Spain offers a high-quality healthcare system that is accessible to both residents and expatriates. In this guide, we will explore the healthcare options available to US expats in Spain, including the public healthcare system, private hospitals and insurance, and important factors to consider when seeking medical care.
Overview of the Spanish healthcare system
The Spanish healthcare system is renowned for its universal coverage and high-quality care. It is in fact a two-tiered system, consisting of public and private healthcare providers. The public system, known as the Sistema Nacional de Salud (SNS), provides comprehensive coverage to all residents, including US expats legally residing in Spain.
Coverage in Spain’s public healthcare system
TheServicio Nacional de la Salud includes primary care services such as family medicine, pediatricians, nursing services, and midwives, as well as prevention, diagnosis, rehabilitation, and emergency services. Each resident is assigned a family doctor who can refer them to specialists when necessary. It’s important to note that available healthcare services provided vary between autonomous regions, so you should check the conditions applicable to your place of residence.
Eligibility for public healthcare in Spain
To access public healthcare in Spain, you need legal residency, registration with the Instituto Nacional de la Seguridad Social (INSS), and a public health card called “tarjeta sanitaria individual” that must be presented during visits to public hospitals or health centers. Family members, including spouses, children under 26 years old, and siblings of the insured person, can also benefit from public healthcare if they legally reside in Spain. Those who don’t meet the criteria for public healthcare can opt for a special pay-in scheme called Convenio Especial, which allows access to the public healthcare system for a monthly fee.
Obtaining the Tarjeta Sanitaria Individual
To obtain the Tarjeta Sanitaria Individual (TSI) or Individual Health Card in Spain, follow these steps:
Register with the Local Town Hall: If you are a resident in Spain, you must first register with the local Town Hall (Ayuntamiento) where you live. This process is known as “empadronamiento” and involves providing your personal information and proof of residence, such as a rental contract or utility bills.
Visit the Local Health Center: Once you have completed the empadronamiento, visit the local Health Center (Centro de Salud) with your identification document (passport or national ID) and proof of residence.
You will be given an application form to fill out, which asks for personal information such as your name, address, contact details, and healthcare history. The local health authority will then review your application and process your request for the Tarjeta Sanitaria Individual.
Private health in Spain
While public healthcare in Spain is comprehensive, some individuals prefer to have private health insurance to avoid potential delays and have access to additional services. Private health insurance is also a requirement for many visa applications, so most expats need it initially. There are various private insurance providers in Spain, such as Sanitas, Adeslas, and Asisa.
Americans studying in Spain are also required to have private health insurance
Hospitals in Spain
Spain boasts a top-ranking healthcare system, with both public and private hospitals renowned for their quality of care. Public healthcare covers emergency services and surgical procedures. However, one drawback of the public system is the long waiting lists for specialists and non-emergency treatments. To locate the nearest hospital, you can refer to the website of the Spanish health ministry.
Costs of healthcare in Spain
Public healthcare in Spain involves some costs, depending on the autonomous region and the individual’s level of income. Prescription medication, orthopedic and prosthetic devices, dental care, and eyeglasses meanwhile typically aren’t covered by the Spanish public healthcare system.
Private health insurance plans vary in cost based on factors such as age, gender, and pre-existing conditions, similarly to in the US.
Giving birth in Spain
If you are a registered short-term or permanent resident in Spain, you are entitled to use state healthcare, and giving birth in Spain is free, including medical support throughout the pregnancy, including prenatal exams, scans, and intervention during delivery and after childbirth.
Otherwise, you will need private insurance, and the additional personal costs may vary depending on your insurance plan. It is advisable to find a plan that covers childbirth in full.
However, if you are uninsured for any reason, the costs for giving birth in Spain are relatively low, averaging around $1,950 USD according to a study.
Children born in Spain to non-Spanish parents do not automatically receive Spanish citizenship. Spanish law follows the concept of Ius sanguinis (right of blood), meaning the child will have the parents’ nationality. However, if either parent is a Spanish national or was born in Spain, the child may be eligible to apply for Spanish citizenship. In cases where the parents’ nationality cannot be awarded to the child, Spain may grant Spanish nationality.
Finding English-speaking doctors
Although many healthcare professionals in Spain speak English, finding English-speaking doctors may be preferred by some US expats. In larger cities and popular expat destinations, you are more likely to find doctors who are fluent in English. Researching online expat forums, asking for recommendations, or consulting with expat groups can help you find doctors who can effectively communicate with you.
Prescription medications
Obtaining prescription medications in Spain is straightforward. Once you have your TSI card, you can visit pharmacies to obtain prescribed medications at a subsidized cost.
Emergency medical services
In case of emergencies, dial 112 in Spain (rather than 911. The emergency response teams consist of trained physicians, nurses, technicians, and patient transport assistants. The Spanish emergency medical services operate on a two-tiered system, with Advanced Life Support and Basic Support teams. After an on-site assessment, they will transport the patient to the closest hospital.
Emergency care is generally covered by public healthcare in Spain. However, if you have private healthcare or are not yet eligible for Spanish healthcare, you may need to personally cover the costs and subsequently invoice your healthcare provider.
In summary, by taking proactive steps to secure your medical coverage, whether in the public system if you qualify or through a health insurance plan, you can relax and focus on immersing yourself in the rich cultural experiences, breathtaking landscapes, and vibrant communities that Spain has to offer, while knowing that your health needs are taken care of.
If you have any questions about financial planning as an American living in Spain, get in touch.
This article is for informational purposes only; it is not intended to offer advice or guidance on legal, tax, or investment matters. Such advice can be given only with full understanding of a person’s specific situation.
