Practicalities, healthcare and retirement
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 all who are in insured in the Spanish or another European social security system and also free in the case of emergencies and 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 who are no longer insured in any social security system and who are living in the Valencian Community can contribute to a scheme run by the Valencian government. The scheme costs about 270 euros a quarter per person, gives cover for the whole of Spain, but doesn't give entitlement to a European Health Insurance Card. People living in Valencia who are insured under the Valencian government's scheme should buy a travel insurance policy when travelling outside of Spain. The Catalonian government had a somewhat cheaper, but similar scheme for people who were not insured in any social security system, however it now appears that everyone resident for at least 3 months and on the census anywhere in Catalonia should be entitled to healthcare in Catalonia and to a individual health card issued by the health authority (CatSalut) there. Elsewhere in Spain, it would be a question of buying private health insurance if not insured in a European or Spanish social security system, and buying private health insurance can be a problem for people with pre-existing health conditions.
If you need more information or assistance with the formalities, you are very welcome to join Pineapple's Spain forum. Membership is free of charge.