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Healthcare When Retiring to Spain ...

Types of healthcare available.                How to apply and receive it                     Early retirees of non-pensionable age.  Types of medical facility..                         Useful addresses.

 

Types of Healthcare Available ....

Public

Spanish State Healthcare is amongst the best in the world. It was modelled on the British and Belgian systems. Most cities have hospitals, new ones are being built all the time, old ones extended and refurbished and the only problem seems to be the shortage of available doctors to man the new installations. In villages and towns where there is no hospital there is always a Health or Medical Centre where people register and where minor problems are dealt with. Each region or county will operate its own system and service levels will vary between regions, although the Costas tend to all have modern, efficient services. The patient does in theory have more power than in the UK, with the right to choose any hospital or specialist surgeon anywhere in Spain. More information may be found at www.seg-social.es

Private

The Spanish Private Healthcare sector is expanding all the time with new centres springing up and more modern facilities, or upgraded facilities seen nearly everywhere. The main insurers in Spain are Sonitas (www.sanitas.com) with upwards of 1.5 million paying members and DKV (www.dkvseguros.com) where prices for a couple of 55 years of age start at 70 euros per month each for basic care, rising to 230 euros each for top of the line care (prices accurate in 2007). Other international companies are BUPA (www.bupa.co.uk) and the Exeter Friendly Society (www.exeterfriendly.co.uk). The private sector ranges from medical centres where you can simply pitch up and ask to see a doctor, normally with basic facilities on site, such as x-ray and phisio rooms, to full scale private hospitals with modern up to date facilities and procedures.

Chemists and Prescriptions

Spanish people go regularly to the doctor and go even more frequently to the chemist. The chemist does seem to have far greater diagnostic and prescriptive powers than his UK counterpart. They will readily discuss, diagnose and recommend medicines, thereby avoiding long visits to the doctors.

Furthermore the Spanish do like their medicines and the sytem was critically started on the principle of self-medication, whereby individuals able to self-subscribe all manner of antibiotics and often quite powerful drugs that would inevitably require prescriptions in the UK.

Prescriptions are increasingly required however and they cost under 3 euros and are free for pensioners.

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Applying & Receiving State Healthcare

Pensioners

As you would expect, pensioners (women of 60 and men of 65) who receive a state UK pension may elect to have their pension paid in Spain together with certain benefits they receive. The process is quite complex and MUST start in the UK, involving an initial discussion with the Department of Works and Pensions:

The DWP, The Pension Service, Tyneview Park, Newcastle upon Tyne, NW98 1BA. Tel. 0191 218 7547, Fax 0191 218 7376,        

E.mail:  tv.customercare@thepensionservice.gov.uk

Website:  www.thepensionservice.gov.uk

NOTE: If you intend to have your pension paid into Spain and also to register for State Healthcare, then you will have to become a resident of Spain and this will have tax / fiscal implications which should be discussed with a financial advisor beforehand, in order to organise your affairs in a tax effective way, which fiscal resdency will require.

Your visit to the DWP will normally result in you receiving a duplicate copy of the pension / benefit transfer form, the E121. This form is needed in Spain. Do not leave without it.

It is recommended that you apply for your European Health Insurance Card (EHIC) so that you are covered health-wise whilst in Spain until you are officially registered with the Spanish authorities (see next section - How to Apply for Your EHIC Card).

Once in Spain, the local regional laws can differ slightly as to exactly how you go about registering for healthcare, therefore it is crucial to employ the services of a local expert who is familiar with the procedures and able to negotiate the bureaucracy and procedures (in Spanish) that are required. Such a professional may be contacted by clicking HERE.

In a nutshell you shall require your NIE number (Numero de identificación Extranjero), normally your application form for a residency permit (although rules and requirements for this are changing in 2007) your passport, proof of Spanish address (normally your Certificado de Empadronamiento, or "Padron"), your passport (photocopied), a couple of passport size full colour photos and your duplicate E121 forms.

Armed with all this you then go to your local Instituto Nacional de Seguridad Social (I.N.S.S.) where you trade the above for a Spanish Social Security Number which allows you to then register with your local medical centre, where you will be allocated a local G.P. and also entitling you to the receipt of State Healthcare and free prescriptions. Note that the medicines and drugs you are prescribed with will not necessarily be exactly the same as you are used to receiving in the U.K.

This procedure effectively transfers your residency status and free healthcare entitlements to Spain and you have become 'Spanish' in this regard. Therefore when you travel outside of Spain (and yet within the European Economic Comminity) you will require an EHIC card to receive free emergency treatment in Britain, or your home country, should you return and require medical treatment.

To ensure this whole process is achieved smoothly, it is recommended that you enlist professional help.

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For Early Retirees ....

The receipt of free State Healthcare upon early retirement to Spain is not self-evident and will be determined by various factors such as location and attitude towards foreigners by the local authorities, the length of time contributing to the UK NIC, your financial position and whether you hold a valid form E106, which is solicited from the DWP.(see previous section on Pensioners) by phoning 0191 218 7777. This form will only give you temporary cover in theory, although in practice if you are able to get fully registered locally, you may be able to receive healthcare for an indeterminate period. The cover will be from 2 to 5 years depending on how long you have been paying NIC in the UK and also how recently.

Note: the E106 form will cover other family members as well.

The most well used form of cover is the European Health Insurance Card. This entitles the holder (get one for each family member) to reduced cost or free emergency medical treatment at the same level as an 'insured' Spanish national. Note that the treatment on offer is notionally for emergencies only and therefore using this card will not entitle you to a Spanish National Insurance number, neither will it entitle you to registration with a local GP and free prescriptions. Applications are made easily online at www.ehic.org.uk , or you may ring 0845 6062030 or pick up a form from a local Post Office. Once received, this renewable Health Card will last from three to five years and it must be presented to the Emergecy Department of the Hospital or Medical Centre that you have visited.

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Types of Medical Facilities ....

Most cities have at least one hospital, others have several, some private, some public, all are normally modern, well equipped and with casualty or Ermergecy Departments called 'Urgencias'.

It is Spanish custom for someone from the immediate family to stay with the patient overnight and to act as a surrogate nurse. Don't be suprised therefore if the nurse does not visit you regularly during the day and night.

Smaller towns have medical centres, a large propeortion of which have recently been updated or had new ones built. Spain has prospered during the past 20 years and most Mayors have made it a priority to invest in brand new local medical facilities. Here in the 'Centro de Salud' or Health Centre the range of services will vary depending on funding and staffing levels. Some may have a couple of part time doctors and little else and others will have specialists and x-ray equipment, thereby obviating the need for Hospital visits.

Your local GP or 'Medico de Cabezera' will normally will normally work out of your local Centro de Salud and therefore it is prudent to assess whether the Centre in the area you intende to retire to does indeed have the requisite medical facilities that you require now, and also that you consider may become necessary in the future.

Note that in the quieter rural areas your local Health Centre may only be open for a few hours each day.

If you require specialist care that requires out-patient departments, then these are called 'Consultos Externos' and these would normally be available only from the Hospitals.

The private sector has smaller 'Clinicas Privadas' as well as full-blown private hospitals.

Dentists (Dentistas)

These are always private (apart from emergency extractions) and tend to be expensive, paying at least 50 euros for  check up and around 100 euros for a filling.

Chemists (Farmacias)

Every village has a chemist - profits on drugs are high. Even in small villages you can count on finding a lovely clean new bank and an equally bright new chemist. They are normally open during normal shop working hours of say 09.30 to 14.00 and then 17.00 to 20.30 Monday to Friday, half day Saturday and closed on Sunday. They are recognised by the Green Cross sign always on view outside and are called 'Farmacias'.

Each area will have its own 24 hour chemist or, 'Farmacia de Guardia' and you must ask around to find our which one it is for emergencies. They often take it in turns so be careful to check any rota that is displayed.

Useful Addresses

www.seg-social.es - for local Health Centres and National Social Security offices.

www.acespana.org - Age Concern España

www.imsersomayores.es - List of Nursing Homes

Emergencies - dial 112

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