Healthcare & Prescriptions here in Spain

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Posted and filed under General Articles of Interest, Medical Care in Spain, Newsletters.

HEALTHCARE IN SPAIN

UK STATE PENSIONERS

Under EU regulations, the UK pays Spain an average annual cost to provide healthcare for its pensioners. Healthcare is provided to UK state pensioners resident in Spain and holders of a S1 form from the UK on the same basis as healthcare given to Spanish pensioners. Therefore, healthcare changes that are applicable to Spanish state pensioners are equally applied to all UK state pensioners.

PROOF OF HEALTHCARE

If you are applying for your residence certificate, you may be asked to show proof that you are covered for healthcare in Spain when making your application. If you are a UK state pensioner for example, you may be able to use your S1 form to meet this requirement. A full list of requirements should be obtained from your local Oficina de Extranjeros or designated police station. More details can be found on http://www.interior.gob.es/ (information is in Spanish) and follow the links for extranjería.

PRESCRIPTIONS

Most people, including UK pensioners, are required to pay a percentage of the cost of their prescription medication.

The amount each person pays will depend on annual income and individual situation.

“CONVENIO ESPECIAL” / SPECIAL AGREEMENT

The Spanish government has a state-run ‘Convenio Especial’ (Special Agreement) for those without access to state health cover (so not not insured or not beneficiaries of the National Health System).

– The special agreement for the provision of health care subscribed with the Generalitat allows access to health services of the National Health System, within the Region of Valencia.

– The special agreement does not cover the benefits such as pharmaceutical, orthopedic, dietary products or non-urgent health care.

Persons registered in a municipality of the Region of Valencia who do not have the status of insured or beneficiaries of the National Health System, nor have access to a system of public health protection in any other way, and that prove residence in Spain during a continuous period of at least one year immediately prior to the date of the request of the special agreement can apply.

Requirements

A) To prove effective residence in Spain for a continuous period of at least one year immediately prior to the date of the request of the special agreement.

B) To be registered, at the moment of submitting the application for the special agreement, in a municipality belonging to the territorial scope of the Comunitat.

C) Not having access to a system of public health protection even through bilateral agreements that in this matter have been signed by Spain with other countries.

What fees must be paid and how to make your payment?

The amount of the fees to be paid for the subscription of the special agreement for the provision of health care will be as follows, depending on the age of the subscriber on the date on which the corresponding monthly fee is accrued:

1º.- If the subscriber is under 65 years: monthly fee of 60 euros.
2º.- If the subscriber is 65 or older: monthly fee of 157 euros.

The fees will be paid by direct debit.

 

What documentation must be presented?

– Application for the signing of a special agreement for the provision of health care

– In the case of Spanish citizens, the National Identity Document (DNI) in force. In the case of persons who do not have Spanish nationality, a document certifying the Foreign Identity Number (NIE), or in their absence, a national identity document or passport in force.

– Documentation proving the applicant’s residence in Spain during a continuous period of at least one year immediately prior to the date of filing of the application.

– Documentation accrediting the fulfillment of the requirement of registration of the applicant in a municipality belonging to the territorial area of wherever in the Region of Valencia on the date of requesting the subscription of the special agreement.
– SEPA direct debit direct order

Persons interested in subscribing to a special agreement for the provision of health care must apply formally to the Territorial Department of the Department of Health of the province where the municipality of residence resides, submitting the corresponding subscription request.

The competent Territorial Directorate shall issue a decision on the appropriateness of signing the special agreement and shall notify it within a maximum period of 30 days from the day following that they receive the request.

The interested person will have a maximum period of three months to formalise the special agreement with the administration.

The health care agreement is terminated for any of the following causes:

A) Upon death of the person who has signed the special agreement.
B) When the person who has signed the special agreement acquires the status of person insured or beneficiary of the National Health System, or gets health coverage by a system of public health protection by any other means.

Please let us know if we can help in any way with this matter enquiries@spanishsolutions.net.

30 Comments

  • John Brian Shelton

    I am a 66 and my wife is 64 and we are planning to come to spain in the winter for 3 months returning to the UK in January for 1 week and back to Spain for another 3 months. Will our EHIC be enough to cover our stay? We have a property within the Torrevieja area and have been told from fellow travellers that we could apply for a temporary SIP card to assess the medical system is this correct?

    • Amanda Thomas

      Good afternoon, how lovely. The EHIC is better and will be fine, as a temporary SIP only covers emergencies. With kind regards

  • Mrs Lorraine Della

    I am in receipt of a Medical Card & allocated GP in spain. I also have a S1 declaring my husband as dependent. unfortunately when i recived my card in 2009 we didnt receive a card for my husband. Have been trying to get a card for him but the spanish authorities are saying the S1 is out of date! even though they admit he should have had a medical card at the same time as i recieved mine. what do i have to do to get him a card. Both been residents in spain since 2005

    • Nicola Ryan

      Good Morning Lorraine,

      The best thing to do is contact the HMRC again and ask for another S1 with your husband as the dependant. We hope this helps.

      Kind regards
      Nicola

  • Graham Mann

    We are pensioners currently living in Spain and have a green residency card as we have been here over three months and planned to stay six months here and six months in UK. We are also registered with the public health via the S1 form. My husband now requires a knee replacement which we intend to pay private for in the UK . However can we still register with a Doctor for general medical conditions,if necessary, as we will be back there for a few months before hopefully returning to Spain

    • Nicola Ryan

      Good Afternoon Graham,

      Thank you for your enquiry.

      Would this be for the UK, if so it would be best to discuss this with the Overseas Team at the HMRC. If it is to register with a doctor in Spain, yes you can register with a doctor no problem. You need to have the S1 endorsed at the Social Security first and then take the certificate, with supporting documents to the Centro De Salud.

      We hope this helps.
      Kind regards
      Nicola

  • Su Hore

    Hi
    I want apply for Residencia in Spain before Brexit. Can my husband apply for Residencia in 2022 when he receives his State Pension and joins me in Spain ? Please can you kindly advise.

    • Jane

      Hi Su

      With procedures changing at pace we could not comment at this time on procedures for 2022.

      Kind Regards

      Jane

  • Aileen

    Hi
    We are from the UK and have had 2nd home in spain for a number of years. We are not resident (but have NIE, bank account and pay non resident taxes)etc
    We spend just under 6months in total over a year in spain at the moment as we still work and have a family and house in UK
    We are now considering becoming residents here (due to brexit related issues) prior to end of jan.
    Can you advise on the following:
    – can we return to the UK regularly for work and family issues? Is there a limit on this?
    – we have fully paid up state pensions, but it seems we cannot access S1 forms until we are in reciept of pensions..which will be 4 years from now.is this right? Assume from this, we will be unable to access health .care if req in UK?

    • Jane

      Hi Aileen

      You can return to UK, if in Spain for more than 183 days you will become a Spanish Tax resident. To apply for residency you will need to show 3 months of Bank statements showing you live in Spain. Currently yes S1 cannot be accessed until you are receiving State Pension. You would no longer have UK health cover unless you take out travel insurance.

      Kind Regards

      Jane

  • Adam Smith

    Hi, Thanks so much for your very informative website.
    I am 65 and my husband is 62; we are both from the UK with British passports and living in the Canary Islands for for the past 30 months and have residencia since January 2020.
    We both have private health care in Spain and I will be able to use an S1 next year when I reach 66. Does my husband have to continue paying for private health cover or can he apply for a Con­venio Es­pe­cial; the mention of Valen­cia in this article seems to imply the Con­venio Es­pe­cial is only available in that region so would not be available to us here in the Canaries. Could you please clarify for me?

    • Jane

      Hi Adam

      As you are in the Canaries I suggest you contact your Town Hall to check the Convenio Especial is available in your area.

      Kind Regards

      Jane

  • Aileen Walker

    Thanks Jane for your reply.
    3 further questions, if that’s ok
    1. So, if we become residents in spain, spending a minimum of 183 days a year there, we can visit scotland and live in our house here for part or all of the remaining days of the year?

    2. In relation to travel insurance, we currently have a policy with a UK company that allows us to come to spain for up 90 days at a time, as many times as we like. Can we continue with this to give us healthcare cover in the UK when we are in UK when we are residents in spain ? If this is not possible, can we buy a similar travel insurance policy in spain?
    3. Regarding tax, My husband is self employed in UK, but often works online when we are in spain…we understand the system for taxation in spain. I usually work via NHS staff bank for short periods when we are in UK and tax etc is deducted on a weekly basis,,,will this be a problem or does the double taxation agreement cover this?

    • Jane

      Hi Aileen

      Yes you can visit Scotland, but for first 5 years should not be out of Spain for more than 6 months at a time.
      I can’t comment on your insurance you would need to ask your insurance company. If it doesn’t I am sure you can obtain holiday insurance from a company here in Spain.
      On your tax you will need to declare it here in Spain, double taxation will depend on the amounts involved, it is best you seek advice from a fiscal advisor here in Spain.
      If we can help with any of the above please contact us.

      Kind Regards

      Jane

  • Nicole

    Hi,
    Could you please advise what:
    “The in­ter­ested per­son will have a max­imum period of three months to form­al­ise the spe­cial agree­ment with the ad­min­is­tra­tion.”
    actually entails.
    Kind Regards,
    Nicole

    • Jane

      Hi Nicole

      This simply means after the decision you have 3 months to go ahead, after that you would need to reapply.

      Kind Regards

      Jane

  • aileen walker

    Hi Jane
    I have found your sight helpful and your responses useful too.
    Can I ask if you have an office in malaga area?

    • Jane

      Hi Aileen

      We don’t but can deal with many processes remotely. Thanks for your feedback.

      Kind Regards

      Jane

  • aileen walker

    Hi Jane
    sorry, i meant to ask if you can recommend companies which offer travel insurance for expats resident in spain

    • Jane

      Hi Aileen

      Sorry we aren’t an insurance agents but please give us a call if you want details of our local agent.

      Kind Regards

      Jane

  • Abi

    my husband and I have been resident in Spain for approx 15yrs but have never joined the health system. As we are now both over 70 we feel the need to do this We went to the local office with our paperwork and asked if we could join the system as permanent residents but we were told no, we have to have an S1. As we do not have any connection to UK and are permanent residents here we think that we should be able to join the system as permanent residents without an S1
    Can you help

    • Jane

      Hi Abi

      Do you receive a UK State pension? If you contact the UK pensions office to obtain your S1 as this will be required to join the healthcare system.

      Kind Regards

      Jane

  • paul smith

    We have lived full time in Murcia regn. for 4 years , have padron and temp residenca green card , we are both 66 now [OCT} what is our healthcare position now we have retired , are we covered by uk agreement , or do we need to pay into the Spanish system? also we will get a combined state pension of approx.£20,000 pa . do we need to still complete a tax return in Spain? thanks.

    • Jane

      Hi Paul

      If you both have an S1 as a UK pensioner then this will give you cover for Spanish healthcare. Each persons tax position can vary so I suggest you contact a fiscal gestor re the tax position.

      Kind Regards

      Jane

  • Jane Goodwin

    Hi Jane

    We have been residents I Spain since January 2020. We had private health but from January 2021 we wish to pay into the Spanish system. We are both in our 50’s. My partner is 55 & I’m 57. How do we go about this? We get an income from the UK & pay tax, however we will be paying tax here from January 2020. Does this entitle us to pay into the health care here. Also now we are residents from 1st January 2021 will our EHIC cards be invalid as you need to have an S1 as well. Does this mean we will need to get travel travel insurance to cover us when we are in the UK for visits? We do pay NI in the UK & this will continue even though we will be paying tax in Spain using the double taxation treaty.

    Hope you can help answer my questions

    Many Thanks Jane

    • Jane

      Hi Jane

      Yes you can apply for convenio especial and we can support you to do this if you wish. Your EHIC will no longer be valid and as not state pensioners will not have an S1 so will need travel insurance when visiting. On the double taxation you need to speak to your accountant, if you don’t have one we can suggest a good company.

      Kind Regards

      Jane

  • Linda Farley

    We are planning to move to Galicia to live close to our son whose wife is Spanish. They have three Spanish children. Will we be able to do this post Brexit? Unfortunately I had a stroke eighteen months ago while on holiday with him in Galicia. How much is it likely to cost me for health cover? My husband is 70 and fit for a man of that age. We are planning to sell our English house, Our English state pensions are about £1250 a month. How much capital and income will we need to proove. Also we have a house in France will we be able to visit it from Spain? Thanks for reading this.

  • Valerie

    My partner has an Irish Passport and I’m a British passport holder only. We’ve owned our home in Spain for 45 years and live permanently in UK . We holiday with family there for less than 2months, 3 to 4 times a year at different dates. We have a bank account and all requested required papers NIE etc and pay all our communal taxes to the Council in our village. As my partner is classed as still being in the EU does this automatically cover me as all our Utility Bills and our Spanish home are in both our names . Also the problem of staying and travelling to and fro with different passports seems could be a problem also

    • Nicola Ryan

      Good Morning Valerie,

      Thank you for your enquiry.

      Do you mean entering and staying in Spain please, if so, the fact that your husband has an EU passport, will not cover you, we are sorry.

      As your husband has an EU passport, he will have freedom of movement, he would be able to stay in any EU countries without having to leave after 3 months. Unfortunately as you hold a Non EU passport, you would need to leave after 3 months or before. We have added the link for the Schengen calculator below which will allow you to confirm if your future/previous dates of travel with family would be possible. We hope this helps.

      https://ec.europa.eu/home-affairs/content/visa-calculator_en

      Kind regards
      Nicola

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