Inside

Health, Doctors, Hospitals and the Medical System in Spain

Find out what to expect from the medical system in Spain if you're moving there to live and work or to retire. Understand how to register with the system and what to do in the event of an emergency.

The Spanish healthcare system is funded by social security contributions and combines public and private healthcare.The government sets the overall budget for the country, but each region takes individual responsibility.

To benefit from the Spanish National Healthcare system and medical assistance, residents must enrol with the General Social Security Fund (Dirección General de la Tesorería General de la Seguridad Social - TGSS). This gives access have access to free or low cost healthcare. Provincial social security offices are located throughout the country.

For contact information for provincial Tesorería General de la Seguridad Social - TGSS offices: Click here

The Healthcare System

Any person legally resident in Spain can benefit from the Spanish social security and healthcare system provided they fall into one of the following categories:

Employed workers
Self-employed workers
Students
Workers affiliated with a work co-operative
Civil servants or military personnel

Contributions

Spain's social security system has two levels:

Contributory: The contributory scheme consists of one general and five special schemes, which includes the majority of the working population. Students are covered by a special protection plan.
Non-contributory: The non-contributory level is for people with no or with a very low income. The benefits include medical assistance.

Social Security Number

Any resident, either salaried or self-employed, is issued with a social security number. This entitles a person to healthcare, sickness, unemployment benefits, as well as government pensions. Once a number is obtained, it is valid for life.

Employers request a social security number for an employee if they don't already have one. Self-employed workers may make the application themselves or hire a gestor to complete the process for them.

The application form and required documentation should be presented to a local office (local to the applicant's workplace or home) of the TGSS. Once the application has been submitted, the worker receives a certificate of registration (documento de afiliación) and a registration number.

The following documents must be presented:

A form of national identification; a Número Identificatión de Extranjero (NIE) is sufficient
Residency certificate or passport
The form TA1 (Social Security application form)
- To download form TA1: Click here

If a person loses their job or ceases to work, they must notify the Tesorería General de la Seguridad Social immediately. The worker is liable for contributions until the agency is notified.

Healthcare Benefits and Health Cards

Once registered with social security, a certificate entitling medical assistance is issued. This document can be used to apply for a health card (Tarjata Sanitaria Individual - TSI) at the local health centre. The TSI health card should be used for all public health services and at the pharmacy when buying prescription medication. Social security pays a percentage of the cost of treatment and hospitalisation; the patient pays the remaining amount or takes out supplementary health insurance. Prescribed medicines are covered up to 40 percent by social security, and are free for pensioners. Official prescriptions are green, when part of the cost must be paid by the patient; pensioners prescriptions are red.

Cards are individual - children and adults each have their own - and are valid for four years. The TSI health cards carries the following information: full name of card holder, social security number, NIE number (DNI for Spanish citizens), type of user (such as worker or pensioner) and the expiry date.

To get a health card, apply at the local health centre taking the social security certificate, passport and NIE/DNI certificate. The health centre issues a receipt, which has the same function as the card itself and can be used immediatly; the health card is sent to the applicant and their beneficiaries by post. Beneficiaries are family members who are dependent on the worker or pensioner.

People not qualified or affiliated

Any person who is not affiliated with the Spanish social security system may choose to to take out private health insurance or pay the full amount of any medical costs.

Private Health Insurance

There are many international companies providing health insurance to foreign residents. International health insurances offer basic policies, as well as comprehensive policies, normally with a 24-hour help line in English.

Finding a Doctor, a Dentist, a Pharmacy or Hospital

To receive medical treatment, those enrolled in the Spanish social security programme should visit a public health centre (centro de salud) in their area of residence (normally located within 15 minutes of any place of residence), or their general doctor (médico de cabecera). They will be referred to a specialist if necessary, however, there can be waiting lists to see specialists and for non-urgent operations.

To find a local health centre: Click here

Lists of English speaking health professionals can be found at many tourist offices and through Embassies or Consulates.

All doctor’s offices must provide the leaflet Carta de Derechos y Deberes (Charter of Rights and Obligations), outlining the services patients are entitled to.

Medical Emergencies

In case of an emergency go directly to a hospital, where emergency services are generally available. A social security card, a European Health Insurance Card (EHIC) or proof of private insurance should be presented at the hospital. The EHIC card gives the right to free emergency treatment for residents of EU/EEA countries in state hospitals or clinics only. Treatments not qualifying as an emergency are not free.

Bilateral agreements exist with some countries such as Peru, Paraguay, Ecuador, Chile, Brazil and Andorra. Citizens from these countries may benefit from free medical treatment in cases of medical emergencies or accidents. Citizens of other countries should have private medical insurance when travelling to Spain.

For emergency services, Tel: 112

Pharmacies

In order to exercise their various professional activities, pharmacists must register with the appropriate provincial Pharmaceutical Association. All of the Pharmaceutical Associations form part of a national body, the Consejo General de Colegios Oficiales de Farmacéuticos (General Spanish Council of Pharmacists). Registered pharmacists are able to provide first line care and consultation.

The association's website has much useful information in English, including health advice and a vaccination calendar: Click here

Pharmacies (farmacias) are generally open from Monday to Friday from 09:30 to 14:00 and 17:00 to 21:30, and Saturday 09:30 to 14:00. Information about pharmacies open 24 hours a day (Farmacia de guardia) can normally be found on the window or doors of any pharmacy.

To find a farmacia de guardia: Click here

Dental Procedures

Dental treatment is not covered by social security. Private health insurance can cover dental treatments if this has be opted for in the policy.

European Healthcare Agreements

The European Health Insurance Card (EHIC) is not valid for healthcare in Spain if the holder is a resident of Spain.

European Conventions and Form S1 (former E121 and E106)

A person who has paid regular social security contributions in another EU country for two full years before coming to Spain can benefit from public health cover for a limited period, from the date of their last social security contribution made in the other EU country.

To do this, it is necessary to obtain Form S1 (former E106) and present it to the local Social Security office in Spain. Pensioners and those in receipt of invalidity benefits must obtain the Form S1 (formerly E121) from their home country's social security administration.

Retired EU Citizens living in Spain

EU nationals who have reached the retirement age as established in their home country, and are residents in Spain qualify for free health care provided they have a Form S1 (former E121), obtained from the former country of residence.