rbs_gb

Long Post Warning - It may be best to comment without quoting!

Many of the online guides about applying for an NLV still tell you that you have to have private medical insurance without co-payments in order to apply for an NLV. This situation changed recently, and an S1 certificate from the NHS is now accepted as an alternative to private medical insurance. A few sites have been updated and say this, but the process of actually doing it isn't straightforward. Up until 2022, the S1 would be taken to the local office of the INSS (the Spanish Social Security) along with your visa to register for healthcare. With the new system, as you don't yet have your visa to register the S1, you have to complete a pre-registration process first. For the NLV application, your S1 has to be registered with the Spanish Social Security online first while you are still in the UK, and the consulate will accept a registration certificate from the Spanish Social Security, Not everyone qualifies for an S1, but anyone receiving a UK state pension should qualify.

Here is my experience, as I remember it!

Step 1: First you need to get your S1. Ring the NHS overseas business unit and do a telephone interview to tell them you want an S1. Use this link for more info: https://www.nhs.uk/using-the-nhs/hea...ur-healthcare/ Note: You will need to provide your Spanish address for this, and you will need it again later in the process. If you are eligible for an S1 they will send you two copies of the certificate in the post. If you can't get an S1, forget the rest of this, you will need private health care.

Step 2: You now need to register the S1 certificate online with the INSS using this link and this page is only in Spanish. That may change over time, but for me, everything from here on was in Spanish.

https://tramites.seg-social.es/acces...a-españa.html

Very important notes! This page will only work using a PC with a web cam, and ONLY on google chrome. I had to install chrome after getting advice and being told sorry, this page doesn´t work with other browsers. You might get past step 2A and 2B below but it will fail at step 3 was my experience. You should make sure that your privacy settings will allow chrome to access your camera. You will also need your phone to hand as parts of the process use two factor authorisation codes sent to your mobile. You will also have to complete email verification checks by clicking links in incoming emails. This whole process is in Spanish only, and you will get on screen instructions and prompts in Spanish at each stage.

Step 2A: You do the registration in two parts, the first part is to complete a C176 form, and that is the button where it says "Descargar PDF". You need to download this PDF form, fill it out on your computer and save it as a file because it is one of the documents you need for Step 2B. When completing the C176, you will need the PIN number of your S1 form. You will also need to know the full address and postcode of where you will stay in Spain when you first arrive. They will use this to pass your S1 application to the correct regional INSS delegation and that is where eventually you will complete the process to get your public health cover active in Spain. In my case, I had a phone call the next day from the Santander INSS office to invite me in for an appointment to complete the process. Wow!

Step 2B: Once you have completed C176 and saved it, you then go to the second button on the original page "Enviar Solicitud". For this you will need your passport to hand, your S1 certificate, and digital copies of the cover page of your passport and the page that show all your personal data. Caution! This page times out and needs to be completed in a single visit, without any option to stop or save it halfway through.

Step 3: You will see a graphic of a persons head and shoulders, arm to the left holding a document. At this point, using the PC camera, you have to hold your passport up in your left hand, open on the data page with your passport photo showing, and fit yourself in the bit with head and shoulders. You are using the camera on the pc to mimic the on-screen graphic. Make sure you don't obscure details on the passport with your fingers! Basically when you have everything "in frame" and in the right position, you take the photo. This records you and your passport details and effectively shows you are making the application in person. This photo has to be readable in detail by the INSS in Spain so make sure you stay still and everything is in focus.

Step 4: You then have to upload the C176 form you did at step 2A, and upload the two photos of the passport.

Step 5: A bit surreal, but you now have to literally sign the page. If you have a laptop with a touchscreen you could use that. In my case, I did the best I could to write my signature with the mouse!

So, having completed all this, and any two step verification checks, you can now "submit" your S1 application to the INSS, and you will get a confirmation email back that it has been received. All you can do now is hope you got it right!

Finally, in my case within two days of completing the process, I received a further email back confirming the S1 had been successfully registered with the INSS and a long confirmation code to use to get the actual registration confirmation document as a PDF. This is what you present with your NLV application at the consulate.

Final thoughts: This is just my experience. Your experience may vary! The whole process for using the S1 for an NLV is still relatively new, and for sure will evolve with time. A lot of people may prefer to simply pay for private health insurance for the purposes of the NLV application, and then register the S1 once in Spain.

Hope that helps
Ray

missile

Very informative post :-)

Jon-Bxl

Yes great post. Thank you, rbs-gb

Can I ask about step 1 please? If you are an expat (born in the UK with UK passport .... not sure if thats important ... But I mention it anyway) and will be eligible for a full UK state pension.... How can they deny you an S1 at retirement age ??

Thanks in advance

Jon

Lynn R

I agree, it's quite the most useful post I have seen on the forum for some time, thank you for taking the time to write it and I am sure NLV applicants will find it very helpful.

Rosemary

I have copied this thread and made it a sticky as it is so useful. Closed the sticky so that the discussion only takes place on this thread.

Rosemary

Ronnyone

You can be denied it if you are not in receipt of a UK pension- either you haven't paid enough qualifying years or you recieve a pension from another country. I guess its rare but I imagine someone on long time disability benefits or similar might not get a full pension but instead receive benefits and I'm not sure these qualify you for S1.

spainrico

I don't think a full pension is required for an S1 -

'The S1 form (previously the E121) gives 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 and you can use your S1 entitlement as “proof of healthcare” for your residency application.Jun 17, 2020'

https://www.gov.uk/guidance/healthca...ary-islands#s1

Jon-Bxl

Thanks ..... so in the question a UK expat who is eligible for (and will therefore receive) a full UK state pension is guaranteed to get a S1? (Currently)

Jon

rbs_gb

Wow, thank you all for the comments. For what it is worth, I was told by the Santander INSS "You're the first person we've seen using the pre-registration system".

In respect of eligibility for the S1 I'm no expert. My impression is that anyone getting a full state pension is pretty much guaranteed but as others have pointed out, not all pensioners receive the full state pension. They have a term "exportable benefit" and they work out a simple yes or no answer based on your history. It really is that binary, there isn't "half an S1". The online telephone interview with the overseas business unit took about 15 minutes (most of which I recall was spelling out the address in Spain and getting it correct). They tell you immediately if you are eligible for an S1. It really is the starting point for the whole process.

Listen Very Carefully

But an S1 will only kick in once you are resident in Spain or wherever.So waving an S1 around when you are still resident in the UK is a bit chancy is it not as depending on local regs you may not get its benefits straight away.eg in France you have to show three months residency to apply to join the French Health system as a retiree You need health insurance to cover that period plus the time it takes to process the application

rbs_gb

I've no idea about France, but this is very much a Spain specific method which does not apply anywhere else. The online pre-registration is an online equivalent of what most expats already in Spain and using an S1 will have done when they went to their local INSS office. When you get your pre-reigstration certificate, the Spanish INSS effectively have vetted your application to use the S1 to get public health care and have pre-approved it.

Ronnyone

I was thinking the same. Dont you already need to be a resident to get the S1?. I was trying to find out about this from the point of view of getting free healthcare if a permanent resident but not at retirement age. Like the other poster there was a telephone interview where you get lots of questions to see if you qualify for the carta de exportación. And that requires you to state your spanish address and things like when you got residency- so not sure how it works if you aren't a resident and need it for a visa. Incidentally they basically had no idea if you qualify for free healthcare after 5 years and just kept saying that is a decision for the Spanish authorities you just get the letter ( in spanish) to give to INSS but then they say that the letter is the S1 so its really not very clear what s going on!!

rbs_gb

Hi Ronnyone. No, that has changed. You can still do it that way, i.e get a visa using private health care, get an S1, take it to the INSS with your visa and residence etc. The method in the post started last year and is the *alternative* option for anyone who wants to avoid taking out private health care and use the S1 to apply for the NLV visa. Cheers. Ray

Ronnyone

I was thinking the same. Dont you already need to be a resident to get the S1?. I was trying to find out about this from the point of view of getting free healthcare if a permanent resident but not at retirement age. Like the other poster there was a telephone interview where you get lots of questions to see if you qualify for the carta de exportación. And that requires you to state your spanish address and things like when you got residency- so not sure how it works if you aren't a resident and need it for a visa. Incidentally they basically had no idea if you qualify for free healthcare after 5 years and just kept saying that is a decision for the Spanish authorities you just get the letter ( in spanish) to give to INSS but then they say that the letter is the S1 so its really not very clear what s going on!!

Fred James

I would suspect that the S1 is just a virtual authorisation that will only be activated when your visa is approved and the granting of a visa is notified by INSS to the UK.