Access to Healthcare in Spain.
This information was presented by representatives of the Dept. for Works and Pensions, taken out of the package presented to attendees when the two representatives conducted meetings in Mallorca, March 23rd. 2010 and updated October 2012. Individuals should always check with the appropriate department(s) to ensure that the information contained here has not changed.
Please note that the form E121 referred to throughout this document has now been replaced by the form S1.
If you get a UK State Pension, Bereavement Benefit or long term Incapacity Benefit/Employment Support Allowance and you decide to move to Spain permanently, ask for your E121 from the International Pension Centre (IPC) in Newcastle, 00 44 191 218 7777. YOU MUST OBTAIN AN E121 BEFORE YOU BEGIN THE PROCESS OF ACCESSING THE SPANISH HEALTHCARE SYSTEM. Once registered with the Spanish authorities, the E121 gives you and your dependants the same medical cover in Spain as a Spanish national under the Spanish state-run health scheme. Make sure you ask the International Pension Centre to include any dependants on the E121 form when you apply for it. You can also ask the INSS to apply to the UK for a new E121 if you wish include them at a later date.
Note: - treatment given privately and repatriation costs to the UK are not covered - and - some social services may not be available. You may wish to take out private insurance to help with the cost of any treatment before your E121 is registered.
Registering with the Spanish authorities.
In order to register your E121 you´ll need to get the followng in this order:
1. Certificate of Residence in Spain (Certificado de Residencia/Numero de Indentificacion Extranjero) - available from the nearest National Police station:
2. Certificate as a Local Resident (Certificado de Empadronamiento) - available from the local Town Hall (at the Padron Office).
Advice on how to obtain these certifcates can be found on UkinSpain website, www. ukinspain.fco.gov.uk and on the Spansh Ministry of the Interior website (MIR) - or you can contact the local Comisaria de Policia for Certificate of Residence in Spain or Town Hall for Certificate as a Local Resident. Be sure to check what documents you will need to take with you and what will be the process to complete your application successfully. MAKE PHOTOCOPIES before you go to your applointment. If you forget something or neglect to have all the required documents it is unlikely that you will be allowed to proceed with your application and you will have to return another time.
Once you have your certificates take them along with both copies of your E121 form to the local Instituto Nacional de la Seguridad Social (INSS) office. They will keep both copies of your E121 and issue you with acceditation (Documento acreditivo del derecho a la asistencia sanitaria). Take the accreditation to the local health centre. Once you are registered you will be able to access the Spanish state-run health scheme. Upon payment of 10.00 Euros at a local bank, you will be issued with a plastic card at a later date, (Tarjeta Sanitaria individualizada Nacional), at the same health center; a card is required and the fee paid for every individual. The card is also necessary to fill prescriptions. FULL ACCESS TO THE STATE SYSTEM STARTS FROM THE DAY YOU REGISTER YOUR E121 WITH THE INSS.
What if your circumstances change?
You need to tell the International Pension Centre if you or a dependant family member:
- starts to work in or starts getting a pension from another country.
- changes address in Spain or moves to another country, including the UK.
Someone will also need to inform the IPC in the event of your death or that of a family member in receipt of a pension or benefit.
If you travel to the UK or another EU country.
If you travel to the UK or another EU country you weill need a European Health Insurance Card (EHIC) to get state healthcare. You will need to apply for your EHIC from the UK. If you are not contacted by the Department of Health you may phone the State Pension number below or pick up an application form at any UK post office.
Where to get more information.
For E121 or health care cover, phone: 00 44 191 218 1999.
For State Pension, phone: 00 44 191 218 7777
To find your local INSS office, visit www.seg-social.es and click on the link Direcciones y telefonos on the left hand menu.
Renewing Medical cards.
Medical cards are usually only valid for two years, the expiration date is on the card. There is no automatic notification process nor are new cards sent through the mail. It must be renewed before expiration, usually two weeks before, by taking it to the local healthcare center/clinic who will process the renewal. The card, upon payment of 10.00 Euros at a local bank, can usually be collected 10 days later. DO NOT LET THE CARD EXPIRE otherwise the Spanish authorities may require the indivdual the apply as though a nwe applicant and go through the process described above.