Balearic and Canary Islands

Healthcare information for UK nationals visiting, living in or moving to Spain.

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This content was originally published on the NHS website.

Healthcare in Spain after Brexit

The UK and Spain have each taken steps to ensure that people living in each country can continue to access healthcare as they do now until at least 31 December 2020. This means that if you are currently living in Spain and the UK currently pays for your healthcare, for example you are an S1 form holder, your healthcare access will remain the same after the UK leaves the EU until at least 31 December 2020.

Working in Spain

Spanish legislation guarantees the right to healthcare for all workers registered in the Spanish social security system, even if there’s a no-deal Brexit. If you’re working in Spain, you may have a Spanish-issued EHIC. This will continue to be accepted in other EU countries and the UK.

Make sure you:

You can find out more information about the healthcare agreement with Spain from the Spanish government website.

S1 certificate holders

If you’re an S1 form holder, you are currently entitled to a UK-issued EHIC for use when you’re travelling outside of Spain. This may not be accepted in all EU countries if there’s a no-deal Brexit. Make sure you have comprehensive travel insurance.

European Health Insurance Cards (EHIC)

UK-issued European Health Insurance Card (EHIC) holders in Spain, such as tourists, students and some workers, will also be able to continue to access healthcare in the same way until at least 31 December 2020.

Living in Spain

Make sure you register with the Spanish authorities if you plan to live or work in Spain. The FCO has guidance about how to register as a resident.

Working in Spain

If you’re going to work in Spain and make national insurance contributions, you’ll be entitled to state-run healthcare on the same basis as a Spanish national.

For more information:

  • visit Seguridad Social (information available in English)
  • register with your local Treasury of Social Security (TGSS) office

You’ll also be entitled to a Spanish-issued EHIC. This is known as a Tarjeta Sanitaria Europea (TSE) in Spanish.

UK posted workers

If you’re a worker posted by a UK company to Spain, you may be entitled to health cover funded by the UK in Spain.

You can find out more from HM Revenue and Customs (HMRC):

Non-workers who are not entitled to an S1

You may be able to apply for permanent residency if you have been registered as a resident in Spain for more than 5 years continuously. This will allow you access to state-funded healthcare under the same conditions as a Spanish citizen.

If you have lived in Spain for less than 5 years you may be able to apply for the Convenio Especial.

This is a pay-in health insurance scheme offered by the Spanish government. It allows people who are not employed to buy into the Spanish healthcare system.

You can apply for this scheme if you’ve been registered as living in Spain for a year or more.

The scheme gives you access to the state healthcare system for a monthly payment of:

  • €60 per person under the age of 65
  • €157 for people aged 65 and over

It covers all pre-existing medical conditions but it does not cover prescriptions. Speak to your regional healthcare authority in Spain for more information about the scheme.

If you have been registered in Spain for less than 1 year, and you’re not working or claiming a pension, you may need to purchase private health insurance to access healthcare.

S1 certificate

You may be entitled to state healthcare paid for by the UK if you live in Spain and you receive:

  • an exportable UK State Pension
  • a contribution-based Employment Support Allowance
  • another exportable benefit

You’ll need to apply for a certificate of entitlement known as an S1 certificate.

An S1 certificate entitles you and your dependants access to healthcare in Spain.

If you have an S1 certificate, it will be valid after the UK leaves the EU.

You may be eligible for an S1 certificate if you:

  • receive certain UK benefits, such as a UK State Pension
  • are employed by a UK body or firm (you’re a posted or frontier worker)
  • are a dependant of someone who has an S1 certificate

You can apply for an S1 certificate through the NHS Business Services Authority.

If you receive a UK State Pension, you can apply for your certificate via the Overseas Healthcare Service on +44 (0) 191 218 1999 (option 5).

For other exportable benefits, you may need to contact a different team depending on the exportable benefit.

Read more about claiming benefits if you live, move or travel abroad. Please note that different exportable benefits can have different rules in terms of healthcare cover.

The Foreign and Commonwealth Office (FCO) has information about what UK and Spanish benefits are available to Britons living in Spain.

Studying in Spain

If you’re a UK resident studying in Spain, your UK-issued EHIC will be valid after Brexit.

You should continue to buy insurance to cover your healthcare, as you would if you were visiting a non-EU country.

Read more about healthcare when studying abroad and planning your healthcare when moving abroad.

Visiting Spain

Make sure you have comprehensive travel insurance if you’re planning to visit Spain.

The government always advises UK citizens to take out comprehensive travel insurance when going overseas.

Your EHIC is not an alternative to travel insurance and you should have both when you travel abroad.

Medical care is given to anyone needing urgent attention. You can expect to be charged in full for any care you are given without an EHIC.

You should always buy enough travel insurance and make sure you have access to funding to cover any medical treatment abroad.

Keep all receipts and any paperwork and make copies if necessary. You or your insurance company might need them to apply for any refund. Your EHIC gives you access to the necessary state-provided healthcare in Spain at a reduced cost, or sometimes for free, if you’re staying there temporarily.

Make sure you’re treated by a healthcare provider in the state system. Your EHIC will not cover you for private healthcare.

You may have to travel some distance to find a state healthcare provider in some parts of the country, particularly the outlying islands.

Some hospitals and health centres (centro de salud) offer both private (privado) and state-provided healthcare (asistencia sanitaria pública). You must tell them which service you need. If you’re asked to pay for health services upfront, it’s likely that you’re not being treated under the state health system.

There may also be separate waiting times for private patients and patients treated under the state healthcare system.

Spanish health authorities are decentralised, so systems can differ between regions.

You can find a directory to all regional health bodies on the Spanish health ministry’s website.

Select your region on the map provided and find the section marked Servicio de Salud (healthcare system).

Pre-existing health conditions

You should buy medical travel insurance before visiting Spain if you have a pre-existing health condition.

You must tell the insurance company about any pre-existing health conditions you have so you can get the cover you need.

If you have a pre-existing condition that will need treatment while abroad, ask your doctor in the UK for advice before you travel.

Take any documents about your health condition or medication with you. If you’re travelling to have planned medical treatment, read the NHS guide about going abroad for medical treatment.

Oxygen

You can receive oxygen therapy during a temporary visit to Spain, but you must request it in advance from the Spanish authorities. This must be done in writing.

You need to send this request at least 1 month before you are due to travel. For a template letter and instructions, see Request oxygen therapy while visiting Spain: template letter.

Healthcare services in Spain

Finding help in an emergency

Call 112 if you have a serious, life-threatening emergency. This number is free of charge and valid in all Spanish territories.

The Spanish word for A&E department is ‘urgencias’.

Be aware that if you ask a hotel or travel representative to call a doctor, you may be treated privately.

To be treated under the state system, you must call 112 and ask for an ambulance to take you to the nearest state hospital.

Dentists

Dental treatment is not covered by the state healthcare system unless it’s an emergency.

Most A&E departments or health centres have a dentist attached that can deal with dental emergencies.

Hospitals

You’ll need a referral for any specialist treatment. Make sure you’re referred to a state hospital as only these provide treatment free of charge. Even in a state hospital you’ll need a valid EHIC. Check that you’re not treated as a private patient.

In the state healthcare system, you have the right to insist your EHIC is accepted. You do not have to provide travel insurance details unless you choose to.

You can visit a public health centre for medically necessary treatment using your EHIC in any part of Spain, but it may not cover all medical costs. Most main health centres provide an A&E service from 8am to 8pm. At some health centres, the A&E unit operates 24 hours a day, including weekends and bank holidays.

Look for your nearest health centre on the Spanish government website

Prescriptions

Once you have a prescription from a Spanish state doctor, you can take it to any pharmacy (farmacia) in Spain. They can be identified by a green cross. There are prescription charges in Spain that are non-refundable.

With an EHIC, people of working age are charged 50% and pensioners are charged about 10%.

If you receive a UK State Pension, you’ll have to declare this to pay the lower rate.

If you’re told by a hospital that you need medicine after being discharged, you must take the hospital medical report to a doctor.

The doctor will give you a prescription. This is because doctors in state hospitals only prescribe medicines on the appropriate medical report but do not issue official prescriptions.

Bringing your own medicines to Spain

If you have a condition that requires you to bring your own medicines to Spain, you should have a letter from your GP stating:

  • what medicines you need
  • why you need them

If possible, have the letter translated into Spanish, as this will also be useful in case you need to see a health professional during your stay.

If any of your medicines are in the controlled drugs category, you need to comply with regulations on drugs exports in the UK.

You also need to apply for the Spanish import license at your nearest Spanish consulate with the following documentation:

  • license for exportation of controlled drugs
  • full name, current address and contact telephone number of applicant or drug unit
  • flight details (including dates) and destination address in Spain
  • fax number or address details to send the Spanish Import License once received from Spain

Ask your doctor in the UK for advice before you travel and make plans for how to manage your condition when you’re abroad.

You should also take your health condition identification or letter saying what medicine you’re taking.

Published 23 September 2019