How The Healthcare System Works In Spain

Spain boasts one of the world’s top healthcare systems, with a framework centered on guaranteeing unrestricted access to health services for all its citizens and residents. The country’s publicly financed healthcare system is supplemented by a private system.

Spain’s publicly financed National Health System (Sistema Nacional de Salud, SNS) offers a broad range of services, including medical consultations, hospitalizations, specialized care, diagnostic tests, and more.

The Spanish healthcare model’s triumph is credited to its rapid implementation of innovative medical technologies and treatments, coupled with highly competent healthcare professionals trained to the highest standards, guaranteeing the provision of the highest quality healthcare services.

An Overview Of Healthcare In Spain

Spain’s healthcare system comprises two sectors: public and private, with the former managed by the autonomous regions and the latter comprising privately owned hospitals and clinics. In 2020, there were 342 public hospitals and 429 private hospitals in the country.

The system’s focus on prevention is a major strength and is achieved via measures including:

• Regular check-ups
• Health screenings
• Health education campaigns

This emphasis has contributed significantly to the country’s impressive life expectancy of 82 years in 2020, one of the world’s longest.

The primary care network is another standout feature, comprising health centers and general practitioners who are easily accessible to patients. Most non-emergency conditions can be treated at this level, with patients referred to specialists or hospitals if necessary, reducing the system’s burden.

Spain’s emergency response is exceptional, with a well-established network of ambulance services, emergency rooms, and intensive care units manned by highly skilled professionals, working around the clock to ensure patients receive timely care when they need it most.

Public Healthcare In Spain

Spain’s public healthcare system is regarded as one of the best in the world. The system is funded by taxes and social security contributions, making it available to citizens and legal residents alike.

Access to universal healthcare is guaranteed by law, meaning that everyone in the country has the right to receive medical attention, regardless of their financial status.

SNS is a comprehensive healthcare system that is available to all residents of Spain—including international citizens who are registered with the Spanish public healthcare system.

Overview Of The System

The management of Spain’s public healthcare system is decentralized and carried out at the regional level. Each of the country’s 17 autonomous regions is accountable for its own healthcare services.

Consequently, there could be disparities in the quality of care and services provided in different parts of the country.

Who Can Use Public Healthcare?

Anyone who is legally resident in Spain is entitled to use its public healthcare services. This includes:

• All legal residents, including those who are employed, self-employed, or retired
• Students who are studying in the country
• People in Spain on a long-term visa

Foreign visitors who are not residents in Spain are only entitled to limited public healthcare services. However, emergency treatment is always provided, regardless of a person’s residency status or ability to pay.

How Public Healthcare Is Funded

The funding for Spain’s public healthcare system comes from a combination of taxes and social security contributions, with the autonomous regions being accountable for managing and allocating healthcare funds provided by the central government.

Alongside taxes and social security contributions, patients in Spain must also make co-payments for some healthcare services. The amount of these co-payments varies, depending on the service and the patient’s financial standing.

For instance, patients may be required to make a small payment for the following:

• Medication
• Hospitalization
• Specialized consultations

However, pensioners and low-income groups are exempted from these obligations, providing some respite.

Some Important Service Details

Spain’s public healthcare system boasts a vast range of services, including primary care, specialist care, diagnostic tests, hospitalization, and emergency care. Patients can easily access these services at various health centers and hospitals situated across the country.

Primary Care

General practitioners and nurses at health centers offer primary care services that act as the initial point of contact for patients. This includes routine check-ups, medical tests, vaccinations, and health education. Patients can also receive referrals to specialists if required.

Specialist Care

Hospitals and clinics provide specialist care, where an array of specialists, such as dermatologists, ophthalmologists, cardiologists, gynecologists, and more, are available. Specialist consultations may require a referral from a general practitioner.

Diagnostic Tests

The public healthcare system also offers a wide range of diagnostic tests, including:

• X-rays
• MRIs
• Blood tests
• Other tests to aid in the diagnosis and treatment of medical conditions

Emergency Care

In case of emergency, patients can avail free emergency care services, without any charge, 24/7, at emergency rooms and hospitals throughout the country.

However, the public healthcare system does not provide all healthcare services. Dental care, for instance, must be paid for separately, and some medications, such as those for chronic or long-term conditions, may not be covered under the public healthcare system.

Major Deficiencies Of Public Healthcare In Spain

Spain’s public healthcare system is widely praised, but it does have some deficiencies and shortcomings. Additionally, the system is under pressure to lower costs and enhance efficiency, which could potentially undermine the quality of care provided to patients.

Current issues with the public system include:

• Challenges in accessing specialist care in certain regions
• Long wait times for specialist consultations
• Lack of autonomy in choosing a doctor or specialist
• Absence of English-speaking staff in public hospitals or care centers

Private Healthcare In Spain

Private healthcare services in Spain are available alongside the public healthcare system, providing additional options for those wanting to supplement or receive an alternative to public healthcare.

Overview Of Private Healthcare In Spain

Private healthcare services are typically offered by privately owned and operated hospitals, clinics, and specialized practices which are registered with the Spanish healthcare regulatory authorities.

Who Uses Private Healthcare In Spain?

Individuals who cannot access public healthcare insurance may seek private health insurance as their primary option. Considering there are more private than public hospitals, and a quarter of the people have private health coverage, private healthcare is a popular choice for many Spaniards.

These services are used by a range of individuals in Spain, including:

• People who want to bypass queues in the public healthcare system
• People who want access to newer treatments
• People who simply prefer the comfort of private healthcare services

Access to private healthcare in Spain is often provided through private health insurance schemes. Many insurers offer coverage for private healthcare services to complement the coverage provided by the public healthcare system.

How Much Does Private Healthcare Cost In Spain?

In contrast to other European countries, private healthcare in Spain is comparatively inexpensive. The expense of private healthcare is primarily determined by the nature of services and the level of treatment.

Several private health insurance policies in Spain permit individuals to select the level of care and services they require by providing a range of coverage options. These policies may cover:

• Dental care
• Vision care
• Diagnostic tests
• Specialist consultations
• Hospitalization
• Other services

Some Important Service Details And Benefits

Private healthcare services in Spain offer a range of benefits that are not provided by public healthcare services. Some of the key benefits of private healthcare in Spain include:

Quicker Access To Healthcare Services

Unlike the public healthcare system, which can have long wait times for medically necessary care, private healthcare services in Spain typically offer quicker access to medical treatments, procedures, and consultations.

Greater Choice And Flexibility

Private healthcare services allow individuals to choose the timing and location of their treatments, as well as the health care providers they will use.

Patients can also receive additional services that may not be covered by the public healthcare system, such as physiotherapy, nutrition counseling, or home-based treatments.

Fewer Restrictions

Many private healthcare plans offer more liberal policies that allow patients to seek treatments on their own terms, even if they may not be covered by insurance.

Higher Quality of Care

Private healthcare providers in Spain invest in advanced medical technologies and facilities, and employ some of the most skilled and experienced healthcare providers in the field. This results in higher quality, more personalized care services.

Greater Privacy and Comfort

Private healthcare providers in Spain offer private rooms in hospitals among other enhanced amenities. This adds to patients’ comfort and privacy.

They also provide additional options for more personalized and specialized care, offering a greater degree of autonomy in the health decisions made and treatments received.

Private Health Insurance In Spain

In Spain, private health insurance is available either as an addition to the public healthcare system or as a comprehensive policy that covers the entirety of healthcare costs. In early 2023, approximately one in every four people in Spain had private health coverage.

Major Health Insurers In Spain

The private health insurance market in Spain encompasses various insurers, ranging from international companies with a presence in Spain to Spanish-based firms that solely operate in the country. Some of the significant health insurers in Spain include:

Adeslas

As one of the most comprehensive Spanish-based health insurers in the market, Adeslas offers a wide range of health insurance plans, including those that cater to families and businesses.

Sanitas

Sanitas is a subsidiary of the global insurance company Bupa and specializes in providing health insurance plans with access to its network of medical centers and hospitals throughout Spain.

Mapfre

Mapfre is a renowned international insurance provider with a presence in Spain and offers health insurance plans that supplement public healthcare services or as standalone coverage.

Plan Types Available And Costs

Private health insurance plans in Spain are offered in many different types of coverage and range in price.

Two different types of private health insurance plans are typically available in Spain, they are:

• Those offered generally to residents in Spain
• Those specifically designed to cover expats, including those living in or visiting Spain

Costs for private health insurance in Spain vary significantly based on the extent of coverage provided and individual circumstances such as age, medical history, and pre-existing conditions.

Basic plans can start at around EUR €30-€50 (USD $33-$55) per month, while more comprehensive plans can range from EUR €150 to €300 (USD $164 to $328) per month or more.

Some plans require a co-payment, which is an additional fee paid by the policyholder upon receiving healthcare services.

Eligibility For Coverage

In general, anyone of legal age with a Spanish National Insurance Number (Número de Identificación de Extranjero or NIE) can apply for private health insurance in Spain.

Insurers may place restrictions or additional sub-limits on the coverage provided, depending on the following factors of the individual:

• Age
• Health status
• Prior medical conditions or treatments
• And more

Private health insurance plans in Spain generally do not discriminate based on nationality or residency status, meaning that both expats and Spanish residents can purchase the coverage.

However, certain plans offered by insurers in Spain are designed to specifically cater to foreign residents or visitors to Spain, so expats can look out for them as these plans may suit their needs better.

Ultimately, private health insurance in Spain provides another option to access quality healthcare services, adding to the healthcare options provided by Spain’s well-regarded public healthcare system.

Conclusion

At this point, you should have a basic understanding of the healthcare system in Spain. A common question expats ask is whether they should retain their original health plan or secure a plan that provides coverage only in Spain (such as from Nordic Health Care) for their time there.

This is not an easy question to answer, because a lot of factors come into play. For how long you intend to live in Spain, what your plans are for the more distant future, and many other issues all have implications for what is the best strategy for you.

But this is also exactly the kind of dilemma we help our clients tackle every day. With over 20 years of expertise in insurance and employee benefits, we frequently know the answer before our clients are even aware of the problem.

One thing is certain though: as an expat in Spain, it’s vital to have adequate health coverage. At Pacific Prime, we specialize in helping people like you find the best solution that fits your budget. In fact, even if you plan to live in some other country in Europe, we can help too!

So, contact us today!

Frequently Asked Questions

What is the overall quality of healthcare in Spain?

The overall quality of healthcare in Spain is highly regarded and one of the best in the world. Spain performs well in areas such as life expectancy, infant mortality rates, and overall healthy life years.

Can foreigners use public healthcare services while in Spain?

Foreigners who are resident in Spain can use the public healthcare system in the same way that Spanish citizens do, by obtaining a Spanish National Health Card (Tarjeta Sanitaria Individual or TSI). However, short-term visitors may not have access to public healthcare services in Spain.

Is health insurance mandatory for foreigners in Spain?

Generally, residents of Spain are required by law to be covered by the Spanish public healthcare system or have private health insurance. So, foreigners living and working in Spain for extended periods must have health insurance coverage.

Does the United States have a medical expenses reimbursement agreement with Spain?

The US does NOT have a medical expenses reimbursement agreement with Spain. That’s one other reason why it is crucial for US citizens to secure sufficient private health insurance for their time in Spain.

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Jantra Jacobs

Senior Copywriter at Pacific Prime

Jantra Jacobs is a Senior Copywriter at Pacific Prime with over 10 years of writing and editing experience. She writes and edits a diverse variety of online and offline copy, including sales and marketing materials ranging from articles and advertising copy to reports, guides, RFPs, and more.

Jantra curates and reports on the results of Pacific Prime’s monthly newsletters, as well as manages Pacific Prime’s Deputy Global CEO’s LinkedIn posts. Complemented by her background in business writing, Jantra’s passion for health, insurance, and employee benefits helps her create engaging content - no matter how complex the subject is.

Growing up as a third-culture kid has given her a multicultural perspective that helps her relate to expats and their families while 8 years of working remotely have given her unique insight into hybrid work arrangements and enthusiasm for employee benefits.

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