GovWire

All residents in Spain need to register to access healthcare.

Once registered for healthcare, basic state services are free, but there are some things that patients need to pay for. For example, you usually have to pay something towards prescriptions either a reduced price or the full price.

UK nationals usually access the Spanish national health system in one of these ways:

• through entitlement to healthcare if theyre employed or self-employed and make social security contributions in Spain
• registering a UK-issued S1 form with the social security office (see UK-funded healthcare: getting and using an S1 form in Spain below)
• through entitlement to healthcare as a permanent resident if theyve lived in Spain for 5 years
• paying directly into the public health insurance scheme (Convenio Especial)
• using a European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC) for temporary stays when studying, or as a posted (detached) worker

Healthcare if you live and work in Spain

You must register as resident or apply for the appropriate visa if you want to stay in Spain for more than 3 months. See the guidance on Living in Spain for more information about visa and residency requirements in Spain.

You must show proof of healthcare cover:

• before you can register as a resident
• when you apply for a visa

This will usually be through social security contributions as an employee, private insurance or paying voluntary contributions (the Convenio Especial).

If youre working or self-employed in Spain, youre entitled to state healthcare on the same basis as a Spanish worker. Your dependants are also entitled (see If youre a dependant of someone living or working in Spain below).

Register at your local health centre with your social security number. You can get a social security number from your local National Social Security Institute (TGSS) office in Spain.

Your dependants need to register separately with the INSS.

You may be entitled to a Spanish EHIC for travel, including visits to the UK.

If you are not working and not entitled to an S1 form

If youve been a resident in Spain for 5 years or more, you can apply for permanent residency. This will give you access to state healthcare on the same basis as a Spanish citizen.

Once youre a permanent resident, you need to register for healthcare at your local INSS office.

Youll need to show a legislation letter (documento de no exportacin in Spanish) stating that you are not covered by the UK for healthcare. You can request this by calling NHS Overseas Healthcare Services.

The INSS will give you a document which you need to take to your local health centre.

If the UK pays for your healthcare, for example through an S1 form, you cannot register for healthcare as a permanent resident.

If you are not a permanent resident and you are not working

If youve lived in Spain for over one year, you can apply to join the public health insurance scheme. This is called the Convenio Especial. You pay a monthly fee to join the scheme, which gives you access to the Spanish health system.

You can apply if youve been registered on the padrn (at your local town hall) for at least one year.

Find out how to apply on your regional health authoritys website.

If youve lived in Spain for less than one year and cannot get healthcare cover, youll need to buy private health insurance.

If the UK pays for your healthcare, for example through an S1, you cannot join the Convenio Especial.

You may have the right to apply for a UK S1 if you start drawing a UK State Pension.

If youre a dependant of someone living or working in Spain

Dependants and family members are classified differently in Spain than the UK.

Find out whos considered a dependant under Spanish law.

If you classify as a dependant of someone entitled to state healthcare in Spain (because theyre either working in Spain, a permanent resident or receiving Spanish benefits) youll need to apply at your local INSS office.

If you live in Spain but work and make social security payments in Gibraltar

If you are covered by the Withdrawal Agreement, you are entitled to access state healthcare in both Spain and Gibraltar for as long as you continue to live in Spain and work and make social security payments in Gibraltar. You can apply for an S1 form from Gibraltar.

If you are not covered by the Withdrawal Agreement, from 1 July 2022 you are no longer covered for state healthcare in Spain under reciprocal healthcare arrangements. You must check if you are entitled to access state healthcare in Spain via another route, or take out private healthcare insurance.

Contact the Spanish social security office (INSS) or the Gibraltar Health Authority if you are unsure of the status of your healthcare cover.

How to access healthcare services

Once youre registered for healthcare, youll get a health insurance card. Take it with you whenever you visit a doctor, hospital or pharmacy.

Find your nearest clinic or hospital on the Spanish Ministry of Health website (in English)

How much youll pay

Once registered for healthcare, basic state services are free.

There are some things that you may need to pay a percentage of the cost for, such as orthopaedic services.

Spain uses a co-payment system where residents usually pay between 10% and 60% of the cost of prescription medication. How much you pay depends on your circumstances.

If youre paying into the Convenio Especial, youll pay the full cost for prescription medication. Youll also pay for:

• non-urgent transportation
• orthopaedic supplies
• prostheses
• dietary supplies

Some basic dental treatment is available under the state system, but most people use private dentists. Many private insurance companies have specific dental policies.

If your UK employer has sent you to Spain temporarily (posted workers)

A posted worker, also known as a detached worker, is someone employed or self-employed in the UK, but temporarily sent to a European Economic Area (EEA) country.

UK posted workers can access healthcare in Spain using an EHIC, GHIC or S1 form.

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