Where do I get the necessary forms for Spanish National Health medical care?
The Spanish public health system is called Instituto Nacional de la Salud (INSALUD). The various 'E' (for 'European') Forms are available in all EU countries. You must obtain them in your home country before you come to Spain.
What form do I need as a Non-Resident and what treatment does it cover?
A Non-Resident needs The European Health Insurance Card (EHIC), which gives entitlement to emergency health care only during a short stay. Please note that you will always be billed for any treatment that does not qualify under the 'emergency' category, and that this free emergency treatment is only available in National Health hospitals or clinics (if you go to a private doctor or hospital you will have to pay).
The European Health Insurance Card (EHIC) will be accepted in most emergency cases where visitors run out of their vital prescribed medication and for state hospital stays resulting from emergency admission.
A European Health Insurance Card (EHIC) gives no entitlement to free or reduced cost on-going medical treatment for a pre-existing illness. For this you will need Form E112 which is issued only on the authorisation of your Department of Health after supporting medical evidence has been supplied by your General Practitioner.
If you need prescription medicines of a non-emergency nature, you can usually purchase them in a Farmacia (pharmacy/ chemist) – easily recognisable by the green or red cross outside the premises.
A European Health Insurance Card (EHIC) gives no entitlement to medical repatriation costs. Dental treatment is not generally available under the Spanish National Health System and is therefore not covered by the European Health Insurance Card (EHIC). We strongly advise you, therefore, to take out full private medical insurance cover – this is normally included as part of your comprehensive travel insurance. In addition, don't forget to enter your next of kin details on the relevant page of your passport.
How do I use the European Health Insurance Card (EHIC)?
Present the form, together with a photocopy, to the Spanish National Health medical service you are using. Following any treatment, ensure that the original form is returned to you.
I'm a Resident and a pensioner - what form do I need and what treatment does it cover?
EU Pensioners (those receiving State pensions as a result of having worked in their home country and having contributed to that country's Social Security System) should obtain Form E121 - this enables them to transfer their rights to State medical care from their home country to the Spanish Social Security System. Dependants of such pensioners receive the same entitlement but must have their own Form E121. Please note that dental treatment is not provided under the Spanish National Health System.
Once rights to State medical care have been transferred to Spain, anyone visiting any other European country – including their home country – should obtain a European Health Insurance Card (EHIC) from their local health centre (in Spain) before they travel. This will entitle them to free emergency treatment in the country to be visited.
Procedure
As soon as application for a Residence card has been made, you may apply for a Social Security Card. We can process this application for you and then present you with your Social Security Card.
You need to take this Social Security Card to your local Centro de Salud (Health Centre), along with your Padrón document (proof that you are on the Town Register). Here the card will be 'activated' and you will be registered for future State medical treatment. Medicines prescribed by an Insalud doctor are free for pensioners and their dependants.
Please bear in mind that not all medical staff are multi-lingual, so if you do not speak Spanish you may need to take an interpreter (at your own expense) when you visit the Health Centre or speak to a doctor.
The Spanish Health Services do not cover the wide range of assistance you may have been used to in your home country. It is advisable, therefore, to consider a top-up private medical insurance policy as an extra safeguard, which should also cover private dental treatment and medical repatriation costs.
Those not in receipt of a State pension from their home country do not qualify for State medical care and are required to obtain medical insurance for private treatment in Spain. (Such cover can be obtained from insurance companies locally in Spain, and, in Torrevieja for example, private treatment is available at several clinics, as well as at the San Jaime Hospital.)
I'm a Resident but not a pensioner - what form do I need?
Those officially employed in Spain and paying into the Spanish Social Security System receive State medical care and, on retirement, a pension. You will be issued with a Social Security Card (Documento de Afiliación a la Seguridad Social) which you should take with you to register at your local Health Centre.
Those not paying into the Spanish Social Security System (ie not working) do not qualify for State medical care and are required to obtain private medical insurance for treatment in Spain.
In some cases, a person moving permanently to Spain who is below pensionable age but who has been paying into their home country's Social Security/National Insurance system, may be entitled to receive State health care in Spain, for a limited period, on production of Form E106. The duration of entitlement will depend on your past National Insurance contributions record. Please check with and apply to the relevant Department in your home country before you leave for Spain. The procedure for Form E106 is the same as that for Form E121 (see above).
Are there nursing/convalescent homes and residential/retirement homes in Spain?
Yes there are, but not many. Care for rehabilitation, convalescence or terminal illness is usually left to the relatives, as is the care of the elderly.
EU Residents who have been in Spain for many years will qualify to go on the waiting lists of the limited number of State Residential Homes.
There are a growing number of private Residential and Nursing Homes which provide various levels of care and treatment. These, however, can be expensive.
In either case (State or private), anyone going into a Spanish residential home who does not speak Spanish fluently will inevitably experience problems.
Will I be entitled to any Spanish benefits?
EU Residents who have not paid into the Spanish Social Security System will have no entitlement to Spanish health or incapacity benefits.
If you were already in receipt of any such benefits in your home country you will need to see which, if any, remain payable to you in Spain.
