Healthcare in Spain for UK citizens

What’s on this page?

1. Understanding Healthcare in Spain
2. Access to Healthcare for Expats
3. Healthcare in Spain After Brexit
4. Private Healthcare in Spain
5. Cost of Healthcare in Spain
6. Navigating the Healthcare System in Spain

Spain has been attracting citizens from around the world for many years with its excellent living conditions. An excellent climate with over 300 sunny days a year almost everywhere, beautiful nature, a high standard of living, proximity to the sea, rich cultural heritage - all these factors do not leave indifferent people who want to move to Spain for permanent residence from the UK.

British citizens are also attracted to Spain by relatively low prices for housing, goods and services, healthy Mediterranean cuisine, organic products, a relaxed lifestyle and the hospitality of the locals. In nearly every province of Spain you can meet immigrants from the United Kingdom: from large cities and resorts on the sea coasts to small towns and villages inland, where quiet patriarchal life is organically combined with vibrant national festivals and holidays.

But before making radical changes in life, potential expats are concerned with pressing issues, first of all, medical care in Spain for British citizens. Understanding the essence of healthcare in Spain, the quantity and quality of available medical services, as well as changes in healthcare in Spain after Brexit is a critical component of adapting to a new country.

Healthcare in Spain is one of the best in Europe (second place after Denmark) and the world (sixth place) according to the Healthcare Index 2023. It is of high quality and available to everyone living in the country, regardless of whether the person is a resident or non-resident. British citizens wishing to come to Spain for permanent residence should be aware of the structure of the medical care system and the possibilities of gaining access to it as a citizen of another country.

Understanding Healthcare in Spain

The Spanish healthcare system operates on two levels - national and regional, according to administrative divisions. Medical services are provided by both public and private institutions. More than 99% of Spanish citizens use public healthcare. The quality of medical care is ensured through highly qualified medical personnel, modern technologies and the latest equipment. The authorities of the autonomous communities are responsible for the medical services provided.

Public health care is funded by taxes, and to receive public healthcare you need to register with the National Health Service, which makes most of it free or inexpensive, including doctor visits, hospitalizations, and prescription drugs. Many people turn to private clinics for medical services. Private healthcare in Spain guarantees quick access to medical care and a wider range of services provided, but you should take into account the costs when visiting a private clinic.

Therefore, an affirmative answer to the question: is healthcare free in Spain requires going to a public clinic if you have a public health insurance policy. Other conditions for receiving healthcare in Spain for expats will be discussed below.

Access to Healthcare for Expats

Healthcare in Spain for EU citizens and UK citizens has some differences. If you are a citizen of an EU country and stay in Spain for a maximum of 3 months (90 days), you can use the European Health Insurance Card (EHIC) for free access to healthcare in Spain. British citizens who come to Spain for this period and have a valid EHIC card will also receive free medical care.

If your EHIC has expired, you will need to obtain a UK GHIC health card to cover the costs of emergency care and other medical services while staying in Spain for less than 3 months.

In cases of arrival in Spain for a period of more than 90 days, a British citizen must:

• for the first year of stay in the country, take out private health insurance;
• if you have a job and pay social security contributions, gain access to the public healthcare system;
• register at the medical center of your locality;
• obtain a state health insurance card for visiting medical institutions.

Special attention should be paid to the organization of medical care for British citizens wishing to retire in Spain. Even after Britain left the EU, the mutual health agreement between the two countries continues to operate, which presupposes the continuation of the conditions of service for citizens of these countries even after the United Kingdom leaves the EU.

Having received a non-lucrative or Golden visa, a British citizen receives an S1 form from the United Kingdom to entitle him to medical treatment in Spain as a person receiving a UK state pension. In this case, you can also answer the question in the affirmative: is healthcare free in Spain for UK citizens?

UK citizens coming to Spain for a stay of more than 90 days, who do not plan to work and who are under retirement age, must apply for private health insurance. This is a necessary requirement for living in Spain in order to cover the costs of your treatment yourself through insurance premiums.

If a British citizen decides to work, then in the future it is possible to take out state health insurance by making contributions to the social security system. Also, if you register with the local council and stay in Spain without leaving for 12 months, you can use the system of voluntary payments existing in Spain, and after a year, if the contributions are paid correctly, you can issue a state insurance policy.

A UK citizen who is officially employed under an employment contract or is a freelancer in Spain and who regularly contributes to the social security system is entitled to public healthcare. The healthcare in Spain also provides the opportunity to include dependent relatives who come with the main employee to free medical care.

The attractive thing is that a British citizen officially working in Spain, who has taken out state health insurance and a Spanish health card, can receive the necessary assistance in any EU member country.

Healthcare in Spain After Brexit

After the UK left the European Union, British citizens' access to the healthcare systems of EU member states was guaranteed until 31 December 2020. After this, the provisions on broad guarantees of receiving medical care in accordance with the Protocol on the Coordination of Social Security apply from 01/01/2021. Let us have a look the conditions for receiving medical care for different categories of British citizens interested in healthcare in Spain after Brexit:

Private Healthcare in Spain

Private healthcare is in high demand in Spain not only among foreigners, but also among the indigenous population. Healthcare in Spain for expats primarily still involves contacting private medical institutions and taking out private health insurance.

Private healthcare has its advantages:

• faster access to medical services compared to the public system;
• wide range of services provided;
• high quality of service.

You can access this healthcare by going directly to one of the private healthcare providers and making an appointment. Many expats choose to take out private health insurance to cover the cost of private healthcare services. Conditions for receiving medical services with private insurance depend on the health insurance plan and the specific insurer.

The cost of private health insurance depends on certain conditions:

Cost of Healthcare in Spain

An important question: how much is healthcare in Spain? For UK citizens with public or private health insurance, a large number of medical services will be provided free of charge or at low cost. With state insurance, the following will be provided free of charge:

• general medical care;
• emergency;
• reception by subspecialists;
• set of basic tests;
• prenatal care.

Private insurance offers a wider range of free services, which depends on the selected insurance package and the specific insurer.

If you do not have insurance, prices for basic medical services are as follows:

• provision of primary medical care – from € 100;
• consultation with a specialist – from € 150;
• one-day hospital stay – from € 200.

Navigating the Healthcare System in Spain

Citizens of the European Union legally residing in Spain can receive free medical care on the basis of the EHIC - European Health Insurance Card or the Spanish Health Card (TSI). The application for a Spanish health card is submitted to your local primary healthcare center and can be received within 2-3 weeks. Afterwards, you need to register for an appointment with a family doctor, and an appointment with a specialist is possible upon the referral of the family doctor.

An important document is the S1 form, which allows you to transfer social benefits from the country where you previously lived to the country of your new residence. Form S1 is proof that your use of the Spanish healthcare system will be covered by the UK's NHS.

If you are a pensioner receiving a state pension in the UK, you will need to obtain an S1 form, which entitles you to free healthcare in Spain. This form is requested from the UK National Health Service. Next, you need to register with the Instituto Nacional de la Seguridad Social (INSS) - the administrative body for social security in Spain, having with you:

• application for medical care;
• form S1;
• padrón certificate;
• passport;
• TIE card.

Moving to Spain from the UK comes with high expectations and hopes for better living conditions. This is due to the favorable climate, low prices, the beauty of the surrounding landscapes, delicious healthy food, and the history and culture of Spain. But at the same time, the language barrier, employment opportunities, adaptation to a new lifestyle, and medical care issues cause some concern.

While still part of the European Union, the UK established strong ties with Spain regarding the provision of guaranteed medical care to its citizens staying in Spain for a short time or moving permanently. After Brexit, some conditions for providing medical care to the British have changed, but in general the system of access to medical services has remained at the same level and should not cause concern.