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Spain boasts one of the most highly regarded and accessible healthcare systems in Europe, playing an important role in the well-being of its residents, including expatriates. The country offers a public healthcare system funded primarily through taxes, while also featuring a high-quality private sector. If you’ve just moved to Spain or are planning to do so, it’s important to understand how both systems work so you can make informed decisions about your healthcare.
Public healthcare in Spain
The National Health System (SNS) is universal, meaning that anyone registered with Social Security has access to free or very low-cost healthcare. This includes doctor visits, hospitalizations, emergency care, specialized treatments, and subsidized medications. To access public healthcare, you will need the Individual Health Card (Tarjeta Sanitaria Individual or TSI), which is issued once you are registered as a resident in your autonomous community and with Social Security.
What services are covered?
The National Health System provides a wide range of medical services, from primary care to hospitalization, including the following:
- Primary care: primary care is your first point of contact with the healthcare system. You will be assigned a general practitioner (GP) or family doctor at your local health center, who will oversee your overall health.
- Specialist care: if you need to see a specialist (such as a cardiologist, dermatologist, or gynecologist), you will first need to consult your GP, who will evaluate your case and refer you to a specialist if necessary.
- Emergency care: public hospitals offer 24-hour emergency care, which is completely free for residents. If you have a medical emergency, you can go directly to the nearest hospital emergency room or call 112, the emergency services number.
- Hospitalization and surgeries: hospitalization, including surgeries, is covered by the public system. This means that if you need to be admitted to a hospital or undergo surgery, you won’t have to worry about major expenses, as these services are state-funded.
- Medications: medications prescribed by public system doctors are subsidized, meaning you’ll only pay a portion of the full price. Pensioners, for example, enjoy an even higher subsidy, often paying minimal or no cost for their medications.
How to use the public healthcare system
Using the public healthcare system in Spain is straightforward. First, you’ll need to book an appointment with your general practitioner. This can be done online, by phone or by visiting your local health center. Your GP will monitor your general health and, if needed, refer you to specialists or order additional tests.
If you require medication, your doctor will issue a prescription, which you can take to any pharmacy. Always remember to carry your TSI, as it identifies you as a beneficiary of public healthcare.
Private healthcare in Spain
While public healthcare is of high quality, some expats and residents choose to use private healthcare, either to avoid waiting times or to receive more personalized service. Private healthcare is accessible through private insurance or by paying directly for services.
Advantages of private healthcare
- Shorter Waiting Times: while public healthcare offers excellent coverage, wait times for specialist appointments or non-urgent procedures can be long. Private healthcare typically offers faster appointments.
- Flexibility: private facilities often provide greater flexibility in appointment scheduling and more direct access to specialists without the need for a referral.
- Choice of Doctor: in the private sector, you can choose your doctor or surgeon, while in the public system, a doctor is usually assigned to you.
Private health insurance
Many people choose to take out private health insurance to complement public healthcare or to avoid using it entirely. Private health insurance plans vary in cost and coverage but often include:
- Direct access to specialists.
- Coverage for hospital stays in private clinics.
- Dental, eye care, or cosmetic services, which are often not covered by the public system.
Some employers offer private health insurance as part of their benefits package, which is a great advantage for expats.
If you decide to use private healthcare without insurance, it’s important to note that costs can be high. For example, a private specialist consultation can range from €50 to €150, depending on the clinic and specialty. More complex treatments, such as surgeries or hospitalizations, can be significantly more expensive. For this reason, most people who use private healthcare purchase insurance that covers some or all of these expenses.
Spain’s healthcare system is efficient, accessible and high-quality, both in its public and private forms. If you’re an expat newly arrived in Spain, it’s advisable to apply for your Individual Health Card to access public services, but you should also consider private health insurance if you prefer more flexibility in your healthcare. In any case, being well-informed will help you make the best decisions regarding your health during your time in Spain.
