Spain is known for having one of the best healthcare systems in the world, and is ranked as one of the top European countries for numbers of doctors per capita; it currently has around four doctors per 1,000 residents. Until now, Spain has operated both a state healthcare system, paid for in part by social security payments, and a private system. However, on 27th July 2018, a new royal decree law about access to healthcare was approved. How will this change the current situation and how does it affect expats and migrants? Let’s take a look.
Current State Healthcare In Spain
As it is now, Spanish state healthcare is paid for by contributions from people of working age in the form of social security payments. It is also subsidised by the government, which invests around 10 percent of its GDP into the system. The vast majority of people living in Spain use this system, and it is accessible to anyone who is a resident and who is:
• employed or self-employed and making social security payments
• a child
• pregnant
• under 26 and studying in Spain
• a state pensioner
• in possession of an EHIC card and is staying temporarily in Spain.
Registering For Access To State Healthcare
Once you’re registered in the healthcare system in Spain by getting a social security number – a process which requires you to submit ID, your residency certificate and a completed application form to your local TGSS office – you’ll have access to healthcare in the country. This will then entitle you to see a doctor at a health centre or a general doctor’s practice, get referrals for specialists as necessary and be able to access prescription drugs.
Access To Prescription Drugs
Whenever you’re given a prescription by a doctor working in the public system in Spain, you’ll have to pay part of the cost out of your own pocket, depending on your income and work status. State pensioners only have to pay 10 percent of the cost, for example, while anyone working and earning over €100,000 a year will have to pay 60 percent. Other people pay proportions in between. Note that dental care is not covered by the public healthcare system except in cases of emergency. For routine dental work, you’ll either have to pay the expense yourself, or take out private insurance.
When Private Healthcare Makes Sense In Spain
If you are not eligible for the public healthcare system, or you simply want to have private health insurance for other reasons – such as to shorten waiting times or to cover treatments that would otherwise not be covered – you may opt in to a private system, of which there are many reputable options. For some non-EU citizens applying for visas, or non-EU students studying in Spain, private health insurance may be a requirement of being allowed to stay in Spain. However, with the current modifications to the law, this could change.
What Are The Changes?
The new law aims to guarantee universal and uniform access to healthcare to everyone living in Spain, regardless of their nationality or statehood. This even extends to illegal and undocumented migrants in Spain, and so includes the almost 800,000 people living there who were previously denied access to healthcare. This is being lauded as an “advance for human rights” by Marta Mendiola of Amnesty International and demonstrates the Spanish government’s commitment to prioritising the wellbeing of its residents over, for example, spending on war, which is seen as a positive step by many Spanish residents.
How Does This Apply To Me?
There are still some limits on the applicability of this law, but overall, it means that if you’re a resident in Spain, you should now be granted access to healthcare. The exception is if there is another, existing way you can gain access to healthcare, such as through a bilateral agreement with your home country, through another EU law or any other regulation that may apply to you. Also, this right to healthcare cannot be extended outside of Spain to your home country or anywhere else you might choose to live if leaving Spain.
While much of the information on requirements for the application or renewal of certain types of visas for Spain, such as the non-lucrative visa and the retirement visa, will still tell you that proof of a private health insurance is required, under this new change to the law, this isn’t technically the case. However, since it’s such a new development, it’s best to err on the side of caution and follow the rules that are presented to you until there’s been time for this change to filter down and be fully recognised at all levels in the visa application process.