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-   -   Health care / how it works / dual nationality (https://www.expatforum.com/expats/spain-expat-forum-expats-living-spain/1495284-health-care-how-works-dual-nationality.html)

Alex2020 26th January 2020 07:27 PM

Health care / how it works / dual nationality
 
Hi all,

I have a few questions about health care in Spain.

To start with, I should mention that I'm lucky enough to have dual nationality (I have both English & Spanish passports), so (I think!) if I move to Spain, so long as I'm paying tax too, I should be okay healthcare wise?

So, what I'm not sure of is how a few things work.

I have an unruptured brain aneurysm, which doesn't currently need any treatment other than yearly scans to make sure it's not changed (health not really effected, other than have to keep blood pressure decent).

In the UK, my GP has referred me to a Neuro hospital and I have to go there every year (was 6 months, now once a year as seems stable) for an MRI scan just to check nothing has changed.

What I'm not sure of, is how I'd go about that is Spain? Also, could I choose which hospital I went to, for example? (in the UK you can choose your hospital for your first outpatient appointment).

I ask because there's one in the area I'm looking at, that seems very, very well respected in neurosurgery & neuro-interventional radiology, but I'm not sure if I can get referred by a Spanish GP, to a hospital that I choose (in the area I'd be living in).

Looking at Catalonia by the way, in case that effects anything.

Chopera 26th January 2020 08:26 PM

I live in Madrid and have regular PET scans on my lungs for metastatic thyroid cancer. Here you are assigned a hospital based on catchment area, i.e. the location of the medical centre you have registered yourself in. It is possible to be registered in a medical centre that is not particularly near where you live if it happens to be in the catchment area of a hospital you like, it just means you have to travel further to see your GP.

The hospital I am assigned to has a good reputation for cancer treatment (among other things), but I have to go to a different hospital for the scans, because that's where they have the machine. In order to "get into the system" I just went to my GP and he referred me to that hospital.

In my experience the different regions of Spain have different systems, so the above might not apply to Catalonia.

Alex2020 26th January 2020 08:34 PM

Thanks so much for your reply :)

So, just to check, did you ask the GP to refer you to the hospital you're assigned to? Wondering if/how much input it's possible to have, like if you can request a GP to refer you to the hospital of choice that's good for your condition, so long as you're in their catchment area?

Also, sorry for all the questions, but is there a way to find what the capture area of a hospital is?

Thanks! Really, really appreciate people's replies :)


Quote:

Originally Posted by Chopera (Post 15031524)
I live in Madrid and have regular PET scans on my lungs for metastatic thyroid cancer. Here you are assigned a hospital based on catchment area, i.e. the location of the medical centre you have registered yourself in. It is possible to be registered in a medical centre that is not particularly near where you live if it happens to be in the catchment area of a hospital you like, it just means you have to travel further to see your GP.

The hospital I am assigned to has a good reputation for cancer treatment (among other things), but I have to go to a different hospital for the scans, because that's where they have the machine. In order to "get into the system" I just went to my GP and he referred me to that hospital.

In my experience the different regions of Spain have different systems, so the above might not apply to Catalonia.


Chopera 26th January 2020 09:44 PM

Quote:

Originally Posted by Alex2020 (Post 15031526)
Thanks so much for your reply :)

So, just to check, did you ask the GP to refer you to the hospital you're assigned to? Wondering if/how much input it's possible to have, like if you can request a GP to refer you to the hospital of choice that's good for your condition, so long as you're in their catchment area?

Also, sorry for all the questions, but is there a way to find what the capture area of a hospital is?

Thanks! Really, really appreciate people's replies :)

Here it's one hospital per catchment area, i.e. each hospital has its own catchment area and they don't overlap. So AFAIK you can't ask a GP to assign you to a different hospital for the catchment area because there isn't one. I guess it might be different for unusual conditions though, and it might be different in Catalonia. I'm afraid I can't help with that.

I'm not sure how the catchment areas are assigned or where to look them up either I'm afraid. They probably base it on a number of factors to make sure patients are evenly spread between hospitals.

MataMata 27th January 2020 06:30 AM

Quote:

Originally Posted by Alex2020 (Post 15031514)
I'm lucky enough to have dual nationality (I have both English & Spanish passports), so (I think!) if I move to Spain, so long as I'm paying tax too, I should be okay healthcare wise?.

Whether British or Spanish there is no direct link between paying tax and entitlement to healthcare.

Also AFAIK Spain does not permit dual nationality so I think you need to check out that side of things first.

Not sure how it works in detail but if your Spanish nationalty is technical - due simply to parentage for example - and you have never lived or worked in the country it's possible it may not qualify you for health care.

As a rough parallel I believe that British nationals who have entitlement to Irish passports through parentage, and have gone down that route to overcome post Brexit free movement restrictions, cannot benefit from Irish healthcare - and a potential transfer to Spain - unless they are registered for it for which they have to have actually lived there for a year.

xabiaxica 27th January 2020 07:14 AM

Quote:

Originally Posted by MataMata (Post 15031694)
Whether British or Spanish there is no direct link between paying tax and entitlement to healthcare.

Also AFAIK Spain does not permit dual nationality so I think you need to check out that side of things first.

Not sure how it works in detail but if your Spanish nationalty is technical - due simply to parentage for example - and you have never lived or worked in the country it's possible it may not qualify you for health care.

As a rough parallel I believe that British nationals who have entitlement to Irish passports through parentage, and have gone down that route to overcome post Brexit free movement restrictions, cannot benefit from Irish healthcare - and a potential transfer to Spain - unless they are registered for it for which they have to have actually lived there for a year.

While it's true that Spain doesn't rescognise dual nationality with Britain, Britain does - so it's possible that the OP could be Spanish & have later taken British nationality without formally renouncing the Spanish one!

Brits who have taken Spanish nationality but not formaally renounced to Britain, can still have a Britiah passport. Britain doesn't consider that you've renounced unless it is to Britain. The renouncing you do when you take Spanish nationality doesn't count as far as Britain is concerned. You couldn't make it up!

If he has a Spanish passport & DNI then he should always use that to enter & leave Spain.

A Spanish national is entitled to access the healthcare system. That's it. No need to have worked, no need to have lived here previously. Paperwork needs to be done, but that's all.

Juan C 27th January 2020 07:29 AM

I have dual uk and Irish nationality. No problem in spain with that combination.

Spain in general do not permit dual Spanish and another nationality, However, there are a few exceptions so you either need to check that out toser of that includes you, or never carry your two passports at the same time

As for which hospital. I am 80 so have a number of things which need attention ! I have been referred by my GP to a few different hospital depending on which the GP decides is appropriate

PS. From mine, family and friends experience over my 30 years here, the quality of the treatment has varied from excellent to appalling/ dangerous. So good luck

xabiaxica 27th January 2020 07:44 AM

Quote:

Originally Posted by Juan C (Post 15031724)
I have dual uk and Irish nationality. No problem in spain with that combination.

Spain in general do not permit dual Spanish and another nationality, However, there are a few exceptions so you either need to check that out toser of that includes you, or never carry your two passports at the same time

As for which hospital. I am 80 so have a number of things which need attention ! I have been referred by my GP to a few different hospital depending on which the GP decides is appropriate

PS. From mine, family and friends experience over my 30 years here, the quality of the treatment has varied from excellent to appalling/ dangerous. So good luck

It's Spanish / British dual nationality that Spain doesn't recognise. Spain does recognise dual with some countries though.

Juan C 27th January 2020 07:50 AM

Quote:

Originally Posted by xabiaxica (Post 15031738)

It's Spanish / British dual nationality that Spain doesn't recognise.

I do not want to split hairs but I understand it is spanish and another which is not allowed, except as I said in certain circumstances which are not always simple to explain. I have friend who knows she must not show out that she has Spanish and Swiss passports

That is why I suggested those affected would be better to check their particular situation

http://www.exteriores.gob.es/Portal/...ionalidad.aspx

Overandout 27th January 2020 08:03 AM

Quote:

Originally Posted by xabiaxica (Post 15031720)
While it's true that Spain doesn't rescognise dual nationality with Britain, Britain does - so it's possible that the OP could be Spanish & have later taken British nationality without formally renouncing the Spanish one!

Brits who have taken Spanish nationality but not formaally renounced to Britain, can still have a Britiah passport. Britain doesn't consider that you've renounced unless it is to Britain. The renouncing you do when you take Spanish nationality doesn't count as far as Britain is concerned. You couldn't make it up!

If he has a Spanish passport & DNI then he should always use that to enter & leave Spain.

A Spanish national is entitled to access the healthcare system. That's it. No need to have worked, no need to have lived here previously. Paperwork needs to be done, but that's all.

This is all correct. My wife also has both UK and Spanish passports and this is exactly the situation.


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