Living Abroad - Spanish National Health System

Are you covered by the Spanish National Healthbecause they like to choose their doctor
System?andhospital, or because they doubt the quality of
If you are in Spain as a tourist, you will probablythe state health services. To the lastpoint we can
have brought along your copy ofthe E111 formsay: The national health services in Spain are of a
obtained from the national health service in thevery high standard.
UK, or you may havetaken out private healthYou do not have to make appointments in
cover with your tour operator. In either case, youadvance to see a doctor, you turn up atthe
will becovered for accidents and urgent illnessessurgery early in the morning, sign your name on
during your stay. The E111 form will onlycoverthe list, and wait your turn. Youmay have to wait
you for emergencies, not for treatment ofa couple of hours before being seen, but the
chronic illnesses or for undertakingan operation inreceptionist usuallytells you roughly what time
Spain that you would have to wait a long time foryour turn will be based on how many are in front
in your homecountry. If you run out of or mislayof youin the queue so that you can go away and
your regular medication whilst in Spain, yourhave a coffee and come back. As with
E111 form can be used in any pharmacy to obtainanycountry, there are waiting lists for operations,
a replacement.but not nearly as long as in the UK.
You will have to use the doctors, surgeries orIhave known of cases whereby people have been
hospitals of the Spanish nationalhealth services,diagnosed with terminal cancer inthe UK but been
called INSS. If you go to a private doctor orrefused treatment because of budgetary or time
hospital, they will askyou to pay, so if you areconstraints. Thosesame people have then moved
unfortunate enough to need to call an ambulanceto Spain to spend their last days in the sun,
whilst onholiday, make sure the driver knows thathavebeen advised to visit the local doctor and
you need to be taken to an INSS hospital.then been admitted to hospital within daysto have
There are many private hospitals along the Costalife saving treatment.
Blanca, and you may find yourselfarriving at oneIf you do wish to opt for private health cover,
of them as the driver has assumed you hadthere are a number of private Spanishor foreign
private health cover. Ifthis happens you shouldhealth insurances offered to the foreigners in
communicate this to the INSS within 24 hours.Spain. The most popularones being Adeslas, Asisa,
Thepersonnel at the private hospital will assist you.La Estrella, DKV Seguros, Sanitas and Winterthur.
If you have contributed to the national healthToday,all insurance companies have their
services of your own country, and thatcountry"Defensor del Asegurado" (ombudsman for
has an agreement with Spain on health services,theinsured) who you can present your complaints
you can also be covered ifyou stay for longerto if you feel the company is notdealing correctly
periods in Spain, or become a permanent residentwith you. If that does not work, you can
here. Thenyou need to bring a form E-121 in twoapproach Dirección
copies with you to Spain, and register it withtheGeneral de Seguros (phone 91-339 72 00) in the
Spanish health authorities. The registration is withMinistry of Economy.
the local Centro de Salud.If you decide to take up employment in Spain
They will keep one of the copies of the form,thereby making contributions to the
and fill in and stamp the other one, tobe kept bySocial Security system, you will obviously be
you.covered by the Spanish national healthservice.
After a while you will receive in the post a cardYour gestor will assist you in filling out the
identifying you as a person withcertain rights toappropriate forms and registeryou in the Spanish
use the Spanish national health services. On it willSocial Security system. Currently, as a self
be given thename of the doctor you are to visitemployed person, themonthly contributions are
in case of illness, as well as the address of220 EUR per month (£146.81), and it is
thenext INSS health centre. If you go on visits toyour responsibilityto ensure they are paid. Once
other countries from Spain, you mustrememberyou are in the system, the authorities will track
to get an E-111 from your local health centre, toyourcontributions and if you do not advise them
be covered as a touristabroad, even in yourof a change in circumstances, they willexpect you
home country.to pay the contributions. Failure to do so will result
If you are not included in the national healthin fines andeventually, a withdrawal of health
services of your home country, youmay haveservices.
contracted a private health insurance there. FindEverybody should keep, next to the phone, the
out with the insurancecompany if they will payname and phone number of a doctorspeaking
your medical bills in Spain as well. If you areyour language, or of the local health centre, as
completely orpartly without cover abroad, and awell as a companyproviding ambulance services,
travel insurance does not fill the gap, youand the closest hospital where you would want to
shouldtake private health insurance. Somegoto in an emergency (depending if you are
foreigners feel more comfortable withcovered by the National Health Service orrely on
privateinsurance in addition to the public one,private services).