Health Care System

Given the current situation, it is clearer than ever how important it is for all citizens to have access to a quality health service. The Spanish Health Care System is open for Expats if they comply with the requirements.

Taking advantage of the fact that Spain has the best public health service in Europe and the third best in the world, in addition to our public service covering practically all existing medical services, we would like to take this opportunity to inform you that there is initially the possibility of accessing the Spanish Social Security System for those foreigners who are residents in Spain.

We will now indicate how to join this Social Security System in the main areas that receive foreigners in Spain, Madrid, Catalonia, Valencia and Andalusia, since each Autonomous Community has its own conditions of access. If you are in any other city of the Spanish territory and you want us to inform you, do not hesitate to contact us.

MADRID HEALTH CARE SYSTEM

In Madid, the procedure for requesting the underwriting of the Special Agreement for the Provision of Health Care for persons residing in Spain who are not insured or beneficiaries of the National Health System (NHS), which includes the basic common portfolio of NHS care services, but does not include the complementary common portfolio (pharmaceuticals, ortho prosthetics or dietetic products prescribed on an outpatient basis), goes as follows:

It can be requested by people who reside in the Community of Madrid and do not have a recognised right to health care from the National Health System.

In order to subscribe to this Agreement, you will have to cover the amount of 60 EUR per month if you are under 65 years old, and 157 EUR per month if you are older.

How does the process work?

For the application, you must identify yourself properly with your passport or identity card, fill in the appropriate forms and prove your continuous residence in Madrid for one year (it will also be valid to provide proof of residence in another Spanish municipality immediately prior to your census registration in Madrid).

Within one month a resolution will be issued by the Director General of Planning, Research and Training estimating the appropriateness of underwriting the Special Assistance Agreement. After obtaining a positive result, the interested party will have a term of three months for the formalisation of the Special Agreement, to contact the Subdirectorate General for Health Planning and Insurance of the Directorate General for Planning, Research and Training, through the telephone numbers provided, and sign the Special Agreement in duplicate, and one of the two copies will be given to the interested party (please note that the signing of the Special Agreement does not entail the issuance of the Individual Health Card).

The Document for Health Assistance-Special Agreement RD 576/2013 will be printed through SIP-Cibeles, which will include the personal data of the subscriber, as well as the assigned professionals and health centres.

CATALONIA HEALTH CARE SYSTEM 

We proceed to inform you about the procedure for requesting the signing of the Special Agreement for the Provision of Health Care for persons residing in Spain who are not insured or beneficiaries of the National Health System (NHS), which includes the basic common portfolio of NHS care services, but does not include the complementary common portfolio (pharmaceuticals, ortho prosthetics or dietetic products prescribed on an outpatient basis).

It can be requested by people who reside in CATALONIA and do not have a recognised right to healthcare from the National Health System. Note that these people can have access to the Catalan Health Service (Sistema Català de la Salut – CatSalut) and Integral health system for public use of Catalonia (Sistema Sanitari Integral d’Utilització Pública de Catalunya – SISCAT) in case they meet these requirements: 

  1. Not having recognised the status of insured of beneficiaries of the National Health System.  
  2. Not being protected by a special case foreseen in the law (under 18 years old and pregnant women, although not registered or authorised as residents in Spain). 
  3. Not being entitled to public healthcare in application of community regulations and international conventions, not being subscribed to a special convention/agreement for the provision of public healthcare, not being entitled to the provision of public healthcare for people applying for international protection and last but not least, not being entitled to provision of health care for victims of human trafficking in the period of recovery and reflection. 
  4. Proof of being registered in a municipal census in Catalonia. 
  5. Proof of having an income below the amount corresponding to the basic income for inclusion and social protection in accordance with the law. 
  6. Not having access to public healthcare through another entity different from the Catalan Health Service (Servei Català de la Salut). 
  7. Applicants must sign a document by which they authorise CatSalut to verify the data declared and check their veracity. 

 

How does the process work?

Those who can apply for public healthcare through census registration even if they are not insured or beneficiaries of the National Health System (NHS) have to present the application to the Primary Care Center (Centre d’Atenció Primària – CAP). Attached to the application, the applicant has to present the following documents: 

  1. NIE, TIE or PASSPORT. In case it’s a passport, it’s mandatory to provide the documentation of identification that was presented to submit the census registration application. 
  2. Proof of being registered with a municipal census in Catalonia. 
  3. Proof of income below the amount corresponding to the basic income for inclusion and social protection in accordance with the law. 
  4. Proof of not having access to public healthcare by another entity different from the Catalan Health Service (Servei Català de la Salut). 
  5. Document signed by the applicant by which you authorize CatSalut to verify the data declared and check their veracity. 
  6. Document signed by the applicant by which you authorize CatSalut to charge you the sum of the expenses of the corresponding healthcare services in the event of having sufficient financial resources.  

VALENCIA HEALTH CARE SYSTEM

The special agreement for the provision of health care signed with the Generalitat (Valencian Regional Government) allows access to the health benefits of the basic common portfolio of health care services of the National Health System, in the area of the Comunitat Valenciana and during the period of time during which the agreement is in force, covering all services except those included in the supplementary common portfolio of the National Health System, such as pharmaceutical, orthopaedic, dietetic products or non-urgent health care transport.

What are the requirements?

  1. a) Proof of effective residence in Spain for a continuous period of at least one year immediately prior to the date of application for the special agreement.
  2. b) Being registered, at the time of submitting the application to sign the special agreement, with a municipality belonging to the territorial area of the Community of Valencia.
  3. c) Not having access to a public health protection system by any other title, whether by application of national regulations, Community regulations on Social Security or bilateral agreements that have been signed by Spain with other countries in this area.

What fees must be paid?

The amount of the fees to be paid for the subscription of the special agreement for the provision of health care will be as follows, depending on the age of the subscriber on the date on which the corresponding monthly fee is due:

  • If the subscriber is under 65 years of age: monthly fee of 60 euros.
  • If the subscriber is 65 years old or older: monthly fee of 157 euros.

In the event that the subscriber to the agreement is under 65 years of age and during its validity has reached that age, the fee will be automatically updated to the amount foreseen for the 65 years. The update will take effect from the first day of the month following that in which the person reaches 65 years of age.

What documentation must be submitted?

Along with the application for a special health care agreement, persons who are not Spanish nationals will provide a document accrediting the Foreigners’ Identity Number (NIE), or failing that, a valid national identity card or passport, documentation accrediting the applicant’s effective residence in Spain for a continuous period of at least one year immediately prior to the date of submission of the application, documentation accrediting compliance with the applicant’s census requirement in a municipality belonging to the territorial area of the Community of Valencia on the date of application for the special agreement and SEPA Direct Debit mandate.

How is it handled?

Those interested in signing a special agreement for the provision of health care must formally request it from the Regional Directorate of the Ministry of Health of the province where their municipality of residence is located, submitting the corresponding application for subscription.

The competent Territorial Management, in view of the request presented and the fulfilment of the requirements, will dictate a reasoned resolution on the appropriateness of signing the special agreement and will notify it within a maximum period of 30 days from the following day on which the request is received. Once the period set has elapsed without the corresponding resolution having been issued and notified, the request to sign the special agreement shall be deemed to have been accepted.

The interested party will have a maximum period of three months, starting on the day following that on which notification of the resolution granting the request or the silence of the request is made, to formalize the special agreement with the public administration to which the request was addressed. If this period of time has elapsed without the formalisation of the special agreement for reasons attributable to the person concerned, the procedure shall be deemed to have lapsed.

ANDALUSIA HEALTH CARE SYSTEM

The Autonomous Community of Andalusia informs us that these agreements apply especially to citizens of the European Union who have lost the right to health coverage from their country of origin, as established in current European regulations, but is open to other foreigners as well.

Who can apply and what does it cover?

The special agreement will allow people who sign it to access the benefits of the basic common portfolio of care services of the National Health System regulated in article 8 bis of Law 16/2003, of 28 May, with the same guarantees of extension, continuity of care and coverage as those enjoyed by people who are insured or beneficiaries of the National Health System, within the scope of the Autonomous Community of Andalusia.

The basic common portfolio includes all the care activities of prevention, diagnosis, treatment and rehabilitation that are carried out in health or social-health centres, as well as urgent health transport. Pharmaceutical and orthopaedic services, dietetic products and non-urgent medical transport are excluded.

Any person who moves temporarily to the territory of another Autonomous Community shall be entitled to receive in that territory the benefits of the basic common portfolio of care services of the National Health System.

What requirements must I fulfil?

Proof of effective residence in Spain for a continuous period of at least one year immediately prior to the date of application for the special agreement.

Be registered, at the time of submitting the application to sign the special agreement, with a municipality belonging to the territorial area of the Autonomous Community of Andalusia.

Not having access to a public health protection system by any other title, whether by application of national regulations, Community regulations on Social Security or bilateral agreements signed by Spain with other countries in this area.

Application and processing

The procedure for signing the special agreement for the provision of health care will always be initiated at the request of the person concerned or a voluntary representative.

The application form, available at the Citizen Care Units of Primary Care Districts and Health Management Areas as well as on their website, may be submitted in any of the places indicated in Article 16.4 of Law 39/2015 of 1 October on the Common Administrative Procedure of Public Administrations and the application is addressed to the Management Directorate of the Andalusian Health Service, accompanied by the following documents:

  • Identification document of the applicant (DNI/NIE/passport).
  • Document certifying effective residence in Spain for a continuous period of at least one year immediately prior to the date of the application for a special agreement.
  • Certificate of registration in any of the municipalities of the Autonomous Community of Andalusia, with the date updated to the application of the special agreement.

In case the Management Directorate of the Andalusian Health Service decides to consider the application, two copies of the agreement form will be sent to the applicant’s home address for signing.

Financial compensation

The person signing the special agreement is obliged to pay, as a financial consideration for the benefits of the agreement, a monthly fee by means of a deposit in the restricted account of the Andalusian Health Service.

Currently, the amount of this fee is 60 euros for people under 65 years of age and 157 euros for those over that age.

 

At Lexidy, we are here for you should you require any assistance regarding Social Security and the Spanish Health Care System. We look forward to receiving your enquiry.