Living in Spain and No Residency or Spanish Medical Card – The Risks
Over the past few days, we have been trying to help a very ill Irish client who has lived here for many years but she never obtained her Residence in Spain nor her SIP (Spanish Medical Card) preferring to rely on paying for health care when needed and on the EHIC (European Health Insurance Card).
She never doubted that if needed the medical assistance would be there.
However in the past few days she has discovered that she needs urgent treatment and was quoted 16,000€ as the initial cost by the private hospital, plus costs for the follow up continuing problem, which is impossible.
Her doctor contacted us and asked us to obtain a SIP card within a couple of days to allow her to obtain treatment (operations and follow up treatment at the public hospital in Torreveija).
However to get a SIP card, firstly you need a E121 form or S1 form from Ireland (or UK) if you are an old age pensioner, and that is not easy to get from Spain (as you usually get it before leaving a country, although it is possible afterwards) nor is it possible super urgently.
We have to urge clients to never, when living in Spain, to rely on paying for medical cover or a EHIC when they are Residents and over pension age so entitled to state medical cover. As to access state medical cover you must have Residencia. And even for Residents and OAPS it seems it is not a given right to be able to get medical help, except for an emergency (and the seriousness can be argued) and other things follow the initial care.
We contacted the Irish Embassy and they wrote to us saying the following:
As discussed, on the following link there is information on the Cross Border Directive, the Treatment Abroad Scheme and the EHIC: https://www2.hse.ie/costs-schemes-allowances/. The contact details for the HSE are: https://www.hse.ie/eng/contact-us.
On the specific issue of healthcare, access to state healthcare in Spain is different to Ireland and can at times be quite complex. As you may know, in April 2012, Spain introduced a healthcare reform law that affects who is entitled to free treatment under the social security system. Restrictions apply to both residents and non-residents.
We recommend citizens who wish to enquire as to whether they will be eligible for Spanish state healthcare to speak to their local health centre (“centro de salud”), as well as the local Information Office for Social Security, to explain their specific situation.
Irish citizens, including pensioners, can apply to have their Irish Social Security entitlements recognised in Spain, which then may make them eligible to apply for state healthcare in Spain.
The Department of Employment Affairs and Social Protection is the pertinent authority whom you can contact to enquire about Irish Social Security entitlements, http://www.welfare.ie.
Finally, to receive state healthcare, a person is required to be registered as a resident in Spain and in their local area. Further information on these two processes can be found on the Embassy’s website:
We are helping our client now all we can to obtain a S1 form, Residency and a SIP urgently so they are not faced with a huge bill for their treatment in a public hospital in the country where they have lived many years. However, it is very important please for people living in Spain to obtain Residencia or pay for Private Medical Insurance, and not to rely on being able to travel back to their home country, or paying a medical bill or on their European Health Card to cover medical emergencies.