Healthcare

• General Information
• Working in Spain
• Temporary visitor in Spain
• Retired and living in Spain
• Early retiree living in Spain
• Healthcare while working for a UK employer in Spain
  
• Healthcare while studying in Spain
  
• Means-tested Healthcare
  

General Information

The rules for getting state healthcare in Spain are different from those in the UK and more information about the different ways to access healthcare can be found below. In April the Spanish government announced reforms to the state healthcare system which affect everyone living in Spain. More information about these changes can be found on our Healthcare Updates page.

Working in Spain

If you work in Spain it’s pretty straightforward. As long as you are registered with social security and contribute to the National Insurance scheme then you can get state-run health care on the same basis as a Spanish National.

Temporary visitor in Spain

Temporary visitor in Spain

If you are a temporary visitor in Spain you can use your UK-issued European Health Insurance Card to access state-run health care. Anyone can get this card if they are ordinarily resident in the UK to cover all necessary treatment in Spain. That means treatment that can’t wait until you return to the UK, as determined by the Spanish health service. So you might be asked to pay for some services.

Please note that the EHIC card has an expiry date and only covers you - any other family members need their own card. The EHIC also will not cover you for long term, routine or planned treatment. See our EHIC information for further details.

Oxygen therapy during a temporary visit to Spain

If you need to receive oxygen therapy during a temporary visit to Spain, you must request it in advance, in writing, from the Spanish authorities.  You should send this request at least one month before you are due to travel.  For more information on how to do this please see our page on ordering Oxygen in Spain.

Retired and living in Spain

We know that many British residents are here enjoying their retirement. Due to an EEA-wide agreement, if you’re in receipt of a UK State Pension, long-term Incapacity Benefit or Bereavement Benefit, you’re covered for state-run health care in Spain. You need to register for this by applying for an S1 form (previously E121) from the International Pension Centre (IPC). Dependents can also obtain their own S1 directly from the International Pension Centre to then validate with the Instituto Nacional de la Seguridad Social (INSS).

Early retiree living in Spain

If you are an early retiree in Spain you can apply for an S1 form (previously E106). The length of time you’ll be covered depends on your contributory record in the UK, but with a full record cover will normally last up to two and a half years from the day you stop work. During this time you’ll also be entitled to access NHS care in the UK (but you need to use your UK EHIC if you need health care when visiting another EU country). After this period, if you don’t qualify for an S1 form (previously E121), you should arrange private health insurance or ascertain if other options are available to you in Spain (see next two sections). Dependants can also obtain their own S1 directly from the International Pension Centre to then validate with the Instituto Nacional de la Seguridad Social.

Healthcare while working for a UK employer in Spain

If you are coming to work or are currently working in Spain, and continue to pay compulsory UK National Insurance (NI), you may be entitled to healthcare paid for by the UK. This will include any dependants that go with you.

Healthcare while studying in Spain

If you are coming to study or are currently studying in Spain as part of a UK recognised course, you may be entitled to healthcare paid for by the UK.

Means-tested Healthcare (sin recursos)

You may be eligible for healthcare based on having a low income.  In order to apply for this through social services at your local health centre it is likely that you will have to prove that you have no entitlement to healthcare paid for by the UK (e.g. S1) and that you have a low income.

Documents you can use as evidence of your UK taxable income include your latest:

• Self Assessment tax calculation (SA302)
• PAYE (Pay As You Earn) calculation, if you receive one.

If you do not have either of these documents, or need confirmation that you had no UK taxable income in a particular tax year, contact HMRC. You can telephone +44 135 535 9022 (from Spain) and ask for written details of:

• your taxable income in the UK for a particular tax year; or
• confirmation that HMRC have no record of taxable income in the UK for a particular tax year.

Alternatively you can make the request in writing to HMRC at:

Customer Operations
PAYE and Self Assessment
Lynx House
1 Northern Road
Cosham
Portsmouth
PO6 3XA.

If you are applying for healthcare on the grounds of a low income (‘sin recursos’) or applying to join a regional autonomous healthcare scheme, you may be asked to provide a letter from your country of origin which confirms that they do not cover your healthcare whilst you are resident in Spain. The official name for this document is a ‘legislation letter’ and it is available in Spanish. You can request it from the Overseas Healthcare Team by calling 0044 191 218 1999.