Hi, I’m an American who is hoping to move to Spain in about a year. However, I do have a chronic medical issue which requires me to be on medicine, which is actually available in Spain. I have multiple sclerosis and have to be on copaxone, an injectible med I take once a day. (In the States it costs about $1500/month, and is one of the few things here that my insurance actually covers.) I am just curious to know how the health care industry works in Spain. I know they have socialized health care, and I’d totally buy private insurance on top of that, to bypass waiting lists, because I know how serious my illness can be when it acts up (which, thankfully, isn’t so often, which I credit to lifestyle and medicine.) Anyway, I doubt the costs of private insurance there could cost what it does in the States. Does anyone have any recommendations on A) private insurance to buy and B) how the nationalized insurance works? I’d love to hear from anyone who has to be (or knows someone who has to be) on maintanence medicine for something (like insulin for diabetes.)
I do speak/read some Spanish, as I’ve studied it a bit, have traveled a lot in Latin America, and it’s sort of a second language here in my neighborhood in New York. And I do have an EU passport (Ireland).
Keyword, is EU Passport Ireland, does that mean you have full Irish and therefore EU nationality?? If so you will have certain entitlements within the EU system, for example if you move to live in the Valencia region (IE Costa Blanca ), you would be entitle to free reciprocal medical care, as the regional goverment see that as a commitment to EU citizens. Murcia is due to extend healthcare to EU citizens who are resident this year?.
Paying into the system, you could once you are here and have residencia pay into the spanish Social system which will give you full access to the Health system the cost would be in the region of 250? per month for a full ticket (Inc pension contribution, and Unemployment etc), there may be reduced fees for non workers but I dont know what they would be.
Private medical, i have been with Sanitas ES, which has some form of association with BUPA (UK) I pay for my wife and myself 1264? per year, this is classic cover, which covers just about everything, and now even covers treatment when abroadup to to 10,000?. compared to what I was paying in the UK (?3786 per year), it is a bargain. I have as yet not had to use the private cover, but I know of a couple of people who have and they say very good, with the only problem being if you live in an inland rural area it means you have to travel to find a Sanitas registered clinic, as these appear to be only in the major cities or coastal areas.
The Spanish Health system, I have used the local GP (I pay autonomo (self employed)social security)a number of times, and find that they are very very good, with not only dealing with the complaint i went with but insisted on a complete annual medical, blood test for cholestrol etc etc, and now ask me back every year for the tests. One of my customers went into hospital with an eye problem which turned out to be malignant, they dealt with it within two days and now he goes back every three months for a complete body scan all within the Health care agreement.
I have no complaints or bad experiences with the Spanish Health system and find the people and facilities clean, efficient and very helpful.
Most medicines seem to be able to be purchased directly from any Pharmacy, and also at a lower cost than UK, (No Idea about USA costs sorry)
I am Diabetic and recently moved to spain with no medical insurance as yet. I have applied for my NIE does this enable me to get medical treatment. I am very confused with this - I got told that as I still have my E111 I can use that to see the dr but will have to pay for my treatment? can you giv eme any more information please
The NIE will give you no right of access to medical services as far as I understand it.
However you say you have an E111, which is now replaced by the EHIC card(you will need to apply for the new card), which entitles the holder to all necessary treatment within the EU community, unfortunately different regions interpret this differently, for example as I said above if you live and register in the Valencia region (IE get a Padron), you should be entitled to access the Medical system, this is not true for example in Murcia, where they will treat you only in an emergency on the EHIC and then recharge your parent country as per the reciprocal agreement of the EHIC.
Private Doctor and Dental visits in Spain are considerably cheaper than in the UK or I suspect the USA, as from our experience are medicines etc.
If you are a UK national, (I am not sure of your national status as you quote both USAand Ireland) you may be entitled to an E106, dependent on your employment status in UK and contributions which will give you medical cover for 2 years or E121, dependent on your age, IE 60 for Women and 65 for Men which allows you to register with a medical centre in Spain,
If you are a citizen of Eire, you probably have slightly different entitlements and I would check with the relevant authority in Eire.
If you are a citizen of the USA you are probably entitled to nothing.
What is important I guess is for you to confirm your status as an EU citizen and then contact the relevant authority for your home country for as much information before you relocate
Thanks so much for all your information to my response. It is very, very helpful.
I am used to being slammed with medical bills left and right here in the States. Everything you read about in the news about the healthcare crisis in the States is true - it’s awful. (Quality of care is good, but access to it is often difficult due to the extremely, insanely high costs.)
Yes, I have an EU/Irish passport, which makes me a citizen of the European Union. Thank goodness! I have never lived in Ireland, though, so I’m not registered with their health system. The only time I lived in the EU was when I lived in London for about 8 months, so that was the only time I paid taxes anywhere in the EU.
When I go to Spain, I definitely plan on working and fully paying into the system. I am very, very glad to hear your experiences with doctors have been positive. I’m also glad to hear that it was relatively inexpensive for you to get insurance for you and your wife. (If you had your own business or were freelance in the States, the same coverage for the two of you would cost you about $800 a month in the States, more if either person had a chronic condition, such as diabetes, or a preexisting condition.)
Hi Jaime,
just to add to mikes comments about paying into Spanish Social security system.
The best way to get full cover/access to treatments is definatly to be working and therefore, you are entitled.
The option he refers to of paying voluntarily - even if not working - does exist.. but it costs just Eu 30 less than the
contribution for a self employed (autonomo) person. So, around Eu 220 (just for health cover).
I am in the sticky position of being unemployed, have used up all my credits and have to ‘pay as I go’ for
any medical necessities. (I am looking into the apparent abuse by the UK govt of not giving me cover whilst living in
Spain.. but as you can imagine it is a red tape minefield!).
PS - I wish you luck. Just bear in mind that even though you might be paying into the state ss system, some surgeries are limited on their budget and will not willingly authorise expensive drugs. (Eg my friend has pancreatitas and she needs a monthly injection that costs Eu150 - and they will not even pay that. Likewise her husband has Chrones - and they will not pay for any expensive drugs for him either). Both have been paying into the ss system for 10+ years.
Hi All,
In regards to Health and Medical Insurance, please visit MSC Insure, we can very competitive quotes on the best policies on the Spanish Market.
Just to give you an idea one of the syndicates we use offer the following:
Comprehensive and competitive private medical insurance for expats under the age of 79.
Two product both of High standard aimed to suit your needs and budget. The policies have been carefully designed for expatriates based in Spain. The European Medical and European Health are administered and underwritten by carefully chosen syndicate, a leading British Private Medical Insurer who have been established since 1927. Because they are a friendly society, any surplus it generates are simply reinvested to improve the quality of the services and benefits to its members.
European Medical
* 4 levels of cover
* The age you join is the age you stay (rewarding you for remaining on the same plan) - long term savings!
* Portable cover with the freedom to choose where you are treated within the EEA, including the UK
* No compulsory excess, choose an excess to reduce your premium
* No need to have a medical examination before going on cover
* Access to a private GP helpline, 24 hours a day
European Health Plan
* 2 levels of cover
* No premium loading for individual claims ? premiums based solely on age at renewal
* Cover available in Spain and Portugal (and the UK with Level 2)
* Compulsory excess of ?100 per person per year
* Choose to reduce your premium by increasing your excess
* No need to have a medical examination before going on cover
* Access to a private GP helpline, 24 hours a day
Should you require any further information please do not hesitate to contact us.
Just to give you an idea one of the syndicates we use offer the following:
Comprehensive and competitive private medical insurance for expats under the age of 79.
Two product both of High standard aimed to suit your needs and budget. The policies have been carefully designed for expatriates based in Spain. The European Medical and European Health are administered and underwritten by carefully chosen syndicate, a leading British Private Medical Insurer who have been established since 1927. Because they are a friendly society, any surplus it generates are simply reinvested to improve the quality of the services and benefits to its members.
European Medical
* 4 levels of cover
* The age you join is the age you stay (rewarding you for remaining on the same plan) - long term savings!
* Portable cover with the freedom to choose where you are treated within the EEA, including the UK
* No compulsory excess, choose an excess to reduce your premium
* No need to have a medical examination before going on cover
* Access to a private GP helpline, 24 hours a day
European Health Plan
* 2 levels of cover
* No premium loading for individual claims ? premiums based solely on age at renewal
* Cover available in Spain and Portugal (and the UK with Level 2)
* Compulsory excess of ?100 per person per year
* Choose to reduce your premium by increasing your excess
* No need to have a medical examination before going on cover
* Access to a private GP helpline, 24 hours a day
The health plan look good but can they really give that to the people? Sometimes it looks good on paper yet when in reality the have trouble giving that to them.
I am also an Irish passport holder living in the south of spain. To get access to the spanish medical system is very easy for EU residents. The public health system here is one of the best in the world, so much that i wouldn?t bother with private health insurance. From my experience insurance companies try their best to not pay out or help you, in the end they are setup top make a profit and it wil be you who pays their profit.
You will need to apply for an NIE (at the police station) once you are here and then a social security number (in the local social security office) . Once you have these numbers, you can then go to your local public health center and register with a doctor and thats it. Depending on where you choose to live, some local health centers have a weekly volunteer translator to help expats. After a few weeks/months, you will also be sent a medical card which makes it easier but this is not necessary.
To prove a point, my girlfriend is from Poland and is living here 6 months and has never paid taxes yet she has a medical card whereas i have lived and paid taxes for almost 3 years and still haven?t received my card, buts thats spain and i just accept it. I can book an appointment for a doctor on the Internet using the number given to me when i registered with my local doctor.
easylifespain (post above)...
Whilst I appreciate that in your personal experience the Social Security Health System here works and you have no problems.. I think this is because you ARE working/paying taxes etc. It might also be that as your partner your GF gets automatic cover.
I know for a fact that many of us once we have been unable to pay into the system, for whatever reason, (or are an OAP who has not yet got their necessary papers in order from the UK) will not get any kind of free treatmen -as we are not entitled. I know many people who have been refused (including myself) as they are tightening up on this- especially in the costal areas/where there are a large number of ex-pats.
Hi Susan, from my experience, from what my spanish friends have told me, and from EU law once you have a NIE and a social security number, you (as an EU citizen) are entitled to use the public health system. You do not need to be working to apply for a NIE or social security number and indeed, both are free and can be obtained on the same day.
Maybe you should explain you circumstances a little better so we will know if you are doing something wrong or haven?t sorted out the “relevant papers” required. If you do need a helping hand with this or some advice, feel free to ask or alternatively you can keep paying for private medical care although you and any other EU citizens are not forced to do this by anyone. EU law clealry states that all EU citizens have the same access to social services as local residents and this applies to every EU country, both as resident or tourist.
Dear ELS… I would be very pleased to have the legislation that tells the local health authorities that I am entitled to free health care, even if not working. I even went to the ‘Trabajadora Social’ at the local healt centre and she was as helpful as she could be. She confirmed what I had already been told (by the admin part of the social security office) that if I was not working/paying, then my entitlement would only last for 6 months from date of last payment.
If there were anyway this was not correct, I am sure I and 1,000’s of others in my position would be taking up free health care!
This has been a bone of contention from a particular lobby group that things we should get the same access as in the UK, but it doesn’t seem to work like that.
As I say, if you are able to supply the legal details you will be everyones best friend.
Kind regards,
SJ
mmmmm You can only get free medical care if the Doctors/Medical Center allow you to register with them…
Example: there computer system can allow “Refugee Medical Help” this means That “The Person or Persons” have no financial means to support themselves medically This includes no monies coming in from abroad etc….....
I believe its Section 22 On there System I know as I was on it 2 years ago for 6 months and today clarified it still exisits
AND IT DOES!!!!
No one can be denied medical care in any EU State If you are a Resident… Spain like to think they can get EU Funds and do what they want with it… However the law is the law and the authorities must do what the law clearly states!
Hola Mac.. thanks for clarifying the rule (I had heard of it B4 but forgot what number!)...
ELS…. I don’t want to stir up trouble, but if you look up in the Tapas bar section of the Forum there is a group called
PUMA 22 for ex pats in Valencia - where they have had their ‘rights’ to free medical treatment withdrawn. This action group is campaigning.
I can see it only being a matter of time before they get really heavy handed on the CDS.
Infact I have posted previously of the situation in Coin where many previously registered OAPs were getting free treatment no problem. The medical centre is now making all prove their entitlement and demanding paper X/Y/Z (even if presented before) and they have stopped treatment on some very seriously ill people!
My own health centre told me I was no longer registered at the 12 month grace period after I was made redundant/had no funds coming in. As I said before, even a visit to the clinics Social Worker only confirmed that they are not going to re-register me.
I have had to take ‘alternative measures’ to ensure I get at least emergency treatment.
I have to agree with Susan on this matter. The only way you get into the social system is to be working and paying into it, which then entitles you to free health care with your social card. Mind you I have also heard of someone getting health care if they had their empadronamiento, how true this is I don’t know.
So as not to scare anyone - I have heard that a medical centre/hospital will treat ANYONE… in an emergency. Whether you have an ECH11/other paperwork or not. (They may decide later to bill you if no paperwork is presented, but this can be dealt with when you have been ‘fixed!’).
I have an empadronmento, so would use this if I really had to.
I have been told by the staff at my local centre that they would not turn me away in an Emergency…
So a small peace of mind.
It is difficult/worrying though if you are unfortunate not to have work and be from another EU country - as we are not covered as far as I know. Spanish citizens will get free cover no matter what by default (and why shouldn’t they.
I choose to live here, so have to comply with local rules.
It would be ‘good’ though if we were truly integrated & the free cover we enjoy in the UK were also applicable here.
