UK visitors to Spain and UK citizens resident in Spain are subject to differing regulations regarding health care :
- Holidaymakers and people spending short periods of time in Spain – EHIC
- Pensioners and people in receipt of long term incapacity benefit – E121
- People intending to live in Spain who have taken early retirement – E106
- Dependants of those with E121 and E106
- People who intend to work in Spain
Holidaymakers and people spending short periods of time in Spain – European Health Insurance Card (EHIC) The European Health Insurance Card (EHIC) allows you to access state-provided healthcare in all European Economic Area (EEA) countries at a reduced cost or sometimes free of charge. You can apply for a EHIC online at www.nhs.uk it is free of charge and is valid for up to five years. The EHIC entitles you to treatment that you might need during your trip and allows you access to the same state-provided healthcare as a resident of the country you are visiting. The EHIC is not an alternative to travel insurance and it will not cover any private medical healthcare, repatriation to the UK or lost or stolen property. For specific information relating to Spain, see www.nhs.uk/NHSEngland/healthcarespain/Pages/healthcarespain.aspx Prescription and non-prescription drugs are available from chemists (farmacias) which are distinguished by a large green cross. Many drugs available only on prescription in the UK can be purchased over the counter in Spain. However, you should always seek a doctor`s advice.
Pensioners – Form E121
A pensioner is anyone receiving the UK old age pension or a disability pension. They are entitled to the same free medical treatment as Spanish pensioners. EU countries pay each other annually for the estimated treatment costs. In order to claim this entitlement you need form E121 from the DSS in the UK. This form has then to be registered with the Oficina Nacional de Seguridad Social (INSS) which is your local social security office in Spain. They also require a residence card and a valid passport. The INSS issues a tarjeta de afiliación and allocates an ambulatorio/consultorio or local medicalhealth centre and a doctor. This provides permanent cover and does not need to be renewed. The residence card is required before registering the E121. The good news is that all prescribed medicines are free for pensioners and their dependants. Prescriptions are filled at the Farmacia (chemist) identified by a large, illuminated, green cross. They must work to a rota to ensure that there is always one open in each area. The local press carries lists. Farmacias also sell non-prescription drugs and offer good diagnostic advice. The Spanish Health Service does not cover all of the range of services which are offered in the UK. Different regions and provinces offer differing levels of care such as home nursing or even meals in hospital. Your gestor can usually provide such information. Just recently there has been an increase in the numbers of Spanish State Nursing Homes and Sheltered Accommodation. See www.seg-social.es for more details of Centros para Personas Mayores (centres for older people). Privately run homes do exist – but at a price. It may be advisable to take out private cover for dental and home nursing care.
There is a system for registering the dependants of those with forms E121 and E106. An Assistencia Sanitaria is completed in duplicate, showing details of all dependants and taken to the Oficina Nacional de Seguridad Social (INSS) (your local social security office). If the dependant is a spouse the original Marriage Certificate and a copy must be supplied. For children, the Birth Certificate plus a copy are needed. If the dependant is a partner then a Certificado de Convivencia must be obtained from the Town hall or the Guardia Civil Hall. As with everything else in the EU things are constantly reviewed and developed. Your gestor can advise you.
People who intend to live in Spain and need cover whilst looking for work or who have taken early retirement – Form E106
If you decide to take early retirement, or wish to receive medical cover whilst you are finding work in Spain, you may apply for a form E106. Please note you are only eligible to use this form if you have been working and/or paying into the UK system for the last three years. The E106 provides temporary cover, usually for two years. Thereafter you will not be able to request an extension. If, after expiration of the E106, you have reached retirement age, you can then apply for the E121 as described above. In all other cases, you will be expected to provide your own medical cover, either through private health insurance or by working within the system. With an E106, you do not receive a medical card. You take your El06 form to your local state health centre/doctor in the same manner as an E111. Please note that private doctors, clinics and hospitals do not accept any of the European (E) health care forms. It is also important to note that the E121 and El06 forms are regarded as permanent. In other words, you will be transferring your health provision from the UK to Spain. This means that you will still be eligible for cover in the UK, but as a visitor. Should you decide to visit the UK, but not to live, you will need to take with you the Spanish equivalent of the UK E111. Your gestor will apply for this for you. Should you decide to return to the UK to live, you should contact the DSS and ask them to re-register you on the British health system. As with everything else in the EU things are constantly reviewed and developed. Your gestor can advise you.
People who intend to work legally in Spain.
UK residents employed in Spain should join the Spanish Social Security system employers will deduct the contributions from salaries and self-employed people pay their own. The minimum social security contribution for medical cover is €225.11 per month. There is a 25% reduction for people under 30 and for women over 45. Your gestor can get you a social security card which you take to the ambulatorio/consultorio (medical/health centre) with the appropriate form. You will be issued with a tarjeta sanitaria (medical card) entitling you to ordinary health care. Self-employed people will need to get an NIE (foreigner’s national identity number) before going to the ambulatorio – again, your gestor will do this for you.
Students on a recognised UK course – Form E128
UK nationals who are in Spain as students on a recognised UK course are entitled to form E128 for up to 2 years. They and any dependants here are then entitled to treatment for any condition during their two years in Spain. Form E128 is obtained from :-National Insurance Contributions Office in Newcastle upon Tyne Tel. 0845 915 4811. Students working in Spain as part of their course are also entitled to form E128 for up to 2 years.
People under retirement age and who are unable to work – Form E121.
If you are unable to work, and claim incapacity benefit, you may also apply for a form E121, regardless of your age. If you do not claim incapacity benefit, you will not be eligible to use this form. Again, you must apply for a Residencia card in order for the Spanish Social Security office to accept your request for state medical care. For more information about your social security insurance, benefits and healthcare rights in the European Economic Area www.dss.gov.uk or call National Insurance Contributions Office in Newcastle upon Tyne Tel. 0845 915 4811.