State and Private Medical Care
State run Medical and Health Care is considered one of the best in Europe with services provided similar to those in the UK.
Who can receive free health care in Spain?
A distinction is made between those persons visiting Spain from time to time (an example would be those on holiday) and those persons who have taken up permanent residency:
1. Visitors to Spain will be provided with free medical care and assistance if they hold an European Health Insurance Card (EHIC). The EHIC entitles the holder to the same treatment at the same cost as a national of that country. For example, if medical care is provided free of charge in the member state where treatment is required, the claimant will be entitled to free medical care on presentation of the card or an equivalent document.
2. Residents of Spain will need to obtain a Spanish social security number. Those not working will need to be in receipt of a state pension (this can be a UK pension) and those not in receipt of a state pension will need to make contributions to the State Security Fund before a social security number is issued. Those who have become resident in Spain (the EHIC may not then be applicable) and have not made any contributions and are not in receipt of a state pension may not be eligible for free health care. Once, though, employment or self employment has commenced a social security number will be issued and this will then be valid for the holder’s lifetime.
How to obtain a Social Security Number
An application using a TA1 (Social Security application form) should be made to the nearest office of the “Tesorería General de la Seguridad Social” (General Treasury of Social Security). The location of their offices can be found visiting by www.seg-social.es/Internet_1/Oficinas/ ; an application form can be down loaded.
A. The applicant will need to provide a Número Identificatión de Extranjero (NIE) – ( National Identification number) and produce a passport.
B. 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 an intermediary (lawyer or accountant) to make the application on their behalf.
Obtaining the NIE number:
These are issued by the National Police and can be obtained by attending a local National Police Station and requesting an “EX18 NIE” form and “RESIDENCIA” application form. For non -Spanish speaking applicants it is advisable to be accompanied by someone who does. Alternatively you can collect an application form to take away for completion.
You will need to take with you your passport, together with a photo copy of it, and two passport size coloured photographs.
An application must provide a Spanish address. This is required for communication purposes. If you do not have a Spanish residence this can be another persons address but they will have to accept responsibility to notify you of any communications received.
Upon submitting your completed forms you will be issued with a Form 790 which you will need to take to your bank so that the police administration fee can be paid by them on your behalf. Your bank will issue a receipt confirming that the fee has been paid which you will need to give to the police when you collect your NIE and Residencia certificates.
This identification number is used to track the individual’s financial and official activities in Spain. Spanish citizens have a NIF number (Fiscal Identification Number / Número de Identificación Fiscal) which is their DNI (National Identity Document/ Documento Nacional de Identitidad) followed by a letter. The NIE number always starts with “X” and is followed by seven numbers and a letter. The number is personal to an individual; it is not transferable and it does not expire.
Notification needs to be made when there is a change of address.
Private Health Care
There are many very good private health care organisations in Spain similar to BUPA where health care cover can be obtained under an insurance plan. There are also many private clinics offering an extensive range of specialities many provided by ex- pat and other european nationals who have settled in Spain.