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Practicalities, healthcare and retirement

life's a beach - empty beach, chair and hat

Information about the practical side of living in Spain. All about healthcare, European Portable Documents (replaced the old E forms), insurance and not forgetting Spain's documentation so favoured by Spanish civil servants.

Healthcare

Spain has a national health service which is available to the majority of the population. The service is free to most who are in insured in the Spanish or another European social security system and also free in the case of emergencies and in one region, free for those with limited financial resources. Although described as a "national" health service, provision and regulations can vary, depending on the region of Spain. Except in emergencies, individual health cards need to be presented to GP's and hospitals in Spain. Each region of Spain issues different styles of health cards, but cards should valid in any part of Spain. People living in Spain should apply for their region's individual health card. Application processes vary according to location, but in general, people need proof of being insured in a European social security system, together with proof of residence in Spain, before cards are issued. Cards shouldn't be needed in emergency situations. People who are not insured in a European social security system, who haven't reached state pension age and whose resources are limited will need proof of income before being issued with health cards.

Visitors to Spain will need to show a European Health Insurance Card (EHIC). EHIC's are valid for publically funded treatment that becomes necessary during a stay in Spain. It is advisable to have travel insurance as well as a EHIC, because a travel insurance policy will usually cover treatment at private hospitals, clinics and at GP surgeries in Spain.

European Portable Documents, Spanish Residents Certificate, NIE

People who last worked in the UK should apply to the UK for an S1 form, now called "portable document". This will usually be issued to those who've made national insurance contributions within the previous two years in the UK if under state pension age, or to retirees who've reached state pension age, or to people who are in receipt of an exportable benefit from the UK (for example, long term incapacity benefit), or to people who live in Spain, but work for a UK employer (in the latter case, the document number is an A1), for example, someone who has been "posted" to Spain to work.

Individual portable documents should be issued by the UK to applicants and their dependent spouse or partner. Children of the family should also be covered. Once in possession of the document/s, take these (and proof of Spanish residence, marriage certificate if applicable, and NIE) to the nearest Spanish social security office in the place of residence in Spain for stamping. Health cards should be issued subsequently. It is important to buy travel insurance to cover for the period before acquisition of the card and to also be in possession of EHIC.

The Spanish social security office will usually want to see proof of residence in Spain as well as the S1 form and identity documents. Proof of being registered on the census or 'padron' at the town hall is required in some areas and/or proof of being resident in Spain in the form of a residents certificate. Applications for residents certificate can be made to a foreigners office in the area of Spain where living. Applications for a NIE (foreigners ID) can also be made to the foreigners office in the area where living in Spain or in advance of moving to Spain from the Spanish Consulate in London or Manchester. Small charges are levied for Residents Certificate and NIE applications. Application forms can be downloaded from the Ministry of Interior's website. Other documents that will need to be produced, again depending on where in Spain would include marriage certificates or proof of living together. Passports and an address in Spain are needed for NIE applications.

Applications for S1 or A1 portable document should go to the Pensions Service in the UK or to HMRC, depending on the document required. There are other European portable documents as well - these have largely replaced the old E-forms - the E106, for example. In theory, Spanish social security offices should also be able to assist with getting the correct portable documents from the UK authorities, but it is probably better to apply for the portable documents directly to the UK, and preferably before movingto Spain!

Early Retirees

In light of recent changes to laws regarding public healthcare in Spain, Europeans not insured in a social security system (because of early retirement from UK, for example) are required to have private health insurance covering all risks in Spain in order to be legally resident in Spain. Private medical insurance does not usually cover pre-existing conditions, which could present a problem for some. It is also necessary to show enough income so as not to become a burden on Spain's social welfare system, and proof of not being insured in another country's social security system allowing export of healthcare benefits to Spain. Proof of income, health insurance and for early retirees moving from UK to Spain, a letter from the UK authorities stating that the individual doesn't have entitlement to healthcare in Spain will most likely be required before a resident's certificate (required after living in Spain for three months) can be issued

General information about healthcare and the latest changes to healthcare provision in Spain can be found on the British embassy's website at www.ukinspain.com.

Income

Public healthcare in Spain is free for legal residents and insured workers, providing annual income does not exceed 100,000 euros.

Prescriptions

Medication is not usually entirely free and the cost is shared between Governments and recipients.

Valencia, Catalonia

The Valencian and Catalonian healthcare schemes, which used to cover residents not insured in another social security system,in exchange for a fee (270 euros per quarter in Valencia region) is no longer available to new applicants. There appears to be a facility in Catalonia for low income residents there to apply for individual health cards, providing the individual's resources are limited, however, corresponding healthcare would only be provided in Catalonia and not elsewhere in Spain.

Note: Spain's law regarding the new healthcare project is still in its infancy - changes were made in 2012. Please therefore check with the health authorities in the region where you intend to live to ascertain the actual situation. The British Embassy at www.ukinspain.com offers general and helpful information about healthcare and the changes on its website.

Forum

If you would like to discuss these changes with others in our forum or for any aspect of travelling to,living in or retiring to Spain, please join Pineapple's Spain forum. Membership is free of charge.