The Spanish Health Service
There are options available to you if you and your family have recently moved to
The options available are as follows and will depend on your own personal circumstances:
EHIC - (European Healthcare Insurance Card)
The better-known E111 health card was replaced by the EHIC (European Health Insurance Card) in January 2006. The current EHIC card allows you to receive emergency treatment when you are visiting other European countries and as such can be used temporarily in Spain, however it cannot be used to provide continuing treatment or if you are a permanent resident in Spain.
Please note that if you have children, then they will also need to be included in your application with each member your family receiving their own EHIC card. All EHIC cards are valid for 5 years and at which time will need to be renewed.
Application forms are available from the NHS website, more information here: http://www.nhs.uk/nhsengland/healthcareabroad/ehic/pages/about-the-ehic.aspx
You can also apply for a EHIC card by obtaining a form at your local Post Office branch: http://www.postoffice.co.uk/health-insurance-card or by calling the NHS directly on 0845 606 2030
There have been recent stories in the media suggesting that travellers are being denied treatment even though they have a valid EHIC card. Please see our page on the EHIC for further information.
As of April 2017 and following the Brexit referendum, there have been no changes in the issuing of EHIC cards by the NHS Business Services Authority. At this time you are free to apply for a new EHIC or renew your existing one via the NHS website above.
S1 Certificate (Replaces existing E106 / E121 forms)
Should you be relocating from the UK to Spain and are currently in receipt of a UK state pension, you will need to apply for an S1 certificate (replaces the existing E121 form) from the Overseas Healthcare Team in the UK. You will then need to register the S1 with your local INSS office (Instituto Nacional de Seguridad Social) so that you can receive your medical card and can also register with your local GP.
Upon receipt of this certificate, you will be entitled to treatment on a reciprocal arrangement, dependant on your UK contribution history. However, it is not unusual for Expats to experience some delays in receiving these certificates and for this reason many decide that it is simply easier to take out private health insurance in Spain.
There is also a further consideration to take into account, which is that once you have moved from the UK for a period of 3 months, then if you have also been issued an S1 certificate, you are not entitled to use the NHS free of charge unless you can prove that you are returning permanently to the UK. At the same time, once the period of entitlement in Spain expires, you will not then receive free medical treatment in Spain either.
IMPORTANT: Please note that from 31st March 2014, S1 certificates will no longer be issued to early retirees. This means that if you move to Spain after this time and have not reached pensionable retirement age, you will not be covered under the reciprocal arrangements between the UK and Spain. Further information can be found here http://www.healthplanspain.com/blog/health-news/275-expats-in-spain-set-to-lose-free-subsidised-healthcare.html
The S1 application can be done via the International Pension Centre (IPC) https://www.gov.uk/international-pension-centre on +44 (0)191 218 7777 or +44 (0)191 218 7280. Or The Pension Service at https://www.gov.uk/contact-pension-service - 08456 060 265 or by contacting the Overseas Healthcare Team on 0191 218 1999
Registering for Healthcare in Spain?
Although it is possible to register yourself in the Spanish Health Service, there are a number of steps required, not least of which are the requirements to be resident and also to be making social security contributions as a result of undertaking paid employment in Spain.
As a result, it is very common for Expats to take out private medical insurance, not just for medical care itself, but also for ambulance and dental services as well. If you think that you may fall into this category, it would be wise to take insurance sooner rather than later, so that you do not risk being uninsurable for medical problems which arise over the course of time.