Each country's health system is different and might not include all the things you would expect to get free of charge from the NHS. This means you may have to make a patient contribution to the cost of your care.
Visitors to Spain
Your European Health Insurance Card (EHIC) will enable you to access the necessary state-provided healthcare in Spain at a reduced cost, or sometimes for free when on a temporary stay. The Spanish health authority determines what treatment is considered necessary and cannot wait until your return to the UK.
The EHIC also covers you for treatment of pre-existing medical conditions, although it does not cover you if you are travelling for the express purpose of obtaining medical treatment. In this case, see our section about Seeking medical treatment in Europe.
The EHIC also covers you for routine maternity care provided the reason for your visit is not specifically to give birth.
Visit the Healthcare in Spain website, which gives more information about using your EHIC in Spain.
Find help in emergencies
If you find yourself in a serious, life-threatening emergency, you should call 112. This number is free of charge and valid in all Spanish territories. The Spanish word for A&E department is "urgencias".
Be aware that if you ask a hotel or travel representative to call a doctor, you may be treated privately. If you wish to be treated under the public system you must say so. Find more advice in the below section 'Health services and costs'.
Other important phone numbers to note down:
- 112 or 061 – ambulance (ambulancia)
- 091 – national police (policía nacional)
- 092 – local police (policía municipal)
- 062 – civil guard (guardia civil)
- 080 – fire brigade (bomberos)
- 900 202 202 – sea rescue (salvamento y seguridad marítima)
Health services and costs
State-provided healthcare is generally free of charge. However, in some parts of the country, particularly the outlying islands, you may have to travel some distance to find a state healthcare provider. If you need to call out a doctor in an emergency, make sure you have a valid EHIC and ask for state-funded healthcare.
Some hospitals and health centres (centro de salud) offer both private (privado) and state-provided healthcare (asistencia sanitaria pública) and it is up to you to inform them which service you require. They may also often have separate surgery times for private patients and those treated under the state system.
Generally, if you are asked to pay upfront, you are not being treated under the Spanish health service and your EHIC will not be accepted.
Important: your EHIC does not cover private treatment. Any costs incurred for private healthcare are non-refundable.
You should be particularly careful if healthcare arrangements are made by a hotel or travel representative. They might reassure visitors that they can claim back whatever is paid out, but they are referring to private insurance and not the treatment given under the EHIC.
It's always advisable to have adequate travel health insurance and accessible funds to cover the cost of any medical treatment abroad and repatriation. Repatriation for medical treatment is not covered by the EHIC.
Remember to keep all receipts and any paperwork (make copies if necessary) as they might be needed by you or your insurance company to apply for any refund or reimbursement.
Spanish health authorities are decentralised, so systems can differ quite drastically. A directory to all regional health bodies in the autonomous communities can be found on the Spanish health ministry's website (information mainly in Spanish). Simply select your region on the map provided and look for the section marked Servicio de Salud (healthcare system).
Dentists
Dental treatment is not covered by the public healthcare system unless it's an emergency. Most emergency departments or health centres have a dentist attached that can deal with dental emergencies.
Hospitals
Just like in the UK, you'll need to be referred by a doctor for any hospital treatment. Make sure you are referred to a public hospital as only these provide treatment free of charge. Again, even in a public hospital ensure you have a valid EHIC and double-check you are not treated as a private patient.
In public healthcare facilities, you have the right to insist your EHIC is accepted. You do not have to provide travel insurance details unless you choose to do so.
Prescriptions
Once you have a prescription from a Spanish state doctor, you can take it to any pharmacy (farmacia) in Spain. They can be identified by a green cross. There are prescription charges in Spain. When using your EHIC, people of working age are charged 50% and pensioners are charged about 10%. Pensioners will have to declare they are in receipt of a State Pension in order to pay the lower rate.
Prescription charges are non-refundable.
If you are told by a hospital that you require medicine following your discharge, you must take the hospital medical report to a doctor, who will give you a prescription. This is because doctors in public hospitals will prescribe medicines on the appropriate medical report but do not issue official prescriptions.
Bringing your own medicines to Spain
If you have a condition that requires you to bring your own medicines to Spain, you should have a letter from you GP stating what the medicines are and why you need them. If possible, have the letter translated into Spanish, as this will also be useful in case you need to see a health professional during your stay.
If any of your medicines fall into the controlled drugs category, you need to comply with regulations on drugs exports in the UK. In addition, you'll need to apply for the Spanish import license at your nearest Spanish consulate with the following documentation:
- license for exportation of controlled drugs
- full name, current address and contact telephone number of applicant or drug unit
- flight details (dates) and destination address in Spain
- fax number or address details to send the Spanish Import License once received from Spain
Making healthcare arrangements in advance
Although your EHIC covers the provision of oxygen, renal dialysis and routine medical care, you'll have to arrange and pre-book medical treatment before you go. You should always consult your GP or hospital before travelling. Also ensure you are not booked with a private healthcare provider, as these are not covered by the EHIC.
Oxygen therapy
Ensure your EHIC is valid before you travel. You will have to use the authorised oxygen company for the country you are travelling to.
If you need to receive oxygen therapy during a temporary visit to Spain, you must request it in advance in writing from the Spanish authorities. You should send this request at least one month before you are due to travel.
Oxygen therapy needs to be arranged directly with the Spanish authorities. Visit the oxygen page on www.healthcareinspain.eu, where a list of contacts and a template letter in Spanish is provided to help you make the arrangements.
Once you have sent the oxygen request directly to the Spanish authorities, it is your responsibility to then follow up with the relevant oxygen provider to confirm your request has been processed.
The British Lung Foundation (BLF) may have additional oxygen contacts for the country you are travelling to. Their website offers general advice about how to make travel arrangements, including advice on:
Ensure you allow plenty of time to make all your arrangements before you travel.
Dialysis
You should speak to the co-ordinator in your UK dialysis unit before you travel. They will contact the dialysis unit in Spain nearest to where you will be staying. The provision of dialysis will be subject to availability in Spain. The Renal Association website has a list of renal units in the UK.
Ensure you make your arrangements according to your UK schedule. Also, there may be different guidance depending on what type of dialysis you receive. Make sure you speak to your doctor before you travel. In addition, visit the National Kidney Federation website, which offers general advice about travelling with a kidney disease, as well as specific guidance for haemodialysis patients, peritoneal dialysis patients and guidelines for transplant patients.
Any other specialist treatment
If you need to receive any other specialist treatment, such as chemotherapy or other prescriptions, again it may be advisable to make arrangements for this in advance of your trip. Certain areas of Spain receive a large number of long-term visitors per year, which can mean high demand for certain services. Although you are not obliged to make arrangements for treatment in advance of your trip, not doing so may result in delays when you need to access treatment.
Living and/or working in Spain
Working in Spain
If you move to Spain long-term or plan to work in the country, you'll have to make sure to register with the Spanish authorities. Once you are registered to work in Spain and make National Insurance contributions, you'll be entitled to state-run healthcare on the same basis as a Spanish national. For further information, visit the Seguridad Social website (information available in English) and register with your local Treasury of Social Security (TGSS) office.
If you are a worker seconded to Spain or the family member of someone making UK National Insurance contributions, your employer should contact HM Revenue and Customs (HMRC) for the following forms:
- A1 (previously E101) – this will show that tax and NI contributions are paid in the UK
- S1 (previously E106 or E109) – this will give you and your family the same medical cover as Spanish residents
HMRC
Charity, Assets and Residence
Room BP1301
Benton Park View
Newcastle upon Tyne
NE98 1ZZ
For more information, visit the Moving abroad section.
Once issued, register the S1 form with your local INSS (Spanish Social Security) office before you register with your local GP surgery.
Studying in Spain
If you are coming to study or are currently studying in Spain as part of a UK-recognised course, you may be entitled to healthcare paid for by the UK government.
Also read:
Pensioners
If you are living in Spain and you receive a you receive a UK State Pension, or any other benefit that can be paid to you when you move abroad (exportable benefit), you may be entitled to state healthcare paid for by the UK. You'll need to apply for form S1 (a certificate of entitlement) from the International Pension Centre on 0191 218 7777. Once issued, register the S1 form with your local INSS (Spanish Social Security) office before you register with your local GP surgery and obtain a medical card.
Once you have registered your S1 in Spain, you will be entitled to apply for and use a UK-issued EHIC to access state-funded necessary medical treatment when you visit other EEA countries outside Spain, including when you return to the UK.
Early retirees
Since July 1 2014 you are no longer able to apply for residual S1 form.
If you already have a residual S1 this will not affect you – it will continue to be valid until its original expiry date.
The Foreign and Commonwealth Office (FCO) provides useful information about what UK and Spanish benefits are available to Britons living in Spain and information on driving regulations in Spain.
Prescriptions for residents
Spain uses a co-payment system where residents are required to pay a percentage of the cost of their prescription medication. If you are a pensioner and have paid more than you should have for prescription medication, speak with your pharmacist in Spain or local health centre to confirm the process for claiming a refund in your region.