Public Healthcare in Spain

17 April 2021

Healthcare & Health Insurance

Information on public health care in Spain and how to get access to it.

That said, you can occasionally "beat the system" with luck and persuasion.
For information about private health insurance in Spain, see our Semi-insider's Guide to Health Insurance – fully comprehensive and freshly updated!

Let’s not bury the lead: Spain has the #1 ranked healthcare system in the world according to the World Economic Forum for 2019! 

Global Competitiveness Index from 2019 showing Spain's healthcare ranked number 1 in the world.

Read the full competitiveness report for 2019 here

Yes, health care in Spain is free and universal, in fact it's mandated by the constitution to be provided by the government. According to the WHO, Spain’s healthcare is ranked 7th in the World, yet ranks 24th overall in cost per person (lower rank is better). For comparison purposes, know that the UK ranks 18th in healthcare effectiveness and 26th in costs per capita; the US healthcare system ranks 37th and 1st(!) respectively.

Graph showing nations' expenditures on healthcare per capita compared to life expectancy at birth from wikipedia.Expenditures on healthcare per capita compared to life expectancy at birth from wikipedia. No surprise, Spain does extremely well.

The cost effectiveness of Spain’s healthcare system, compared in terms of life expectancy versus spending, is 2nd behind Japan’s.

The problem is that to become an insured you have to have a social security number. To get one, you generally have to either work for a company or become self employed (in which case you’ll pay to be part of the system). That said, you can occasionally “beat the system” with luck and persuasion. An American friend of ours arrived to Spain when she was 76 years old, and managed to convince the people at the social security office to give her a number.

If your country of origin has universal health care, then you may be able to get your country to pay Spain to cover you. For the UK, this is the case for those over 60 and for some people who qualify for the invalidity benefit. You will need the appropriate form (E121 or E106).

In some cases, you may want to keep your universal health care provided by your home country if you intend to be back and forth between Spain and home. In this case it would be recommended to purchase additional health or travel insurance from a home-country insurance provider that supplements your universal health care for the duration of your stay in Spain. In Canada, for example, you will need to continue paying for your provincial health care and notify them of your extended absence from the country to ensure continued coverage. This is a requirement of getting private health or travel insurance anyway.

If you have a Certificado de Empadronamiento, you have the right to emergency care in any public hospital. Once any temporary health care from your country runs out, look into contracting Spanish health insurance.  Also see Doctors in Spain for more about your empadronamiento, getting your health care card and finding a doctor.

You do not need to be a legal resident or have economic means to access healthcare.

How to Access Public Healthcare in Spain

You need a healthcare card in order to access healthcare in Spain. However, if you are not registered (empadronado) you can only access emergency healthcare centres in the event of an accident or a serious illness.

How to get your Healthcare Card

In order to obtain your healthcare card, you need to be registered and join the Social Security system, even if you are in Spain in an irregular administrative situation (i.e. overstayed visa and/or have not empadronado).

These are the steps to obtain your healthcare card:

  • 1. Go to your nearest Tesorería General de la Seguridad Social (Social Security Treasury) to join the Social Security and apply for a Social Security number:
    • You must fill out the form and submit:
      • an official ID
      • your registration certificate (it must be original and the reason for applying for it must appear on the certificate)
    • Once you do that, you will be given a Social Security card with your name.
  • 2. Check the Seguridad Social website to access a directory of all the centres:
  • 3. Go to your nearest health centre and request a family doctor.
    • You will need to fill out the form and submit:
      • copy and original of the Social Security card
      • registration certificate (it must be the original and the reason for applying for it must appear on the certificate)
      • an official ID (passport, residence card, student card, asylum applicant card, inscription identity card, etc.)
    • You will be given a stamped document with the name of the doctor that is assigned to you. You can use that document to go to the doctor until your healthcare card is mailed to you.
  • You do not need to be a legal resident or have economic means to access healthcare. 
  • You need to be registered in order to access non-emergency assistance and obtain a healthcare card. 
  • You have the right to request accommodative services, such as an interpreter.
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