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This guidance will be updated if anything changes to how you get state healthcare in Spain.
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 in Spain
- paying directly into the public health insurance scheme (Convenio Especial)
- registering a UK-issued S1 form with the social security office
- using a European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC) for temporary stays
- through entitlement to healthcare as a permanent resident if theyve lived in Spain for 5 years
Healthcare if you live and work in Spain
You must register as a resident if you want to stay in Spain for more than 3 months.
You must show proof of healthcare cover before you can register as a resident. 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 citizen. Your dependants are also entitled.
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.
You may be entitled to a Spanish EHIC for travel, including visits to the UK.
If you are not working
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.
NHS Overseas Healthcare Services
Telephone: +44 (0)191 218 1999
Monday to Friday, 8am to 6pm
Saturday, 9am to 3pm
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
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.
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.
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.
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
- 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.
HMRC has a helpline for National Insurance enquiries from non-UK residents. They can answer questions about posted worker status and explain which documents you will need to get healthcare while posted.
UK-funded healthcare: using an S1 form in Spain
Theres different guidance if youre a posted worker.
You may be entitled to state healthcare paid for by the UK if youre a Spanish resident and receive a UK State Pension.
You may also be entitled to an S1 form if youre a frontier worker (someone who works in one state and lives in another). You must contact HMRC National Insurance enquiries to find out if youre eligible.
If you started living in Spain before 1 January 2021, you may also be entitled to an S1 if you receive some other exportable benefits.
When you get your S1 form, you must register it with the INSS.
This will mean you and your dependants will be entitled to state healthcare on the same basis as a Spanish citizen.
Youll also get: