5 WAYS FOR UK NATIONALS TO GET HEALTHCARE IN SPAIN WITH OR WITHOUT A NIE Number
How to get state healthcare if you live, work or study in Spain without needing private insurance.
UK PASSPORT HOLDERS IN SPAIN
If you are living in Spain before the end of 2020, your rights to access healthcare in Spain will stay the same for as long as you remain legally resident.
This guidance explains what you need to do in Spain depending on your circumstances. All residents in Spain need to register to access healthcare.
At the moment, UK nationals usually access the Spanish national health system in one of these ways:
1) Through entitlement to healthcare as a Permanent Resident if they’ve lived in Spain for 5 years.
2) Through entitlement to healthcare if they’re employed or self-employed in Spain
3) Paying directly into the public health insurance scheme
4) Registering a UK-issued S1 form with the social security office
5) Using a UK-issued European Health Insurance Card (EHIC) for temporary stays
TRANSFER HEALTHCARE FROM UK
The S1 form entitles UK nationals access to state healthcare on the same basis as a Spanish citizen. You’re entitled to an S1 if you receive a UK State Pension or certain other benefits.
Once registered for healthcare, basic state services are free, but there are some things that patients need to pay for. For example, you usually have to pay something towards prescriptions – either a reduced price or the full price.
WORKING OR AUTONOMOS
If you’re working or self-employed in Spain, you’re entitled to state healthcare on the same basis as a Spanish citizen. Your dependants are also entitled.
Register at your local health centre with your social security number. You can get a social security number from your local National Social Security Institute (TGSS) office in Spain. Your dependants need to register separately.
Once you’ve registered, you’ll get a health insurance card(SIP). Take it with you whenever you visit a doctor.
WILL BREXIT END MY HEALTHCARE?
If you’re living in Spain before the end of 2020, your rights to access healthcare in Spain will stay the same for as long as you remain legally resident.
This means you’ll continue to get state healthcare in Spain from 1 January 2021 on the same basis as a Spanish resident.
You’ll also have the right to apply for a UK S1 if you start drawing a UK State Pension.
If you’ve been a resident in Spain for 5 years or more, you can apply for permanent residency. This will give you access to state healthcare on the same basis as a Spanish citizen.
Once you’re a permanent resident, you need to register for healthcare at your local INSS office. They will give you a document which you need to take to your local health centre.
If the UK pays for your healthcare, for example through an S1 form, you cannot register for healthcare as a permanent resident.
If you are not a permanent resident and you are not working
You can apply to join the public health insurance scheme. This is called the Convenio Especial. You pay a monthly fee to join the scheme, which gives you access to the Spanish health system.
You can apply if you’ve been registered on the ‘padrón’ (at your local town hall) for at least one year. Find out how to apply at your local health centre in Spain.
If you’ve lived in Spain for less than one year and cannot get healthcare cover, you’ll need to buy private health insurance.
If the UK pays for your healthcare, for example through an S1, you cannot join the Convenio Especial.
If you’re a dependant of someone living or working in Spain
Dependants and family members are classified differently in Spain than the UK.
If you classify as a dependant of someone entitled to state healthcare in Spain (because they’re either working in Spain, a permanent resident or receiving Spanish benefits) you’ll need to apply at your local INSS office.
You’ll also need to show a letter stating that you are not covered by the UK for healthcare (documento de no exportación). You can request this by calling…
NHS Overseas Healthcare Services
Telephone: +44 (0)191 218 1999
POSTED REMOTE WORKER
If your UK employer has sent you to Spain temporarily (‘posted workers’)
A posted worker is someone who is employed or self-employed in the UK, but temporarily sent to another European Economic Area (EEA) country.
Currently, posted workers can use an EHIC or an S1 certificate to access Spanish healthcare.
HMRC has a helpline for National Insurance enquiries from non-UK residents. They can answer questions about posted worker status and explain which documents you will need to get healthcare while posted. There will be no changes to healthcare access for posted workers in Spain before the end of 2020.
You can continue to use your EHIC or S1 form during this time.
TRANSFER FROM UK TO SPAIN : using an S1 form
You may be entitled to state healthcare paid for by the UK if you live in Spain and receive either:
1) a UK State Pension
2) some other ‘exportable benefits’
NOTE: Not all UK benefits that can be claimed while abroad entitle you to UK-funded healthcare. Search for ‘Claiming benefits’ if you move abroad or contact Jobcentre Plus to ask about a benefit.
You may also be entitled to an S1 form if you’re a posted worker or a frontier worker (someone who works in one state and lives in another). You must contact HMRC National Insurance enquiries to find out if you’re eligible.
When you get your S1 form, you must register it with your local social security office (INSS). This will mean you and your dependants will be entitled to state healthcare on the same basis as a Spanish citizen.
HOW TO GET AN S1 FORM
If you have a UK State Pension, you must request an application form by phone from the Overseas Healthcare Services. This is part of the NHS Business Services Authority (BSA).
You must register your S1 at your local INSS office. The INSS will give you a Spanish social security number. Take this to your local healthcare centre to register.
You’ll be given a medical card which you can use when you visit a doctor.
UK-funded healthcare using an S1 from 1 January 2021
If you’re living in Spain before the end of 2020, your rights to access rights to access healthcare will stay the same from 1 January 2021 if you’re either:
> receiving a UK State Pension
> receiving another ‘exportable benefit’
> a frontier worker (someone who works in one state and lives in another)
This means that you’ll get:
> continued access to healthcare in Spain using your UK-issued S1 form
> a UK-issued EHIC for travel
> planned treatments in other EU countries via the S2 route
> access to the NHS in England, Scotland and Wales when you’re visiting the UK
STUDYING IN SPAIN
You can apply for a student EHIC. This is different from a normal EHIC and entitles you to cover for longer. Your EHIC gives you access to emergency or necessary state healthcare in Spain on the same basis as a Spanish resident.
An EHIC is not a replacement for travel insurance. You should have both to cover the duration of your course.
If you started studying in Spain before the end of 2020, your EHIC will be valid for the rest of your course.
MOVING BACK TO THE UK
If you return to the UK permanently you will be able to use the NHS like any other UK resident.