Must know details re:
Medical cover and Treatment when you are in Spain
All residents in Spain should ensure they are covered by private insurance if Spanish Social Security or other contributions do not cover them. You will need to contact Newcastle to make sure of your individual circumstances as you are sometimes covered for a period after moving out to Spain, This is dependant upon contributions you made in the UK even though Valencia region has a reciprocal agreement between UK and Spain
Basically you need to know that...
There are big differences in health care and how you get access to health care between the individual EU member states. Many people make the mistake of thinking that as both Spain and the UK are members of EU, they will automatically have access to free health care here in Spain.
First and foremost there is no directive from Brussels, harmonising health care within the union. The only rule is that once having access to health care no discrimination must be made between EU citizens and nationals of the country.
Rule of thumb here in Spain is that access to health care requires that you contribute - but that is a general rule. The matter gets complicated by the fact that within Spain there are differences from province to province. Add to this that often the staff in medical clinics don’t know the laws – they are confused, so no wonder that foreigners living here are confused too. But, to make the confusion complete, the rules change so fast that what was correct yesterday might have no value today.
Being an employee or autonomous, makes matters more simple as you will then be contributing to Spanish National Health Care. As an employee, your employer will be paying on your behalf, as an autonomous you will be paying the contribution yourself.
You do not need to do anything to get registered with the Spanish National Health Service if you are employed, as this is the responsibility of your employer. If you are autonomous, it is your own responsibility to register. Filling in a Spanish form – not least to know which one – can be a bit complicated, so we recommend that you solicit the help from a professional. A Gestoria can do this on your behalf.
If you don’t fit into either of the two categories above, you need to make the NHS back in your home country contribute on your behalf. There are two possibilities. Either you are of pension age, or you are on disability pension in which case you need to contact Newcastle and apply for an E121 form.
When you first move out here you can apply for an E106 form. This form is meant for EU citizens, who plan to move to another EU country to work (free movement of work-force), as an interim method of having health cover while they look for work. Well, that is the idea, but the form is issued to anybody who applies for it, and who is up-to-date with their NHS contributions in the UK. The form is normally issued for 18 months, (sometimes longer dependant upon contributions) after which it is the holder of the form’s own responsibility to ensure he/she is covered in another way.
One thing is for sure, no matter where in Spain you live – whether you live in a province/municipality that will give you access to National Health Care without contributing or not – you need to be registered with INSS. INNS are the equivalent of Social Security in the UK, if you are not registered with INSS and issued with the correct card you simply DO NOT HAVE ACCESS to the Spanish National Health Service.
In Alicante region, where we are you, can obtain a temporary SIP card from the health centre on production of your European health card but this is by no means permanent and will only last for 6 months. You can keep doing this but eventually there may be a problem and your card will be out of date when you need it most.
It cannot be stressed enough that “thinking you have access”, “believing you have access”, “listening to friends, neighbours etc. assuring you that you have access” – is very dangerous …. especially for your bank account. Equally dangerous is to rely on an EHIC card, as this only gives you access to emergency treatment.
Believe it or not some people think they can just go back to the UK if they are sick, but this is also tricky because if you are registered as living here in Spain then you are out of the loop so to speak in UK. Britain’s rule for access to the NHS is resident-based. Even if you have managed to “beat the system” and keep access to NHS in the UK it is very brave to think that you’ll always be able to jump on a plane and go back to Britain – too many people have paid a high price for thinking like that.
So, what is the solution to this? Our recommendation is to reserve “beliefs” for your mental welfare and apply facts when it comes to your physical welfare.
Private Health Insurance?
If you cannot get access to the public health services you’ll have to put your health cover in the hands of a private health insurance company.
But as I am sure you can imagine, this in itself can be like walking in a mine-field, so you must be shrewd as to whom you choose to be your insurance provider.
A couple of things you should look out for are how the company adhere to the provisions of Spanish law. Spanish law allows an insurance company to:
- Reserve their cover for a certain period after joining the insurance scheme
- Cancel the policy if they find the risk having increased due to i.e. the diagnosis of a terminal illness
- Cancel due to age, when the risk increases
- To raise the premium due to age
- Operate with two different premiums – one for males and one for females
You should as well take into consideration whether you just want your medical bills to be paid or whether you want, as well, to ensure that you have the service from a company who is prepared to bridge the gap between you, as a foreigner living in Spain, and the Spanish ways of providing health cover. To find out more please see here...