Healthcare System in Spain

The Spanish healthcare system is ranked among the best in the world. Here's how to sign up to free state healthcare in Spain, or apply for health insurance.

There are numerous factors to consider when looking to live and work abroad, not least those relating to your health and wellbeing. Finding the appropriate level of health coverage is essential for anyone moving abroad, but with so many different options available it can sometimes prove tricky to find the package best suited to you.

If you're living and working in Spain you'll likely have access to Spain's free state healthcare, paid partly by social security payments, which will be deducted from your wage.

As an expat, you are entitled to free state healthcare if you are:

• resident in Spain and work in employment or self-employment and pay social security contributions,
• resident in Spain and receiving certain state benefits,
• resident in Spain and recently divorced or separated from a partner registered with social security,
• a child resident in Spain,
• a pregnant woman who is resident in Spain,
• under 26 and studying in Spain,
• a state pensioner, or
• staying temporarily in Spain and have an EHIC card.

If you don't have the right to state healthcare you have to organise private health cover. If you have been registered on the padrón at your town hall for a year, the Spanish government has a state insurance scheme (convenio especial) with a basic monthly fee. This is administered by the authorities in each autonomous region.

For Spain's public health care, once you have registered with the TGSS (Dirección General de la Tesorería General de la Seguridad Social) you'll be given a social security number and a certificate stating that you're entitled to medical help. You then take the certificate, passport and NIE number along to your local health centre. You can then register with a doctor and apply for a health card (tarjeta sanitaria individual or TSI).

If you have an EHIC (European Health Insurance Card) issued by an EU-member state and you are in Spain on a holiday or other temporary visit (you are not a resident in Spain), you can use your EHIC to access state healthcare in Spain, also use it if you are studying in Spain as part of a course based in your home country. You can get any medically necessary treatment through the state system either at a reduced cost or free with the EHIC. But you cannot use the EHIC if you are coming to Spain specifically to get medical treatment or to give birth.

For more information

• Seguridad Social, the Spanish social security office, where you can find information on all social benefits including registering for national insurance. Some of the information is in English.
• Ministerio de Sanidad, Servicios Sociales e Igualdad, the website of the Ministry of Health, Social Services and Equality has more information about the Spanish healthcare system