Health Care in Spain

by Mark Benson on August 2, 2009

What standard of treatment can you expect?

What standard of treatment can you expect?

Spain is one of the most popular destinations for expats and many people will be grateful to find out that the Spanish health care system is very simple, very effective and free to many people. However, you do need to understand how the system works, how you contribute and how the private healthcare sector in Spain operates.

The standard of health care in Spain

There are many people who have contributed to various medical threads regarding Spain on the forum and the vast majority of these have been very upbeat and very complementary about the overall standard of the Spanish health care system. There is obviously a great interest in medical treatment for those living and visiting Spain for prolonged periods because ultimately, as in many countries around the world, there is the potential to incur significant costs and often substandard treatment in some countries. However, thankfully Spain appears to have a good track record and a very simple and easy to understand system!

Moving to Spain

Before moving to Spain, as you would any country in the world, you need to do your homework with regards to various aspects of everyday life including health cover and the health care system. Thankfully, with Spain being a prominent element of the European Union you can and should apply for the new European Health Insurance Card (EHIC) which allows you to obtain emergency healthcare cover when in Spain.

Even though the EHIC is predominantly aimed at the tourist market, allowing those from within the EU to obtain emergency treatment on the same terms as the local population, many expats also use this during the early days of their move to the country. However, after a few weeks or a few months (if you’re lucky) you will need to look at the long-term situation and arrange the relevant healthcare insurance cover or join the Spanish health care system.

Free healthcare in Spain

There is a free universal health care system in Spain, very similar to that in the UK, although to become part of this scheme you need to obtain a Social Security number. As you would guess, to obtain such a number you would either have to work for a company in Spain or work for yourself from Spain. After obtaining your social security number you are then effectively covered for medical expenses and can use the Spanish health care system, to which you will be contributing.

There are other cases where free healthcare may be available including those unemployed before moving to Spain, students and in many cases those over 60 years of age may also enjoy free healthcare in Spain. However, you do need to be aware of changes in the regulations, how the system works and ultimately whether you are covered.

Private health insurance

As in many countries around the world private health insurance is something which is becoming more and more popular and more and more vital to many people. The ability to effectively jump the queue of the state health care system can often lead to much shortened delays in treatment which in many cases could be literally a lifesaver. It is worth noting that there is a very competitive health insurance sector in Spain which is reflected in the cost of private healthcare insurance in the country.

Obviously the cost of this healthcare will depend upon the level of cover you require, your age, your health and whether you may want your family to be included. Family private healthcare insurance in Spain is also another growth market and one which more and more people are subscribing to as the cost of privately funded medical care continues to rise and state services can be stretched in some areas.

Chemists in Spain

A number of people have commented upon various threads that the Spanish prescription system is very much looser than that in the UK and many items which need to be signed off by a doctor in the UK are readily available over-the-counter in Spain. Asthma inhalers and antibiotics are just two examples of medical products which are available over the counter without a prescription. It is also worthwhile remembering that if you register for free healthcare in the Spanish social security system you can obtain a 60% discount on prescription medicines and if you’re over retirement age there is no cost at all.

Booking a doctors appointment in Spain

Unlike the UK, where the telephone booking system is prominent across the country, the Spanish authorities have grasped new technologies and in some areas it is possible to book an appointment with your doctor via text or online. There are a number of comments in the Spanish Forum relating to doctor’s appointments and the standard of service across Spain which many expats will find encouraging.

While it obviously depends upon which area of Spain you are located, in general it seems that the Spanish GP system is very quick, very efficient and ultimately very rewarding. There are various comments regarding appointments being on time, the medical staff offering every assistance needed and ultimately, while you do not want to be in a doctor’s surgery, there would appear to be very little to worry about on the administration side.

Returning to the UK for treatment

It is rather surprising to see that a number of expats appear to return to the UK from their new Spanish base for medical treatment on a regular basis. As we covered above, there are many people who will qualify for free treatment and if you contribute to the system, why not make use of it?

Whether it is the speed of treatment or standard of treatment which appears to cause some people to look back “home” for medical treatment is debatable but for many people it is a cost which is avoidable and ultimately, according to the vast majority of posters in the forum, the standard of health care in Spain compares very well with the UK.

These are areas which need to be reviewed on a regular basis if you’re moving overseas, and especially to Spain, because ultimately money will be tight for many people and the opportunity to save some money on a regular basis could prove very useful. There’s also the issue of travelling when you are not well which can in some circumstances aggravate an existing medical condition.

Language issues

As you might guess, many expats who move to Spain may become embroiled in expats communities and are often slow to learn the local language and the local practices. There are a number of posts in the Spanish Forum which suggest that the inability to speak and understand fluent Spanish can make a visit to the doctor’s or a visit to the hospital more stressful than it should be. This is certainly a case where people moving to a foreign land need to understand the value of being able to speak, and understand, the local language.

Thankfully, for those who have not yet had the opportunity to learn Spanish, there are a number of translators available in doctors and hospitals up and down Spain which can be worth their weight in gold. Understanding and appreciating a potentially complicated operation in your homeland is difficult but the fact that you may not fully understand, as some information may be lost in translation, a Spanish doctor explaining the situation to you can lead to complications in your mind. Make use of translators where possible!

Health insurance aimed at expats

The expat community in Spain is so large that we have seen the growth of specific expat targeted health insurance schemes which have proved very beneficial to many people. Targeted and focused purely on expats living in Spain they tend to explain situations in a different manner to the traditional Spanish insurance policies and obviously they will be printed in your mother tongue!

It is debatable as to whether there is any improvement in quality upon taking out healthcare insurance for expats but ultimately if it gives the underlying customer, and potential patient, more confidence in the system then that is a major plus point.

General health in Spain

While it is interesting to look at health care in Spain, both the state system and the private healthcare system, the proof is very much in the pudding and it is worthwhile taking a look at the general health of the Spanish population and how this compares to other countries.

Figures available from the Organisation for Economic Co-operation and Development (OECD) show that Spain compares favourably on a number of levels to many other countries. A recent report suggested that the average life expectancy in Spain is 81.1 years which is over two years more than the OECD average which is 79 years. There was also impressive data available with regards to the infant mortality rate in Spain which stand at around 3.8 deaths per 1000 births which compares favourably to the OECD average of 4.9 deaths per 1000 births.

In general it also seems that Spain manages to obtain better value for money compared to other OECD member countries although like so many countries around the world there are problems with obesity which have yet to fully develop.

Overview of the Spanish healthcare system

Many people will be surprised to learn that Spain seems to have a very efficient and very impressive state run health care system which is complemented by a well-developed private healthcare sector. This offers visitors and expats the opportunity to take state cover for medical treatment and potentially top this up with private healthcare cover if they can afford it. Whether countries like Spain, and the UK, will be able to run their free healthcare systems in the future remains to be seen because medical costs seem on the whole to be rising quicker than incomes and tax funding.

It is interesting that various comments about the Spanish healthcare system on the Internet, and the comments associated with the Spanish forum, seem to back up the general opinion that Spain offers a more than competent healthcare system which is in many ways comparable to the UK model.

Doing your homework before you arrive in Spain

Even though there are similarities between the Spanish healthcare system and the UK NHS you still need to be fully aware of how the system works, how you join and ultimately how you get the best out of the services available. Health care is a vital element of everybody’s life and as we have mentioned on numerous occasions, too many people automatically assume that the system in their new homeland will be the same as that in their mother homeland. In many circumstances this is a very dangerous assumption to make and can have worrying consequences.

The more pressure you can take off yourself as you get ready to move overseas the better and being aware of how the system works and how you fund your contributions is a vital part of overall personal and family health care. Do not leave it too late!


While the NHS is often put forward as the best healthcare service in the world it would appear that the Spanish health care system has many similarities and is indeed in good shape. There will be stories, as in any country, of mishaps and long waits to see a doctor but on the whole it appears as though the Spanish system works and the fact you are able to book an appointment with your doctor via text or online is an interesting development which makes good use of the latest technology.

Like so many countries around the world, more and more people are looking to incorporate elements of the state healthcare system and private healthcare insurance in their everyday life. Some treatments will have long waiting times, which is inevitable, and it may be possible to slash these waiting times by taking the private healthcare route. However, the cost of such cover will be a vital element of any decision although unfortunately private healthcare may not be for everybody.

Why not check out the Spanish Forum where there are a number of everyday Spanish healthcare issues discussed with advice and information readily available to the masses. Those who have concerns about moving to Spain and the standard of treatment they can expect would seem to have very little to worry about.

{ 19 comments… read them below or add one }

McKenzie August 26, 2009 at 9:11 am

Can anyone tell me how to find out about official translators in Spanish hospitals? I have just read on the Expats Website that quite a few of these people are available for ex-pats who arenĀ“t fluent in Spanish.



Robin McLaughlin September 14, 2009 at 8:11 pm

Hello to all, i have recently had a long stay in hospital and had an ileostomy, due to this my wife and I have decided that we need to change our lifestyle.
I have thought about moving to spain on several occasions over the last couple of years, but i think now is the time to move. when we have settled all our matters in the UK i would like to move to spain.
My question is regarding the health service ( is it as good as people say it is ) and how hard is it to set up a business in spain, i would be looking to set up a Airport Shuttle service.

Robin McLaughlin


Sue September 22, 2009 at 10:34 am

My father had an ileostomy a few years ago and I know what a big operation that is, so I wish you all the very best with your recovery.

My experience of the health care system here in Spain is very very good. Although still in his forties, my husband had a small stroke and the care he has received here on the Costa del Sol has been first class. He is monitored now and has appointments at the hospital every couple of months, his own GP here sees him every 2 months for a check up and his prescription drugs are heavily discounted as we pay into the health system via social security.

I think it may be useful for you to visit the Spanish forum pages of the main expatforum website to get more replies to this question, and to your question about setting up businesses in Spain. The main forum is probably viewed by a lot more people than the blog.

Take care


Thomas Jones October 9, 2009 at 5:40 pm

Hello, I have a statement and a question. My wife and I have been living in Spain for 6 years. I have had a business here and paid social security for 2.6 years. during those years my wife and I have received the benfit of the Health Service. We both have our own N.I.E. numbers. However recently I visited our local health centre to organise a different Doctor. This was no problem for me however the administrator at the Health centre told me that my wife can no longer use the system and would need to complete a form E121 supplied by DWP in the UK. Can you please explain why my wife can no longer use the Spanish system?
Many thanks for any information you can provide


Allen September 17, 2010 at 12:59 pm

If you have ceased paying Autonomo you have probably lost the right to free healthcare under the Spanish system . I ASSUME THIS AS YOU STATE YOU 'HAD' A BUSINESS, (Past tense)


Magdalena Poullay December 12, 2009 at 9:32 am

Very informative site. Perhaps someone knows?. My husband and I are looking for a private health insurance that would cover pre-existing medical conditions as well as over 65’s in Spain. We are both retired.


RTas January 6, 2011 at 4:50 pm

i am 63 yrs not entitled to an english pension until i am 65. However i am about to relocate to spain how do i get health cover for the interim 2 yrs in spain.


Ann Howlett February 1, 2011 at 10:36 am

I have just heard that the European Commision pays Spain to provide english speaking translators in the health centres. is this true? if so how do we contact the right dept to demand a translator, as th translators here in Spain, cost €20 for the first hour and €10 there after, but with the appointment system here , all patients are given one time when they all turn up and wait for their turn, this means we can be waiting up to 2 hours, which would be cheaper to pay to see a private doctor. we are both over 65, and entitled to free health care


FEr April 25, 2011 at 3:38 pm

Ann, I¨m a spanish doctor; and I´m sorry to say that the European comission pays nothing to the Spanish Healthcare System. Whoever told you that has no idea what he´s talking about.


Jayne Williams June 14, 2011 at 11:08 pm

Hello, I am looking for a care in the home company that could look after my father of 82 for a couple of days a week, whilst his partner has a couple of days off. Things like getting him up and showered in the morning and getting lunch etc. Does anyone have any ideas? He lives in Torrox Costa, Costa del Sol. I have found a few companies but they only go to the west of Malaga.


Shirley Fisk November 20, 2011 at 3:43 pm

As an expat pensioner in Spain I am entitled to free Health Care. Is it true that if I married in Spain to a national from another country that they would also be entitled to the same Healthcare rights as myself?


Nina June 14, 2012 at 11:05 am

My son is working in Spain and has a social security card giving him free health cover, does his social security card also cover us, his parents?


Dot January 11, 2013 at 10:41 am

I will be 60 this year but I can't have my state pension till i'm 64 will I be able to use the NHS system in Spain for free or will I have to wait till I recieve my pension I am not working so I don't have a spanish social security number?


Maureen Andrews February 17, 2013 at 12:29 pm

My Husband is 74years old and since the crisis in Spain he now has to pay 10% of the cost of prescription drugs.We are full residents in Spain and my question is,if a Spanish person took up residency in UK would they have to pay a percentage of prescription charges.As far as I aware this should be a reciprocal agreement.I would be interested to hear comments on this and also does anyone know where I should direct this question to maybe an MEP.


Heather Stewart April 22, 2013 at 10:18 am

Hi my Mother living in Arroyo suffered a major Stroke two weeks ago. As her prognosis does not seem too good i was wondering if anyone knows how long they are likely to keep her in hospital or is there after care facilities for stroke sufferers?


mossieB July 20, 2013 at 2:39 pm

Hi, my wife and I have gotten our NIE numbers. What is our next step in becoming eligible for state health care?
Also, what is a `SIP CARD`?


salud y comunidad June 21, 2014 at 11:17 am

Can anyone tell me how to find out about official translators in Spanish hospitals?


Mrs jones February 3, 2015 at 10:36 pm

We are relocating to Alicante Spain my husband and I are 67 years old also we are taking my 8years old granddaughter We are both retired and paid our contributions into NHS in uK all our working life
do we qualify for free health insurance and prescriptions


scott dunnett June 15, 2015 at 8:36 pm

Hi all just a small question. My partner has MS and is on injections which is paid for by nhs would this happen in Spain or would we have to go private?


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