HOW TO GET HEALTH ASSISTANCE
General description of the health system in Spain
All workers, whether they are paid employees or self-employed, must join the social security system and pay their monthly fee through their employer. You will be given a social security card which gives you the right to free hospital and medical health care. You can also choose private insurance but the management fees will not be reimbursed to you except in cases of emergency. In Spain 40 % of medical treatment is private.
Treatment is free if you go to a doctor who works in the social security system, if special treatment is required the doctor sends the patient to specialists by means of an official report.
Medicines are always prescribed by a doctor using an official prescription. Some medicines are not covered by social security. Treatment in hospitals is free within the social security system; patients also have the right to some services, orthopaedics, blood transfers, etc free of charge, when considered necessary.
You can get private medical health insurance through one of many private medical centres that exist in Spain and which are listed in the Golden Pages as "Medical societies".
Public and Private health
The Spanish State covers the health needs of all its citizens through the National Health System, funded by means of taxes and managed by the Autonomous Communities.
More than 90% of the population uses this system for their medical needs. This system enables Spanish people to choose their family doctor or GP, through whom they obtain access to the rest of the system.
Most of the patients get to see their doctor within a day or two after request. Patients do not normally have to pay any extra costs as they are covered by the Autonomous Community.
To see a specialist, patients have to be sent by their GP, except in cases of emergency.
Private health care
In the last few years private health care has gained importance. It is estimated that 15% of the population has private medical insurance, including most civil servants, who are given the option of choosing between the public system and the private system. Medical Insurance can be used as a complement or as an alternative to public health care.
How can I get health care?
As a foreigner you can benefit from both the Spanish public and private health systems.
Public Health care
Foreign employees who work for a Spanish company and foreign self employed workers in Spain have to contribute financially to the Spanish Social Security. These contributions give them and their families the right to free or funded health care under the same conditions as the Spanish citizens. However, according to Spanish law, everybody has the right to free health care whether or not they contribute to Social Security.
In order to apply for a medical card you must go to your nearest Health Centre and show them your resident card and your Social Security card, if you have one. You will receive a medical card by post within a few weeks.
If you are an EU citizen you have the right to free health care in Spain thanks to the bilateral agreements that exist within the EU countries. Since mid 2004, there has been a European Health Insurance Card, which makes the process of getting health care easier in countries of the EU. This card substitutes the forms E111 and E111B, E110, E128 and E119.
Private Health Care
With regard to private health care, any person can request it. Companies usually offer health and dental care with discounts if both are requested. Prices vary quite a lot depending on the person’s age and gender, although they are not too exorbitant. To give you an idea, the average fee for a 30 year-old man starts at €40, €50 a month, while for a woman it is a bit higher, about €50, €60 a month.
WHERE TO GO IN EMERGENCY EVENTS
Where should I go in cases of emergency?
In cases of emergency, go straight to the nearest accident and emergency service, if you do not have private medical insurance, go to a public centre.
Even though according to the Spanish law, any medical centre, public or private, is obliged to assist patients in cases of vital emergency regardless of their insurance, this is only applied in cases of life or death. The responsibility of making the decision depends on the doctor or nurse on duty. Call the emergency number 112 if you need an ambulance.
WHERE TO GO FOR MEDICAL ASSISTANCE
Where should I go in cases of minor ailments?
Most people go to the pharmacy for minor ailments. These are easily recognised by the luminous green crosses which are displayed outside or on the window.
Pharmacies take turns to open outside the normal commercial opening hours (by night and public holidays) as pharmacies on call. You can know which pharmacy is on duty by looking at the newspaper or on the pharmacy window, where they usually hang a list of the pharmacies on duty.
SOCIAL SECURITY SYSTEM
Registering with the Social security and getting a medical card
Registering with the Social Security
The social security number or registry number is necessary in order to register a new worker at the time of being listed on the payroll. Without it, it is almost impossible to get a job in a company by law. In addition to this, for purposes of health insurance and pensions, this number will appear on the person and his/her family’s documents. Applying for a Social Security number is one of the easiest procedures. You need to present a Spanish passport or a passport together with a work visa and residence card; then, fill in a form which you can get in the social security offices and provide a postal address (only write it down, you will not have to prove it). The civil servant will enter your details into the computer along with your new number and then the only step left is TO ASSIGN A DOCTOR, which is an easy procedure which must be done at your nearest Health Centre or by phoning 012.
HEALTH ASSISTANCE FOR IMMIGRANTS
Health care for immigrants in Spain
The type of service will depend on your situation
1. If you are in a normal situation and you are not registered on one of the Spanish municipal census you only have the right to emergency health care. In cases of emergency you will be given emergency care at the Health Centre and if you are not in a condition to leave your house, the emergency number is 061 or 112.
This service will cover:
a) Serious illness cover
You have the right to continuous health care right up until the medical discharge.
2. You have the right to health care regardless of whether or not you have a residence permit as long as you are registered on the municipal census. In Spain you are offered health care under the same conditions as Spanish people. The only requirement is that you register on the municipal census of the town or city where you reside, regardless of your legal situation.
This service will cover:
a) Serious illness cover
c) Primary care and specialists
d) Pregnancy, delivery and post-delivery health care.
3. If you are under 18 years of age, you have the right to health care under the same conditions as Spanish people.
4. If you are pregnant you will have the right to health care during your pregnancy, delivery and post delivery period.
Who is covered by the Social Security system offered by the Spanish Government?
The State, through the Social Security system, guarantees the necessary protection in those contingencies and situations defined by the General Law of Social Security to those people covered under its application, that is, those professionals who contribute to the social security system, as well as their relatives or dependants, who do not contribute. There are two degrees of cover:
Contributory: All Spanish people who reside in Spain, and foreigners who reside or are legally placed in Spain, are included, as long as, in both cases, they carry out their activity within the national territory and are included in one of the following:
- Paid workers.
- Self-employed workers.
- Members of Associated Work Co-operatives
- Civil servants and military officials.
Non-contributory: It includes all Spanish people who reside in the Spanish territory; Latin American, Portuguese, Brazilian, Andorran and Filipino people and nationals of other countries according to the Treaties, Agreements or Bilateral Agreements.