The Spanish Health System
The Spanish government offers public healthcare to all its citizens and to foreign residents via its national health service. This service is largely free, since it is funded through taxes. Medication may not be completely free however, since patients are expected to contribute to the cost of the medicines they need, if they are able. The value of the contribution differs according to the patient's personal circumstances.
The Spanish health system, the 'Seguridad Social' in Spanish, is a decentralized system: the government works together with local councils to develop healthcare regulations. The government delegates regulation of public health in local areas to the local councils. Thus, the health system is essentially under the jurisdiction of the different councils, who influence both regional services and public healthcare regulations.
To improve the efficiency of the system, specific regional healthcare areas are further subdivided into health centres. The number of health centres in a city will depend on its population. Each health centre is responsible for providing care to a percentage of the local population: typically patients will live near to their particular health centre.
The health system offers two different levels of assistance: the primary care level, 'Nivel de atención primaria', and a specialised care level. Primary care includes, for example, consultations with a GP or 'médico de familia'. Specific medical treatments or complex medical procedures may be included in the specialised care level.
The Spanish national health system is accessible to everyone who is registered with the Spanish social security system, regardless of whether they are a local or a foreigner. To access medical assistance you must have proof of your social security registration in the form of an Individual Health Insurance Card, or 'tarjeta sanitaria individual'. Citizens of countries belonging to the European Union who need medical assistance will need to present their European Health Insurance Card, or EHIC. Non-EU citizens who do not have private health insurance will only be entitled to free medical assistance in an emergency.
However, non-EU foreigners who are living in Spain even for a short period of time should have private health insurance which covers medical assistance in the case of an accident or emergency. This insurance is a requirement of Spanish embassies and consulates, in order to be granted a Schengen visa which entitles you to free travel throughout Spain and other Schengen countries. Typically this insurance policy must offer €30,000 worth of cover, payable in case of an accident or a medical emergency.
The Schengen agreement allows the free movement of people, goods and services within participating countries. It is worth noting that not all EU countries are part of the Schengen Treaty: Ireland and the United Kingdom do not participate in the agreement. On the other hand, some non-EU countries such as Iceland and Norway do participate in the Schengen agreement. Switzerland also recently joined the Schengen area.
Instead of relying on the national health service, you may wish to consider private health insurance offered by many insurance companies. Private health insurance can prove to be more efficient in ensuring quality care, since waiting lists for private patients tend to be shorter than those for patients in the state health system. Patients who require specialised treatments often see the most benefit, since specialist waiting lists are notoriously long, but private insurance also covers many complementary health services such as alternative medicine. Companies who offer private insurance are called medical societies, or 'sociedades médicas'.
The Spanish health care system offers diagnosis and treatment of all illnesses, whether a patient requires a basic consultation, an emergency stay in hospital, or home visits. If you need to see a doctor you can usually attend the health centre, the 'Ambulatorio' or 'Centro de salud', nearest to your home. In case of emergency, you should go directly to a public hospital. Remember to take your ID card and health insurance card with you when you need medical attention. If you have private medical insurance, or any other insurance policy that covers medical care, your insurer may tell you to attend a private clinic instead, and provide you with details of suitable practitioners.
For more information on the Spanish healthcare system, see:
