While the central government used to be the sole regulator, each of the country’s 17 regions takes individual responsibility for the implementation and execution of medical services within their respective locale.
The healthcare system in Spain is generally of a high standard and combines both private and public healthcare, with residents in possession of a Spanish social security number and the necessary documentation being entitled to receive free or low-cost healthcare.
As a result of austerity measures the government has had to cut its healthcare budget, although this does not usually affect expats who are legally living in the country to a large degree. One effect has been that there may be less government coverage for certain treatments, making it advisable for expats to invest in private medical insurance.
Public healthcare in Spain
Public hospitals provide much of the primary healthcare and emergency services that Spanish residents require. The people in the industry are efficient and well educated, and hospitals often employ personnel who speak English or offer the services of interpreters. Unlike in many other health systems, Spanish doctors will try to find patients the cheapest medications to use, as opposed to receiving rebates.
Public hospital facilities in Spain are generally well equipped, and some private health institutions have even been known to send seriously ill patients to state facilities because they can’t afford the same standard of progressive instruments and medical equipment.
The downside is that the public sector has been known to suffer from staff shortfalls, and the waiting periods to see a specialist or have a procedure done can, in some cases, take months. Still, it is said that there are fewer deaths caused by delays in Spain than in the USA.
To be able to use the public healthcare system (Sistema Nacional de Salud) expats would first need to get a social security card at the Social Security Treasury Office (Tesorería de la Seguridad Social). It is then necessary to obtain a medical card at their local clinic, which will give them the right to use the services of the nationwide public health network.
Expats should note that a social security number can only be obtained if they have registered on the Empadronamiento, the municipal register.
Non-residents unfortunately do not qualify to receive universal healthcare; however, there is a pay-in scheme for expats who aren’t otherwise able to access state healthcare, called the convenio especial.
Expats who choose to use state healthcare in Spain should note that they will not be able to choose a physician, since one will be appointed to them. There is also often a pointed lack of creature comforts, and those who prefer cushioned chairs and private rooms may want to utilise private healthcare.
Private healthcare in Spain
Some expats prefer private healthcare in Spain in order to have access to more options for treatment and physicians, and to avoid the queues of the public health system.
There are hundreds of private clinics and hospitals across the country, giving the private healthcare system a greater degree of accessibility.
While single consultations within the private healthcare system may be affordable for most expats, the care required in the case of a medical complication or in an emergency can quickly become expensive. As a result, it’s recommended that expats who plan to regularly utilise private care take out health insurance.
Health insurance in Spain
While the public health service sometimes only covers 75 percent of the cost of treatment, private companies generally pick up the full amount if the account holder pays their monthly premiums.
Most employers offer private health insurance for expat assignees, so expats moving to Spain for professional reasons should check their company contract before arranging their own coverage. Private insurance providers operate in different ways; some reimburse the amount spent on healthcare, while others pay medical bills directly.
A good rule of thumb is to call the insurance company before calling a doctor.
If an expat’s company doesn’t offer private health insurance, it is possible for them to make their own arrangements. Expats should note that most Spanish health insurance providers offer plans that best suit the local market, and it follows that contracting an international service provider or one that covers all of Europe might be beneficial.
Pensioners moving to Spain to unfold their sun chairs should take special care to ensure that they can obtain optimal treatment for the best price.