Access to Spanish Healthcare System
Nov 3rd 2024 | 7:06 pm
#1
Thread Starter
Forum Regular
Joined: Jun 2016
Posts: 83
Access to Spanish Healthcare System
First, some background to my situation. Myself and my husband both have permanent residency in Spain. When we came over here, we started a business (which is in my husbands name), in order to access the public healthcare system. At the time we believed it was the only way to do it as we were not old enough to go the S1 route, so it was either that or one of us work or the Convenio Especial (which we couldn't find any information about before we left the UK).
The gov.uk website states that anyone who has residency in Spain is entitled to access the healthcare system. Is this correct? We have asked our gestor to check with the INSS if this is correct but she works part time and I don't think she has the time. My husband is fed up with running the business and wants to stop doing it, but can't if it leaves us with no healthcare.
Any help is appreciated.
The gov.uk website states that anyone who has residency in Spain is entitled to access the healthcare system. Is this correct? We have asked our gestor to check with the INSS if this is correct but she works part time and I don't think she has the time. My husband is fed up with running the business and wants to stop doing it, but can't if it leaves us with no healthcare.
Any help is appreciated.
Nov 3rd 2024 | 8:04 pm
#2
BE Forum Addict
Joined: Jun 2017
Posts: 1,130
From: Alicante
Re: Access to Spanish Healthcare System
The UK gov site is wrong, They have been told numerous times but persist in putting out this false information.
If you have been legally resident for one year then you can access the Convenio Especial scheme but at a cost, €65/mth if under 65 and €157 if over. The cost of medicines is wholly for you to bear.
If you have been legally resident for one year then you can access the Convenio Especial scheme but at a cost, €65/mth if under 65 and €157 if over. The cost of medicines is wholly for you to bear.
Nov 3rd 2024 | 8:08 pm
#3
BE Enthusiast
Joined: Aug 2018
Posts: 552
Re: Access to Spanish Healthcare System
This is an ongoing issue. The basic history is this. In 2018 the then new government brought in the Universal Healthcare Act. This was one of the first bills they proposed and at the time it was essentially interpreted as providing healthcare to undocumented illegals. Another expat website interpreted the act as giving healthcare to all residents and advised people to show the legislation to officials. They claimed to have legal backing to their interpretation. Soon after the Bill was published AndalucÃa cancelledl the convenio especial. Members on this site confirmed this and that they were now receiving free healthcare. However by 2019 AndalucÃa reastablished the convenio. The UK government website began writing that all permanent residents were entitled to free healthcare in , I think 2017 ( I may be wrong). However this is exactly 5 years after 2012 which was the cut off date for existing residents who previously all got free healthcare. It is suggested that this is why it appears on the UK government website but it is a complicated theory.
The website that promotes the line that all healthcare is free if you don't recognise NHS cover - seems to have adopted the line that the various communities are acting illegally and you have a right to free healthcare and should insist on it. ( Not sure how that works unless you envisage a situation where you refuse to leave the office!!) . However they also advise everyone to make sure they already have some form of healthcare in place anyway ( why if they say you are already entitled to it? They don't seem to explain this). They also don't address the reason why the junta in AndalucÃa reimposed the convenio which was initially their proof it was legal. Either way , in my opinion this has led to people being very confused and has introduced a sense of distrust towards the authorities.
So the present situation is this. The law which I will provide a link to has a paragraph ( 3) which deals with foreigners. Basically it says that you only get free healthcare if you have no resort to other resources. Now this appears to suggest that anyone who has private healthcare or is on the convenio has this - so they don't qualify. There is no mention of the 5 year rule in the legislation but this has entered into the expat community due to the aforementioned UK government website. All the law says is that you persons who don't need to show financial means get healthcare - which is interpreted as those people who move from temporary to permanent.
Now the website I refer claims that the Authorities are using immigration rules ( you cannot be a burden on the state) to interpret the healthcare act.
This is the theory. In practice after 5 years there appears to be scarce proof of persons getting free healthcare after becoming permanent residents. I have seen one post of someone in Catalonia getting it but this and lots of people saying " they know" someone but nothing concrete.
You can always try but first you need the Legislation letter from UK to confirm you don't receive NHS cover as that will need to be submitted. A second thing you can do is stop work and see what happens - you should get 90 days but some people say it simply continues. Either way good luck.
The website that promotes the line that all healthcare is free if you don't recognise NHS cover - seems to have adopted the line that the various communities are acting illegally and you have a right to free healthcare and should insist on it. ( Not sure how that works unless you envisage a situation where you refuse to leave the office!!) . However they also advise everyone to make sure they already have some form of healthcare in place anyway ( why if they say you are already entitled to it? They don't seem to explain this). They also don't address the reason why the junta in AndalucÃa reimposed the convenio which was initially their proof it was legal. Either way , in my opinion this has led to people being very confused and has introduced a sense of distrust towards the authorities.
So the present situation is this. The law which I will provide a link to has a paragraph ( 3) which deals with foreigners. Basically it says that you only get free healthcare if you have no resort to other resources. Now this appears to suggest that anyone who has private healthcare or is on the convenio has this - so they don't qualify. There is no mention of the 5 year rule in the legislation but this has entered into the expat community due to the aforementioned UK government website. All the law says is that you persons who don't need to show financial means get healthcare - which is interpreted as those people who move from temporary to permanent.
Now the website I refer claims that the Authorities are using immigration rules ( you cannot be a burden on the state) to interpret the healthcare act.
This is the theory. In practice after 5 years there appears to be scarce proof of persons getting free healthcare after becoming permanent residents. I have seen one post of someone in Catalonia getting it but this and lots of people saying " they know" someone but nothing concrete.
You can always try but first you need the Legislation letter from UK to confirm you don't receive NHS cover as that will need to be submitted. A second thing you can do is stop work and see what happens - you should get 90 days but some people say it simply continues. Either way good luck.
Nov 3rd 2024 | 8:09 pm
#4
BE Forum Addict
Joined: Aug 2009
Posts: 3,669
From: Costa Blanca
Re: Access to Spanish Healthcare System
Healthcare here is contributory (if you do not qualify for an S1 and thus the UK pays for you) - so if you are working in the Spanish system and contributiing you are entitled to cover but if you stop and close the business this route to healthcare is eventually closed.
Have you paid in long enough and are now entitled to a Spanish pension because this could cover you again?
The only other route is length of residence - some areas (now all?) will agree to give you cover if you can prove 5 years plus - this option has been discussed at length in the past on other threads and disputed by some people (probably not in Alicante province) where I know for a fact this has happened.
I suggest you talk to your local INSS office and explain your situation and see what they say.
Have you paid in long enough and are now entitled to a Spanish pension because this could cover you again?
The only other route is length of residence - some areas (now all?) will agree to give you cover if you can prove 5 years plus - this option has been discussed at length in the past on other threads and disputed by some people (probably not in Alicante province) where I know for a fact this has happened.
I suggest you talk to your local INSS office and explain your situation and see what they say.
Nov 3rd 2024 | 8:58 pm
#5
Thread Starter
Forum Regular
Joined: Jun 2016
Posts: 83
Re: Access to Spanish Healthcare System
The UK gov site is wrong, They have been told numerous times but persist in putting out this false information.
If you have been legally resident for one year then you can access the Convenio Especial scheme but at a cost, €65/mth if under 65 and €157 if over. The cost of medicines is wholly for you to bear.
If you have been legally resident for one year then you can access the Convenio Especial scheme but at a cost, €65/mth if under 65 and €157 if over. The cost of medicines is wholly for you to bear.
Nov 3rd 2024 | 9:05 pm
#6
Thread Starter
Forum Regular
Joined: Jun 2016
Posts: 83
Re: Access to Spanish Healthcare System
Healthcare here is contributory (if you do not qualify for an S1 and thus the UK pays for you) - so if you are working in the Spanish system and contributiing you are entitled to cover but if you stop and close the business this route to healthcare is eventually closed.
Have you paid in long enough and are now entitled to a Spanish pension because this could cover you again?
The only other route is length of residence - some areas (now all?) will agree to give you cover if you can prove 5 years plus - this option has been discussed at length in the past on other threads and disputed by some people (probably not in Alicante province) where I know for a fact this has happened.
I suggest you talk to your local INSS office and explain your situation and see what they say.
Have you paid in long enough and are now entitled to a Spanish pension because this could cover you again?
The only other route is length of residence - some areas (now all?) will agree to give you cover if you can prove 5 years plus - this option has been discussed at length in the past on other threads and disputed by some people (probably not in Alicante province) where I know for a fact this has happened.
I suggest you talk to your local INSS office and explain your situation and see what they say.
Nov 3rd 2024 | 10:58 pm
#7
Thread Starter
Forum Regular
Joined: Jun 2016
Posts: 83
Re: Access to Spanish Healthcare System
This is an ongoing issue. The basic history is this. In 2018 the then new government brought in the Universal Healthcare Act. This was one of the first bills they proposed and at the time it was essentially interpreted as providing healthcare to undocumented illegals. Another expat website interpreted the act as giving healthcare to all residents and advised people to show the legislation to officials. They claimed to have legal backing to their interpretation. Soon after the Bill was published AndalucÃa cancelledl the convenio especial. Members on this site confirmed this and that they were now receiving free healthcare. However by 2019 AndalucÃa reastablished the convenio. The UK government website began writing that all permanent residents were entitled to free healthcare in , I think 2017 ( I may be wrong). However this is exactly 5 years after 2012 which was the cut off date for existing residents who previously all got free healthcare. It is suggested that this is why it appears on the UK government website but it is a complicated theory.
The website that promotes the line that all healthcare is free if you don't recognise NHS cover - seems to have adopted the line that the various communities are acting illegally and you have a right to free healthcare and should insist on it. ( Not sure how that works unless you envisage a situation where you refuse to leave the office!!) . However they also advise everyone to make sure they already have some form of healthcare in place anyway ( why if they say you are already entitled to it? They don't seem to explain this). They also don't address the reason why the junta in AndalucÃa reimposed the convenio which was initially their proof it was legal. Either way , in my opinion this has led to people being very confused and has introduced a sense of distrust towards the authorities.
So the present situation is this. The law which I will provide a link to has a paragraph ( 3) which deals with foreigners. Basically it says that you only get free healthcare if you have no resort to other resources. Now this appears to suggest that anyone who has private healthcare or is on the convenio has this - so they don't qualify. There is no mention of the 5 year rule in the legislation but this has entered into the expat community due to the aforementioned UK government website. All the law says is that you persons who don't need to show financial means get healthcare - which is interpreted as those people who move from temporary to permanent.
Now the website I refer claims that the Authorities are using immigration rules ( you cannot be a burden on the state) to interpret the healthcare act.
This is the theory. In practice after 5 years there appears to be scarce proof of persons getting free healthcare after becoming permanent residents. I have seen one post of someone in Catalonia getting it but this and lots of people saying " they know" someone but nothing concrete.
You can always try but first you need the Legislation letter from UK to confirm you don't receive NHS cover as that will need to be submitted. A second thing you can do is stop work and see what happens - you should get 90 days but some people say it simply continues. Either way good luck.
The website that promotes the line that all healthcare is free if you don't recognise NHS cover - seems to have adopted the line that the various communities are acting illegally and you have a right to free healthcare and should insist on it. ( Not sure how that works unless you envisage a situation where you refuse to leave the office!!) . However they also advise everyone to make sure they already have some form of healthcare in place anyway ( why if they say you are already entitled to it? They don't seem to explain this). They also don't address the reason why the junta in AndalucÃa reimposed the convenio which was initially their proof it was legal. Either way , in my opinion this has led to people being very confused and has introduced a sense of distrust towards the authorities.
So the present situation is this. The law which I will provide a link to has a paragraph ( 3) which deals with foreigners. Basically it says that you only get free healthcare if you have no resort to other resources. Now this appears to suggest that anyone who has private healthcare or is on the convenio has this - so they don't qualify. There is no mention of the 5 year rule in the legislation but this has entered into the expat community due to the aforementioned UK government website. All the law says is that you persons who don't need to show financial means get healthcare - which is interpreted as those people who move from temporary to permanent.
Now the website I refer claims that the Authorities are using immigration rules ( you cannot be a burden on the state) to interpret the healthcare act.
This is the theory. In practice after 5 years there appears to be scarce proof of persons getting free healthcare after becoming permanent residents. I have seen one post of someone in Catalonia getting it but this and lots of people saying " they know" someone but nothing concrete.
You can always try but first you need the Legislation letter from UK to confirm you don't receive NHS cover as that will need to be submitted. A second thing you can do is stop work and see what happens - you should get 90 days but some people say it simply continues. Either way good luck.
Muchas gracias!
Nov 3rd 2024 | 10:59 pm
#8
BE Forum Addict
Joined: Aug 2009
Posts: 3,669
From: Costa Blanca
Re: Access to Spanish Healthcare System
From UK Gov site -
Once you’re a permanent resident, you need to register for healthcare at your local INSS office.
You’ll need to show a ‘legislation letter’ (‘documento de no exportación’ in Spanish) stating that you are not covered by the UK for healthcare. You can request this by calling NHS Overseas Healthcare Services.
NHS Overseas Healthcare Services
Telephone: +44 (0)191 218 1999
Monday to Friday, 8am to 6pm
Saturday, 9am to 3pm
The INSS 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.
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 on your regional health authority’s website.
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.
You may have the right to apply for a UK S1 if you start drawing a UK State Pension.'
This is what I (and I know many others) did (Ok it was some years ago) then - when I was eligible for UK state pension - I got my S1 which I then registered with Spanish health system so that my rights to access are now on that basis and the UK pays.
No doubt some areas applied their own rules and did not comply but in Alicante this was/is happening. I even know NON- residents with a SIPS card! Because local health centre (small village) wants to keep the numbers up.
'If you are not working and not entitled to an S1 form
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.
You’ll need to show a ‘legislation letter’ (‘documento de no exportación’ in Spanish) stating that you are not covered by the UK for healthcare. You can request this by calling NHS Overseas Healthcare Services.
NHS Overseas Healthcare Services
Telephone: +44 (0)191 218 1999
Monday to Friday, 8am to 6pm
Saturday, 9am to 3pm
The INSS 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
If you’ve lived in Spain for over one year, 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 on your regional health authority’s website.
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.
You may have the right to apply for a UK S1 if you start drawing a UK State Pension.'
This is what I (and I know many others) did (Ok it was some years ago) then - when I was eligible for UK state pension - I got my S1 which I then registered with Spanish health system so that my rights to access are now on that basis and the UK pays.
No doubt some areas applied their own rules and did not comply but in Alicante this was/is happening. I even know NON- residents with a SIPS card! Because local health centre (small village) wants to keep the numbers up.
Nov 3rd 2024 | 11:21 pm
#9
BE Enthusiast
Joined: Nov 2013
Posts: 305
Re: Access to Spanish Healthcare System
I'm not sure if I'm allowed to quote a thread from another forum, so please delete if not allowed....
https://www.expatforum.com/threads/d...hcare.1514442/ This thread has been running for some time but I'm not aware of anyone who has managed to get free Spanish healthcare without either paying into the system or lodging a S1 with the INSS.
If you are successful could you please let us know, I'm sure that it will help many other non-working permanent residents without a S1.
https://www.expatforum.com/threads/d...hcare.1514442/ This thread has been running for some time but I'm not aware of anyone who has managed to get free Spanish healthcare without either paying into the system or lodging a S1 with the INSS.
If you are successful could you please let us know, I'm sure that it will help many other non-working permanent residents without a S1.
Nov 3rd 2024 | 11:43 pm
#10
BE Forum Addict
Joined: Apr 2021
Posts: 2,185
Re: Access to Spanish Healthcare System
Why not try private insurance?
There is a good private system here in Spain. You will have to pay but if you do not have a very bad medical history than payments can be lower than going thru the local system.
If you are not working and have no possibility of earning an income - if this could apply to you then go to the town hall and see the social worker or your neighborhoods health center and see their social worker... They will/can arrange a temporary SIP card..
There is a good private system here in Spain. You will have to pay but if you do not have a very bad medical history than payments can be lower than going thru the local system.
If you are not working and have no possibility of earning an income - if this could apply to you then go to the town hall and see the social worker or your neighborhoods health center and see their social worker... They will/can arrange a temporary SIP card..
Nov 4th 2024 | 12:09 am
#11
BE Enthusiast
Joined: Aug 2018
Posts: 552
Re: Access to Spanish Healthcare System
I'm not sure if I'm allowed to quote a thread from another forum, so please delete if not allowed....
https://www.expatforum.com/threads/d...hcare.1514442/ This thread has been running for some time but I'm not aware of anyone who has managed to get free Spanish healthcare without either paying into the system or lodging a S1 with the INSS.
If you are successful could you please let us know, I'm sure that it will help many other non-working permanent residents without a S1.
https://www.expatforum.com/threads/d...hcare.1514442/ This thread has been running for some time but I'm not aware of anyone who has managed to get free Spanish healthcare without either paying into the system or lodging a S1 with the INSS.
If you are successful could you please let us know, I'm sure that it will help many other non-working permanent residents without a S1.
Nov 4th 2024 | 8:38 am
#12
BE Forum Addict
Joined: Jun 2009
Posts: 1,217
From: Valencia area
Re: Access to Spanish Healthcare System
I guess that the OP whose husband has a business pays tax etc (?)
If so they (as far as I know) pay into the SS and if so once that happens they will be entitled to join the Health System, in fact it should be automatic (again as far as I know)
If so they (as far as I know) pay into the SS and if so once that happens they will be entitled to join the Health System, in fact it should be automatic (again as far as I know)
Nov 4th 2024 | 9:22 am
#13
BE Forum Addict
Joined: Apr 2021
Posts: 2,185
Re: Access to Spanish Healthcare System
If they close their business then go to the unemployment office their state sponsored health care should continue if they are looking for work - even part time work.
Spain is not like the UK where it is free for all.
Nov 4th 2024 | 6:47 pm
#14
Polished expat
Joined: Jul 2014
Posts: 18,682
From: Arcos de Valdevez "Onde Portugal se fez"
Nov 4th 2024 | 8:56 pm
#15
BE Forum Addict
Joined: Jun 2017
Posts: 1,130
From: Alicante
Re: Access to Spanish Healthcare System
You can apply if you’ve been registered on the ‘padrón’ (at your local town hall) for at least one year.
