Healthcare is a fundamental aspect for UK nationals and their family members already living in Spain, or intending to come to Spain. Throughout the duration of the UK Nationals Support Project, Asociación Babelia has been continuously receiving enquiries on this matter. In this article, we aim to provide a detailed guide on this topic for those who are still struggling to access healthcare in Spain.
The Living in Spain Guide at gov.uk, provides detailed information on the different options to access healthcare in Spain. There are two different guides, one for UK nationals living in Spain and another one for those visiting Spain.
If you need specific information according to your individual circumstances, the Healthcare Team at the British Embassy in Spain also provides advice on this matter. To contact the healthcare team, please send an email to firstname.lastname@example.org
In this article, we will describe some of the most common options to access healthcare in Spain for those who are not covered by the Spanish Social Security System as employed, self-employed or as their dependent family members.
These options are:
- The S1 (for UK nationals holding a residency authorisation in Spain)
- The Convenio Especial
- Private healthcare insurance
There is however another option for those who are only visiting Spain:
- Temporary healthcare coverages: EHIC and GHIC
This article is only for orientation purposes and it does not represent any official sources of information. Please bear in mind that criteria may be different from an Immigration Office to another. For specialised advice on this matter, you may wish to seek individualised legal advice from an expert lawyer in the immigration field, or from the immigration department at your local town hall, at different organisations providing legal advice to third-country nationals, or at the Immigration Office (Oficina de Extranjería).
1. The S1
The S1 form is a document that allows UK nationals entitled to it and their dependents living in an EU country to public healthcare, as long as they are officially residents in that country.
If you are in receipt of a UK exportable benefit (e.g. a UK State Pension), or you are a posted worker/frontier worker paying compulsory National Insurance contributions in the UK, you and your dependents may be entitled to an S1.
For more information, access the NHS website at the following link: https://www.nhs.uk/using-the-nhs/healthcare-abroad/moving-abroad/planning-your-healthcare/
To access public healthcare in Spain using the S1, you need to be officially resident and to register your S1 at the Instituto Nacional de la Seguridad Social (INSS) – the National Social Security Institute.
How can I apply for an S1 form?
S1 form applications are managed by the Overseas Healthcare Service from the NHS.
To obtain your S1 form, contact the OHS.
- ☎ +44 (0)191 218 1999
- ✉ email@example.com
- ⌚Monday-Friday 8am-6pm (GMT)
In some cases, you may need to contact HM Revenue & Customs (HMRC) to request the S1.
In case you have any doubts about your entitlement to healthcare as a resident in Spain, you can contact the Healthcare Team in Spain by sending an email to firstname.lastname@example.org
Why do you have to register the S1 form?
In order to ensure the continuation of your healthcare cover, the S1 form must be registered with the Spanish authorities.
You can find a detailed guideline on how to register your S1 at this link.
Once I have registered the S1, can I access public healthcare when visiting the UK?
The NHS is a residency-based system, therefore, UK nationals who reside abroad on a permanent basis may lose their entitlement to free NHS healthcare.
According to the information provided by the British Government, UK nationals living in the EU on or before the 31st of December 2020 and their family members with a registered S1 do not have to pay for NHS treatment when visiting the UK.
However, UK pensioners living in the EU from after the 31st of December 2020 will have to ascertain whether the healthcare costs would be covered by the EU country in which they are living. For example, by an EHIC, PRC or S2. Otherwise, any treatment may be charged at 150% of the national NHS rate.
It is highly recommended to carefully read the article from the official source of the UK Government about Healthcare for visitors to the UK from the EU.
2. Convenio Especial for public healthcare
The Convenio Especial (special agreement for public healthcare) is a pay-in scheme for public healthcare services delivered by the Spanish regional health authorities.
It allows access to the public healthcare system by paying a monthly fee during the period of time in which the agreement is in force. In the Comunitat Valenciana provinces of Alicante, Valencia and Castellón), this fee is 60,00€ for those under 65 years old and 157 for those aged 65 or above.
Please, be aware that the Convenio Especial does not insure healthcare cover for the beneficiary while traveling to another EU country.
Who can apply for the Convenio Especial?
The Convenio Especial is addressed to those who do not have the status of insured or beneficiaries of the National Health System, nor have access to a public health protection system by any other title.
In the Comunitat Valenciana, one of the main requirements to be eligible for the Convenio Especial is to prove that you have been living in Spain for a minimum continuous period of one year immediately prior to the date of the request for the special agreement.
To prove that year of minimum residency, the most required document is the certificate of empadronamiento (Padrón or inhabitant register at your town hall).
please bear in mind the interpretation of this requirement in particular may vary from one region to another.
The Convenio Especial is an option recommended for people in vulnerable situations both at economic and health levels and the application has to be submitted to the health autonomous authorities in the region to which the municipality where the applicant is registered belongs.
Who cannot apply for the Convenio Especial in the Comunitat Valenciana?
- Individuals who have lived in Spain for less than one year.
- UK nationals already residents and accessing the Spanish healthcare system through the S1.
- Employees and self-employed in Spain paying the contribution to Social Security.
For more information on how to apply for the Convenio Especial, please click on this link.
3. Private Health Insurance
If you are not eligible for an S1, you are not registered under the Convenio especial or you want to have additional healthcare coverage for any reason, a private health insurance is another option to consider.
What kind of private health do I need?
In order to be eligible for residency in Spain, the private health insurance has to comply with certain requirements.
The policy of the health insurance has to be with no co-payments and equivalent or superior to the coverage that the Spanish public healthcare system offers. Therefore, it has to cover at least the following four areas:
- Primary assistance
- Specialised assistance
According to the experience of residency applicants in particular in the province of Alicante, it is advisable to submit to the Immigration Office a certificate clearly indicating all the specificities mentioned above.
Here is an example:
4. Temporary healthcare coverages: EHIC and GHIC
The EHIC (European Health Insurance Card) and the GHIC (Global Health Insurance Card) are cards that allow access to medically necessary, state-provided healthcare during a temporary stay in certain countries under the same conditions and at the same cost as people insured in that country.
Both cards have to be considered only for travel purposes and not for permanent residence of a UK National in another country.
You can find more information at the following NHS webpage: https://www.nhs.uk/using-the-nhs/healthcare-abroad/apply-for-a-free-uk-global-health-insurance-card-ghic/