The healthcare system in Spain
Spain has one of the best healthcare systems in the world, ranked seventh by the World Health Organisation and eighth by the CEOWORLD magazine Health Care Index. All foreign nationals living and working in Spain are entitled to free state-funded healthcare. Private health insurance plans are also available.
Getting health coverage in Spain
According to the Ministry of Health, public health spending in Spain amounts to 90.3 billion euros per year. This represents 8% of the country's gross domestic product (GDP), approximately 1,907 euros per inhabitant.
If you live and work in Spain and pay social security taxes, you are eligible for the country's free universal healthcare system, called the Spanish National Health System (SNS).
The list of people who qualify for healthcare in Spain includes:
- Pensioners resident in Spain, including expats with residence certificates or cards
- Employees and self-employed persons (autonomos) who are registered with social security and pay into the system
- People whose spouse pays into the social security system
- Children and other dependents of those paying into the social security system
- People recently divorced/separated from a partner who pays into the system
- Residents who receive some social security benefits in Spain
To register, go to your local health centre (centro de salud) to fill in the appropriate form. The application process can vary from region to region, but in general, you will need to take your social security number, passport and foreign identity number (NIE).
After your details have been checked and your form has been submitted, you will be assigned a GP and given your medical card (tarjeta sanitaria). This will come via post, which could take two or more weeks.
You must get a referral from your doctor for non-emergency hospital visits in Spain. Just arrange an appointment at your local health center. Since most people in the country have SNS coverage, you may have to wait a while for a GP appointment. In some regions, this can be at least a fortnight.
Many hospitals and health centers in Spain have doctors and nurses who speak English, but this is not guaranteed, and translators are not provided. If you do not speak Spanish and need to visit a health center or hospital, it is best to hire a translator to come with you.
Benefits of joining the Spanish healthcare system
Spain boasts a top-notch healthcare system, and as an expat, there are numerous advantages to becoming a member.
Access to quality healthcare services: As a member of the Spanish healthcare system, expats can access quality healthcare services through a network of hospitals and clinics without worrying about high out-of-pocket expenses.
Comprehensive medical coverage: The Spanish healthcare system provides comprehensive medical coverage, including general medical care, specialist care, hospitalization and preventive care.
Emergency healthcare services: The Spanish healthcare system provides emergency healthcare services 24/7, meaning expats can access emergency care whenever needed.
Prescription medication coverage: The Spanish healthcare system provides coverage for prescription medication, often at a much lower cost than expats pay in their native countries.
Good to know:
While most of the Spanish population uses the public healthcare system, some also opt for private health insurance for faster treatment for non-emergency procedures.
Private healthcare in Spain
You can choose from various private healthcare insurance companies that offer a range of plans, including dental and eye care. There are many insurance companies to choose from, according to your needs and budget. Some of the leading international health insurance providers are:
Consider what they offer and get a free quote on Expat.com's Health Insurance for expatriates in Spain page.
How to find the right health insurance provider in Spain
Finding the best health insurance provider can be a daunting task. With so many options available, knowing where to start can be hard. However, by doing your research and following a few key tips, you can find a provider that meets your needs and fits within your budget. Here are a few tips to help you make an informed decision and ensure you have the coverage you need to stay healthy and happy.
- Analyze your healthcare needs and evaluate what type of coverage you require.
- Review different policies and compare their cost, coverage and benefits.
- Check the policy limits on medical and pharmacy benefits.
- Know the exclusions and limitations of the policy to avoid surprises.
- Look for added benefits like telemedicine, dental, vision and wellness programs.
- Analyze the insurance company's customer service and claims processing.
- Check out the ratings and reviews of insurance companies to ensure their credibility.
- For complicated medical issues, seek the advice of an independent insurance advisor.
Convenio Especial
Some people may find themselves needing help to meet the criteria for health provisions, such as non-working expats in Spain. In this case, you can use the Convenio Especial, a pay-in scheme for health services delivered by regional authorities. The fees are 60 euros for those under 65 years of age and 157 euros for those over 65. This compares favorably to many private health insurance schemes.
To be eligible for Convenio Especial, you must be resident in your area and signed on at your local town hall (Padron) for at least 12 months.
To apply, you will need the following documents and copies:
- Your passport with at least six months validity
- NIE card/certificate or TIE
- Padron certificate that is not more than three months old
Pregnancy and maternity in Spain
Mothers in Spain are entitled to 16 weeks of maternity leave for one child, 18 weeks for twins and 20 weeks in case of triplets. An additional two weeks is available to women who have given birth to a child with disabilities. If a baby is born prematurely or has to remain in the hospital for seven or more days following birth, an additional 13 weeks of maternity leave is available.
If a pregnant mother needs to take time off work for medical reasons, this does not count against the maternity leave period.
The quality of healthcare in Spain
Spanish public and private hospitals provide quality healthcare services that meet European and international standards. However, the waiting time in public hospitals can be much longer than in private hospitals and clinics.
For their part, pharmacists have been trained to provide first aid, dressings and medications. Most pharmacies in Spain are open six days a week, Monday to Saturday. In many locations, pharmacies will take turns to open out of hours, for example, on Sundays. These details are usually published locally in newspapers and websites.
Important:
For health and medical emergencies, call 112 for an ambulance. You will be able to get assistance in English.
Spain and COVID-19
The first recorded case of COVID-19 in Spain was a German tourist in La Gomera in the Canary Islands in January 2020. The patient spent two weeks in hospital and was then released. At the time, the government considered the virus an external threat brought in by tourists instead of an internal domestic health problem, so it didn't act.
This changed towards the end of February when a person from Seville who had not traveled abroad tested positive. A week later, the country recorded the first death of a citizen with COVID-19. By September 2020, the death toll from the virus had reached 25,594, making Spain ninth in the world in terms of deaths, and there were 534,513 confirmed cases. For several months during the pandemic, Spain had one of the highest death rates from the virus in Europe.
Spain was one of the countries worst affected by coronavirus. Although it is considered to have one of the best and most efficient healthcare systems in the world, it struggled during the crisis. This was compounded initially by a severe shortage of personal protective equipment (PPE) in hospitals.
According to research, the pandemic's devasting outcomes in Spain were due to the country's lack of preparedness and slow and delayed response.
One of the reasons why Spain's healthcare system struggled during the pandemic was it had been weakened by the decade-long financial crisis that started in 2008. This led to numerous spending cuts, such as a cut in the national healthcare spending budget of 13.65% in 2012.
However, Spain's vaccination program quickly gathered pace after a slow start. By May 2021, the Spanish government reached its first goal of the vaccination schedule: to have five million people immunized with both doses by the first week of May.
A month later, the Ministry of Health reported that more than 12 million citizens had received their full vaccine dose. A further 44 percent of the population had received at least one dose.
Today, the Covid situation in Spain has improved so much that in addition to scrapping face mask-wearing in public, the government has relaxed the rule for pharmacies and clinics. People no longer have to wear masks in:
- Health centers;
- Hospitals;
- Pharmacies;
- Dental clinics;
- Physiotherapy clinics;
- Nursing/care homes.
However, masks will still be required in areas with particularly vulnerable patients, such as operating rooms, cancer wards, areas with immunocompromised patients and intensive care units.
Important:
For general coronavirus health information in Spain, visit the Ministry of Health's COVID-19 online resource centre.
For the latest on measures, rules and regulations in your area, check the health authority announcements of your region.
Pharmacies in Spain
Chemists in Spain are referred to as farmacias and can be found in every town and city. Whether for non-prescription tablets or essential medication, they carry a comprehensive stock of therapeutics and health and beauty products.
Unlike in some other countries, you can only buy everyday medicines, such as aspirin or painkillers, from chemists, not supermarkets. With some of these tablets, higher doses have to be prescribed by doctors, but smaller amounts of painkillers and aspirin can be bought over the counter.
Most pharmacies in Spain are open from 9:30 a.m. until 2:00 p.m., from 5 p.m. to around 9:00 p.m. every weekday, and from 9:30 a.m. to 2:00 p.m. on Saturdays. Most areas will have at least one or two pharmacies open Sundays. They take turns, and the rota for Sunday pharmacy openings is usually published in local newspapers. If you go to your nearest pharmacy on a Sunday and it is closed, you will probably find a note on the door or window notifying you of an alternative that is open.
To search for pharmacies in your area, use this handy online map.
Prescriptions in Spain
As in other countries, when your doctor gives you a prescription (called a receta in Spain), you take it to your nearest pharmacy. Depending on your circumstances, you may need to pay something toward the cost of your medication. For example, you will pay less if you're a pensioner or don't earn a lot.
Important:
If you live in a tourist area, some pharmacists will speak with you in English. However, this will not always be the case. Unless you are confident in the language, it is a good idea to look up a translation of what you want to ask for, write it down and bring it with you.
To get you started, here are some common phrases you might find helpful when visiting a pharmacy in Spain:
What are the symptoms? - Cuáles son los síntomas?
Me duele la cabeza - I have a headache
My daughter has a pain in... - Mi hija tiene un dolor en....
I have a prescription - Tengo una receta
When can I pick up my medicine? - Cuando puedo recoger mi medicamento?
Tome las pastillas, y si mañana no se encuentra mejor, vaya al medico - Take these tablets, and if you don't feel better tomorrow, go to the doctor
Tienes algún remedio para...? - Do you have something for...?
Me encuentro mal - I don't feel good
Estoy enfermo - I'm ill
Estoy resfriado - I have a cold
Other useful health-related words and phrases in Spain include:
Llama una ambulancia - Call an ambulance
Tengo que ir al hospital - I need to go to the hospital
La tos - Cough
La inflamación - Inflammation
La gripe - Flu
La fiebre - Fever
Se ha desmayado - He/she has fainted
Dental care in Spain
The country's healthcare system generally doesn't cover dental care, which means you will have to pay for your check-ups. However, there are exceptions for emergency treatment and children.
Most dentists in Spain are private and compete with each other to offer the best treatments using the latest techniques and technologies. The quality of dental care is high, and it's a good idea to shop around dental practices near you. Ask for their brochures, visit their websites and read online commentaries.
Look for a dentist registered with the Consejo Dentista de Colegios de Odontólogos y Estomatólogos (General Council of Colleges of Dentistry and Stomatology of Spain or the General Dental Council).
To visit a dentist in Spain, just make an appointment and bring along some form of ID with you. There are many clinics, especially in cities and big towns, so you probably won't have to wait too long to be seen. If you do not speak Spanish and your dentist doesn't speak English, use a local translator's services.
Among the common dental services at private clinics are:
- Dentures
- Fillings
- Root canal work
- Veneers
- Teeth whitening
- Dental implants
- Gum contouring
- X-rays
- Cleaning
Important:
If you have a dental emergency, go to your nearest hospital and tell them, "necesito un dentista; es una emergencia." This translates as "I need a dentist; it is an emergency."
Useful links:
Sanitas Health Insurance
