Changes to Access to Healthcare for Early Retirees


Posted and filed under Medical Care in Spain.

Changes to Access to Healthcare for Early Retirees

Changes to Access to Healthcare for Early Retirees From Great Britain to Spain Summer 2014

The UK Department of Health has announced that as of the 1st July 2014, early retirees will no longer be able to apply for a residual S1 form to cover them for healthcare when they move abroad to another EEA country, such as Spain. This will bring the UK into line with countries like Ireland, where it is not possible to get access to free healthcare subsidised by Ireland before you are pensionable age.
These changes only affect new applications received on or after 1st July. They do not affect those who already have an S1 form, nor State Pensioners who are entitled to cover under the European Regulations.
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.
If you registered as a resident in Spain before 24 April 2012, have an annual income of less than €100,000 and are not covered for healthcare though any other means, you can make an appointment at your local Social Security office to register for healthcare in Spain as a resident.
If you are in receipt of a UK old age state pension or long term sickness benefit, obtain an S1 form (previously E121) from the International Pension Centre on 0044 191 218 7777. Once issued, register the S1 form with your local Social Security office in Spain.
If you are an early retiree and have recently made national insurance contributions in the UK, contact the Overseas Healthcare Team on +44 191 218 1999 to see if you have entitlement to a residual S1 form for a limited time. Once issued, register the S1 form with your local Social Security office. This is what will change from 1 July 2014 as it is one of series of cost-saving moves across the National Health Service.
The NHS will no longer reimburse another European state for health costs incurred by non-working Britons under pensionable age. Currently, many unemployed expats under age 65 (or women under 60) within the European Economic Area effectively pass their care costs to the Treasury by completing Social Security residual form S1 before leaving the UK. This gives the holder, and probably his or her dependants, up to two and half years’ free health care access.
Claimants should have made National Insurance contributions for the past three years to qualify for the full period of cover. The changes do not affect people who already hold residual S1. The changes do not affect people over state retirement age. Neither do they affect EU citizens seeking emergency care through the EHIC – European Health Insurance Card.
Purchasing public health insurance
If you are not covered for state-run healthcare through other means, the Spanish regional health authorities offer a special pay-in scheme (convenio especial). This is a public health insurance scheme available nation-wide where you pay a monthly fee to access state-run healthcare. The scheme is managed by each autonomous region. Policy holders, including children, pay on an individual basis for access to public healthcare, regardless of pre-existing conditions, anywhere in Spain.
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 a Spanish EHIC at this time.
Visitors to Spain
The UK (EHIC) European Health Insurance card is valid for holidaymakers and temporary visitors who need to use the state health system while in another EU country.
If you are a resident in the UK, you should apply for an 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.
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. If you are working in Spain, you need to apply for your EHIC in Spain.
The EHIC gives you access to medically necessary, state-provided healthcare during a temporary stay in a different European country from where you are resident. 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.

If you are about to move to Spain contact the Overseas Health Team now to apply for a S1 form and they will answer questions. Options if you are unable to obtain a S1 and therefore free health care in Spain are:

1)    Private health insurance – please contact Amanda on for more help with this.
2)    The Spanish special pay-in scheme of public health insurance – contact Poli on
3)   If you are registering as self-employed in Spain, you will be entitled to free health care (and for the initial 18 months is at subsidised rates now for some individuals) – contact Poli on

Thus with our help you will be able to weigh up the best option to still be able to access free health care in Spain if you are moving here. Please also remember that we are also able to help with a number of other issues such as property purchases, rentals, legals, Residencias, taxes, setting up businesses, car transfers and other issues.

Nothing on this website shall be construed as constituting advice to you or any other person, as our advice depends on all the circumstances of the person concerned. Nothing contained on this website constitutes investment, legal, tax or other advice nor is it to be relied on in making any decision. You should obtain relevant and specific up to date professional advice from our experts before making any decision. This information may now be out of date.

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