This chapter explains what sort of healthcare (asistencia sanitaria) you are entitled to in Spain and how you can receive it.
We will tell you about:
- Who can receive healthcare: those insured and beneficiaries.
- What sort of healthcare is available: medical care, emergencies, rehabilitation, medicines.
When can you apply for these?
In Spain, people "insured" under the Sistema Nacional de la Seguridad Social (National Social Security System) and their beneficiaries are entitled to healthcare:
- Insured: you can receive healthcare if you work and are registered with Social Security, as well as if you are a pensioner or unemployed perceiving unemployment benefits or allowances and are resident in Spain.
- Beneficiaries: you can receive healthcare if you are a relative of an insured person, are resident in Spain and fulfil certain requirements (see below).
Some categories of Spanish emigrants and some of their family members can receive healthcare even though they are not covered by any social protection system. They have this right when they return temporarily or permanently to Spain.
Foreigners not registered or authorised as resident in Spain have the right to health protection and to health care under the same conditions as people with Spanish nationality.
Persons who cannot have the insured status because they do not meet the required conditions, can however access public healthcare through a voluntary insurance with the Autonomous Community competent authorities.
What requirements must you meet?
Insured: in order to qualify as "insured" and be entitled to healthcare in Spain, you should fall into one of the following categories:
- Be employed or self-employed and be affiliated and a contributor to the Spanish Social Security System. You can also be assured if you are a pensioner, a beneficiary of any regular social security benefit or unemployed, having exhausted the unemployment benefits or allowances, and reside in Spain.
- If you are a legally permanent resident (irrespective of your nationality), you can also be insured if you do not have other health coverage.
- Minors subject to administrative supervision may also be listed as insured.
Beneficiaries: some family members of insured people can also request healthcare, provided they are:
- Spouse or partner of the insured person (or the former partner if in charge of the insured).
- Son/daughter under 26 years of age or over 26 with a degree of disability of at least 65%.
- Brother/sister of the insured person.
If you fall into one of these categories, you may qualify as a beneficiary and have the same entitlement to healthcare as an insured person, provided you meet the following requirements:
- reside legally in Spain;
- live with the insured person (except if you are legally separated or divorced);
- are in charge of the insured (unless you are spouse or partner);
- for the sons/daughters and brothers/sisters of the insured, not perceiving higher incomes than twice the IPREM (Public Indicator of Multiple Effect Income).
What are you entitled to and how can you apply for it?
If you are insured or a beneficiary, you will be entitled to receive healthcare in Spain, which includes:
In public or private health centres and hospitals, or at home in the case of elderly people or people with disabilities, for example.
If you need emergency care, you may be attended in any medical centre and be admitted to hospital if necessary. In the event you need an ambulance, you will also be covered by the Spanish system.
If you need rehabilitation and have a medical prescription, the national system will cover your costs.
Medicines free of charge
Medicines with some charges
Medicines with full charges
Beneficiaries of non-contributory pensions and job seekers' basic income; unemployed people who have exhausted their entitlement to benefits or an allowance; victims of occupational illnesses or accidents; and hospital patients.
Most non-hospitalised patients should pay between 10% and 60% of the full price, depending on their income.
Social security covers part of the cost of surgical prostheses, orthopaedic equipment and wheelchairs.
Spanish healthcare excludes dental prostheses and glasses.
You can apply for healthcare in Spain at any of the centros de atención e información de la Seguridad Social. You will need to submit the necessary documents together with your application form.
Once the Instituto Nacional de la Seguridad Social (INSS) confirms that you qualify as insured or a beneficiary, you can receive medical care and healthcare at health centres in the autonomous communities. Here they will give you a personal health card with which you can gain access to available services.
It will allow you to receive care from a primary care doctor or paediatrician at the health centre that corresponds to your neighbourhood. This doctor will refer you to a specialist or hospital, if necessary (except in emergencies, when you can go to any hospital). In any other medical centre that does not belong to the state network, you should pay the healthcare costs.
- Affiliate: a person who is registered in a social security system when he/she starts a job. Registration assigns an affiliation number with which you can obtain the Sistema Nacional de Salud user's card.
- Self-employed worker or employed worker: you are self-employed if you do income-gaining work without having an employment contract; you are an employed worker if you have an employment contract, in exchange for a salary.
- Administrative guardianship: is the legal situation where a person is under the guardianship and authority of another person. It is normally applied to people who cannot manage on their own and to children who are not subject to custody.
- Primary care doctor: also called family doctor or general practitioner (GP). Offers medical care for any health problem, regardless of the age or sex of the patient. They are not medical specialists.
Documents you will need
Find out about your entitlements
These links will help you to find out about your entitlements in Spain. They are not European Commission links and do not represent the opinion of the Commission:
- You can find out more about the General Social Security Act in Spain in the Royal Legislative Decree 8/2015 of 30 October.
- Regulation on the conditions for being insured and beneficiary in the National Health System (Royal Legislative Decree 7/2018 of 27 July, on Universal Access to the National Health System).
- Regulation on healthcare for those who are not insured or beneficiaries.
- Decision on healthcare for returnees.
- Regulation on common services of the National Health System.
Publications and web pages of the European Commission:
Who can you contact?
Instituto Nacional de la Seguridad Social (INSS)
C/ Padre Damián, 4
Tel. +34 915688300
Fax +34 915640484
Web page: http://www.seg-social.es
For any problem with your entitlement as a European citizen: EU welfare services.