Healthcare in Spain: A guide to the Spanish healthcare system

14.11.17
8 minute read
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Spain maintains a high-quality network of hospitals and medical centres throughout the country. Theoretically, you’re never more than 15 minutes away from one when you’re in Spain. The Spanish constitution requires the state to provide medical care, so the public system is robust. Spain’s medical network caters to a variety of needs, including home visits, surgeries and wellness checks. Life expectancy in Spain is one of the highest in the world.

Whether you’re packing up to move or have already settled in, this article will guide you through Spain’s healthcare system, including helpful information and tips on how to access medical treatment in your new country.

Quick facts on the healthcare system in Spain

Money in Spain is denominated in the euro and can be written as EUR in global trading markets or simply as €. Some other quick facts on Spanish healthcare:

  • Type of healthcare system: Public, with the option for additional private coverage
  • Average cost of an emergency room visit: €200 (£184, US$240, AU$160)
  • Average cost of a doctor’s visit: Free with European Health Insurance Card, otherwise €100 (£92, US$120, AU$80)
  • Number of pharmacies: 21,458
  • Number of hospitals: 453
  • Population covered by health insurance: 99%

You won’t always know your home currency’s exact value when you arrive in a new place as the global exchange rate always fluctuates. To figure it out, refer to an online currency converter to check your money’s exact current value.

At the time of writing, these are the very approximate exchange rates you can expect:

  • €1000 = £900
  • €1000 = US$1175
  • €1000 = AU$1500
  • €1000 =CA$1500

Average cost of healthcare in Spain

Is healthcare free in Spain?

If you want public healthcare in Spain, it’s yours. By living and working in Spain, you'll have access to state-funded Spanish healthcare. Private insurance plans are also available though. If you’re an unemployed non-citizen, you can pay a monthly premium for a private plan. Here are some estimated costs you might experience in Spain:

Medical Item Cost in Spain
Average monthly medical premium for an individual €50
One-day hospital stay €200
Primary Care visit €100
Specialist visit €150
12 months of prescriptions (maximum) A percentage of the full prescription cost, per drug, depending on your social situation

Prescription costs will vary depending on your economic status. You’re expected to contribute a certain percentage based on your standing. Here is a table of the breakdown of what you can expect to pay:

Annual Income Social Situation % Contribution Contribution Cap
€18,000 or less Of working age 40% No cap
€18,000 or less State pensioner 10% €8 per month
Between €18,000 and €100,000 Of working age 50% No cap
Between €18,000 and €100,000 State pensioner 10% €18 per month
More than €100,000 Of working age 60% No cap
More than €100,000 State pensioner 60% €60 per month

When heading to Spain, consider a TransferWise borderless multi-currency account, which helps you receive and organise your money without crazy fees or even crazier exchange rates. You’ll just pay a small transparent fee when your money moves between currencies. You can send money to over 50 countries and manage money in tens of different currencies, including euros.

Spanish medical system: Public, private, universal, national, state, single payer - which is it?

Spain is known for having one of the top healthcare systems in the world. In 2009, it was ranked as the 7th best in the world by the World Health Organization. The country has a universal healthcare system. Basic medical services are free, but if you have a surgery, stay overnight, or receive extensive prescriptions, expect to pay a reasonable fee. You’ll have the option of buying private insurance if you’d like more extensive coverage, or if you want to lower the risk of surprise emergency payments.

The Spanish state healthcare system

All Spaniards have access to the country’s universal healthcare system, called the Spanish National Health System (SNS), also known as seguridad social. It’s a very popular system, as it covers most healthcare free of charge. Foreigners also have the right to access SNS services if they're working in Spain or if they’re over the retirement age. Undocumented immigrants have the right to treatment if they enter an emergency room.

In terms of quality, the SNS isn't inferior to a private option. Patients can choose to see doctors as often as they’d like, without any copayments or claim filings. Spain’s top medical school graduates tend to practice within the public system, which speaks to the merit of the system. Also, unlike in other health systems, Spanish doctors aren't financially incentivised to peddle expensive prescriptions and treatments, so they're accustomed to recommending the cheapest course of action.

The Spanish private healthcare system

Spain also offers private insurance without any citizenship restrictions. Less than 20% of Spaniards pay for private insurance, and most do so for additional prescription or specialty coverage. 10% of people in Spain pay extra to be treated at private clinics, with wealthier Spaniards more likely to go. Sanitas is the largest health insurer in the country.

Signing up for the healthcare system in Spain

If you live in Spain and work or pay social security taxes, you’re eligible for the public SNS health coverage. You can register at the local health centre with your social security number, passport and foreign identity number. If you haven’t set up your social security number, make sure to do it ahead of time with the local health centre.

EU and UK pensioners are automatically eligible for the public SNS coverage once permanently living in Spain. Similar to those who are still working, retirees should register with their local health centre. You’re also entitled to discounts on most medical costs, including prescriptions and elective treatments.

Non EU or UK travelers must already have valid health insurance coverage before obtaining a residency visa. And, if you’re uninterested in the public system, private insurance is also widely available for additional monthly costs. If you’re American, there’s good news: monthly premiums will be much lower than they’re in the United States.

In case of an emergency in Spain

For emergencies, call 112 right away for an ambulance or police. All foreigners and citizens have a right to be served for emergency or urgent treatment in Spanish hospitals, no matter your insurance coverage or whether or not you have a general practitioner. Of course, if you have SNS coverage or private insurance already lined up, you won’t have to wait as long for care.

Hospitals in Spain

For non-emergency hospital visits, you’ll need to get a referral from your doctor before you can access hospital services. There are public and private hospitals in Spain, so you'll want to check ahead of time before scheduling treatment. The public facilities are free for those covered by SNS and generally low-cost for those not covered by state insurance. Private hospitals will charge a fee if your insurance does not match up, including those with state and private insurance holders.

Ambulance services can also be an additional expense. Non-emergency trips will cost somewhere between €20 to €120 depending on the distance. For those that are chronically ill or in need of constant transport, ambulances are about €10 a month. Otherwise, emergency transport should be covered by the public system at no extra charge.

Doctors and specialists in Spain

Whatever your coverage, it’s pretty simple to find a doctor in Spain. Most health centers in urban areas will have English-speaking staff; however it’s not uncommon for some providers to charge for an interpreter, ranging about €9 per hour.

Finding a GP / family doctor in Spain

Once you’ve registered with either the public or private insurance of your choice, you’ll have to register with a general practitioner in order to get an appointment. You can easily find nearby doctors through the public SNS catalog of primary care providers or through the list of approved providers through your private insurer.

Because most Spaniards have SNS coverage, public doctors will have a much longer list of patients, so be prepared to wait. Wait times can vary across regions, but some report average wait times at around 15 days for a GP appointment. Most hospitals and health centres have staff on hand who speak English. While you might hear Spaniards complain about the wait times, it’s all about perspective: in Spain there are ⅓ fewer deaths from delayed access to care than in the US, for example.

Specialists in Spain

If you want to see a specialist through the state system, you need to be referred by your family doctor. If you have private health insurance you may be able to visit a specialist clinic directly, although insurance companies generally have lists of approved doctors. For elective surgery, the average waiting time is about 61 days.

Note that dentists aren't available for treatment under the state system in most circumstances. Children under the age of 15 have the right to free dental care, but after that they'll be charged. In areas that are popular for expats, there are likely English-speaking dental practices. Dental work tends to be somewhat cheaper than in the UK, and significantly cheaper than in the US.

Health insurance in Spain: Cost and plans

The overwhelming majority of Spaniards and expats use the public SNS health coverage for insurance. It’s free for all citizens and permanent residents who work in Spain or qualify as a retiree. SNS doesn’t cover every health expense however. There’s some concern about the lengthy wait times to see public health providers. Pharmacy costs are additional out-of-pocket expenses where drugs can be purchased for 60% of the full price.

Private insurance is also widely available and can be purchased easily online. Sanitas, the largest private health insurer in Spain, offers coverage with monthly premiums that range from €100 to €200 per month, depending on the need.

Temporary health insurance for tourists

Your European Health Insurance Card (EHIC) will enable you to access the necessary state-provided healthcare in Spain at a reduced cost, or sometimes for free when on a temporary stay. If you’re in Spain for under 3 months, your EHIC should cover you. The card will only get you through the publicly-funded system, so if the clinic you’re at offers both, make sure you know which services are covered and which aren’t. Also, if you need an ambulance, make sure it takes you to a hospital that falls within EHIC coverage.

If you’re going to Spain just for medical treatment, be aware that the EHIC won’t cover your costs. For example, if you’re English, you’ll have to apply for an S2 Form that entitles you to NHS treatment outside of the UK. Check with your consulate on the exact requirements for this type of medical tourism.

For non-European travelers, it’s most likely that your private or public insurance coverage will work in Spain. Since every system is different, it’s best to double-check with your provider before traveling. Some expats prefer the private system because appointment wait times can be shorter than going through the public system.

Useful medical phrases in Spain

Should you need some medical help in Spain, these terms and phrases may help you out:

Medical term Spanish translation
accident accidente
ambulance ambulancia
broken bone hueso roto
dentist dentista
doctor doctor
emergency emergencia
heart attack ataque al corazón
hospital hospital
medical bill factura médica
medical insurance seguro médico
pharmacy farmacia
prescription prescripción
stroke embolia

Useful links

Whether you’re an expat relocating to Spain or simply visiting for holiday, it’s always important to know the ins and outs of the local healthcare system. Hopefully an accident won’t happen, but if it does, in Spain you’ll be in good hands. You’re never far from a hospital, and it’s extremely rare that you'd receive medical treatment that ends up being expensive. Keep this guide in mind as you travel so you can have fun and stay healthy.

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