Are you a UK citizen and don't know if you can access free healthcare in Spain after Brexit? Not sure if the TSE is still valid when visiting Spain? What happens to my health coverage if I move permanently to my second residence in Spain but I don't work? If I am British and want to move to Spain and work as a freelancer, do I need health insurance?
2. My EHIC card expires next year
3. TSE card / private insurance
4. TSE for permanent residents in Spain?
5. Receiving prescriptions in Spain
6. UK pensioners in Spain getting free health care?
7. UK pensioners in Spain have same health rights as Spanish?
8. British in Spain have access to NHS when visiting UK?
9. If I leave the UK to live in Spain, NHS services are not free?
11. Early retirees to Spain need private healthcare?
12. Is there a way to join the Spanish healthcare system at some point?
13. Voluntary contributions into the Spanish health system
14. Voluntary scheme vs. S1 scheme
15. Working in Spain allows free health care?
Introduction
These questions and doubts are some of the most frequent health care enquiries that many British people have every day when they plan to move to live, spend long stays, work or travel to Spain.
In order to understand the requirements for access to Spanish healthcare in all possible contexts and answer all the users' questions, experts Sarah Owen, from the Commonwealth Office for Foreign Affairs and Development in Spain, and Martyn Standing, from the British Embassy in Madrid, participated in the webinar Healthcare in Spain after Brexit, organized by 'A place in the Sun'.
Before addressing all the questions and answers that were addressed, we are going to start by explaining some general lines about the European Health Insurance Card (EHIC) and the Global Health Insurance Card (GHIC) in relation to United Kingdom citizens.
TSE and GHIC
The TSE (European Health Card) can continue to be used in Spain for temporary stays less than 90 days per year, if it has not expired. This card entitles you to receive medical treatment from the public health system if you become ill or have an accident while traveling in Spain.
If your TSE has expired, you must request its replacement with the new United Kingdom card: the United Kingdom GHIC (Global Health Insurance Card). This card will cover emergencies, chronic or existing illnesses and ordinary maternity care. Be careful, keep in mind that the GHIC is not an alternative to travel insurance.
Healthcare for British people who are in Spain for more than 90 days a year
If you live in Spain or spend more than 90 days a year you will need a visa. If you are under 65, you will have to take out private health insurance for at least the first year you are there. If you go to Spain to work with a work permit visa and pay directly to the Spanish Social Security (Special Agreement), after one year registered in the register of the City Council of your city of residence, you can access Spanish public health care.
Remember that you must register at the health center in the city where you live, providing your Spanish Social Security number and your residence permit. You can obtain the Social Security number at the office of the General Treasury of Social Security (TGSS) in your municipality. Once registered, you will receive your health insurance card (Social Security card) that you must take with you every time you go to the doctor. If you have third parties in your charge, their registration will be done separately.
Visas
Non-lucrative visa
If you are going to reside in Spain with a non-lucrative visa - you are not allowed to work - you must maintain private medical coverage until you are over 65 years of age. But you can apply for affiliation to the public health insurance after having been registered in the padrón for one year. Affiliation to this scheme involves the payment of a monthly fee that gives you access to the Spanish health system.
Golden visa
If you move to Spain with a Golden Visa, private medical insurance is also necessary, although you can also request adherence to the Special Agreement and pay a monthly fee after having been registered in the register for one year. Those over 65 who move to Spain will continue to enjoy the same access to Spanish public health as Spanish citizens, through the S1 form issued by the United Kingdom. This is a certificate of entitlement to healthcare that recipients of a UK state pension have access to.
Answers to frequently asked questions
After Brexit, Spain and the UK have a new relationship framework in terms of healthcare for British citizens residing in Spain and for those who are only traveling. Many questions naturally arise from the new rules. The aforementioned experts have answered the most common questions.
1. When visiting Spain, can I continue using the TSE card if I need to go to the doctor?
Yes. Reciprocal healthcare between the UK and Spain continues, which means that there is an agreement between both countries and this agreement includes the use of the TSE card or the new GHIC card. All those cards are valid until the expiration date. You just have to make sure you take them with you when you go to a public hospital or public health center.
Important note: they are not valid in private hospitals or private health centers.
2. When my EHIC card expires next year, what do I need to do to get a new GHIC card?
You just have to visit the GHIC website and apply for the new card in the same way you applied for the old one.
Important note: the current TSEs are valid until their expiration date.
3. The TSE card has never been a substitute for private insurance, right?
Exactly. We always advise people to take out comprehensive travel insurance when visiting Spain or any other EU country. The TSE and the GHIC do not cover everything. One of the biggest things they do not cover is medical repatriation and it can be very expensive.
Important note: It is appropriate for the person to take out comprehensive medical insurance that covers any pre-existing illness and also covers medical repatriation.
4. The above is applicable for the UK citizen who has a second residence in Spain and for those who travel to Spain to enjoy a holiday. Is it also useful for someone who moves to live permanently in Spain?
No, it is only for people who are ordinarily resident in the UK. People who move from the UK to Spain to live would have to register in the Spanish system. It should be mentioned that for those who go on a trip the rules have changed. They are now considered third-country nationals and can only spend 90 out of 180 days in Spain. If you want to stay longer you have to check the requirements very carefully with the Spanish authorities. Contact us for legal advice.
5. If a citizen residing in the UK goes to their holiday home in Spain to spend less than 90 days, how can they ensure that they will receive their prescription without any problem?
The best thing people can do is bring the medication from the UK (they can usually get a prescription from an NHS doctor for at least two months or maybe longer). They should carry this medication with them and not keep it in their luggage, because it could be confiscated at customs. If they don't have enough of the medication to cover the entire trip abroad, what they can do is use the TSE or GHIC at a public health center or hospital to get more supplies of that medication.
6. A pensioner from the United Kingdom who retires to live in Spain after Brexit can have free health care, true or false?
True. The agreement between the United Kingdom and the EU means that what we call reciprocal healthcare, which is a healthcare agreement between the United Kingdom and the states of the European Union continues more or less as it did before the exit of the United Kingdom. Pensioners, in particular, have to apply for a form called an S-1, which they are entitled to if they become state pensioners, but can also include their dependents.
A typical example would be the following: a person who is a pensioner and another who has not reached retirement age, can obtain an S1 form for their spouse, for their common-law partner, for their children under 26...
7. A pensioner from the United Kingdom who retires and goes to live in Spain in the post-Brexit era will have the same health rights as a Spanish resident?
Exactly. Many British pensioners believe that when their country (UK) pays for their healthcare they think they will get everything they would get on the NHS. But that is not true, if they reside in Spain they receive what is in the Spanish national health service. They are on the same basis as a Spanish pensioner and that means that general medicine is free. In other words, for a British retiree residing in Spain, primary and secondary care is free, but there are other things that are charged. For example, dental care is usually private and there is also a charge for some prescriptions, although the price is low.
8. After moving to Spain permanently as a UK citizen, will I still have free access to the NHS when I return to visit the UK?
It depends on your circumstances. If you are a new resident, that is, if you plan to move to Spain from now on or if you moved from the beginning of the year, you do not automatically retain the right to access NHS services. This is because the NHS is a residence-based system, so you need to be habitually resident in the UK in order to access NHS services.
9. So generally speaking, if I leave the UK to live in Spain, I should not expect to be able to use NHS services for free?
There are some small exceptions. For example, if you are a student and you are temporarily in Spain studying, you are still considered to be an ordinary resident in the United Kingdom, so you would still have access to the NHS. But in general, if you are a new resident and you move to Spain from then on, you will not retain access to NHS services. Therefore, it is important that when you travel back to the UK you have insurance that covers your health needs.
Primary care NHS services are free, so if you need to visit a GP they won't charge you, but anything above that, i.e. if you're admitted to hospital or need secondary operations , it will not be covered because it is not considered primary care.
10. If I became a Spanish resident, could I obtain or benefit from an EU-issued TSE card that I could use in the UK?
If you are thinking of moving to Spain but you are not planning to work and you are not claiming a pension, then you will not be entitled to a European health insurance card.
But if you are thinking of moving to Spain and working, then you are going to have to contribute to the Spanish Social Security, so on that basis you would have the right to apply for a European health card that is issued by the Spanish authorities. It is a card that you can use in the UK for temporary stays and that will cover you for anything medically necessary during a short stay in the UK or any other EU country.
11. If I retire or move to Spain before reaching retirement age, do I need private healthcare, yes or no?
Yes, you need it. It is best to check rigorously through the embassy or consulate the visa and immigration requirements to obtain the visa that allows you to enter Spain as a new resident.
As for someone coming in who hasn't worked in Spain and isn't planning to work but is not yet of retirement age, then the short answer is yes, you do need private health insurance. This is because part of the process to apply for a visa and enter Spain as a new resident is to show that you have proof of health coverage, so that you are not a burden to the Spanish system, so that you are self-sufficient and can cover for yourself. your health needs yourself, because you will not be contributing to the system.
12. And if I stay in Spain longer through any available visa arrangements, is there a way to join the Spanish healthcare system at some point?
Yes, there are different ways of accessing healthcare in Spain and it largely depends on your circumstances. So let's say you move and decide that at some point you want to work, then you would be paying social security, at which point you would be entitled to health care (I should add that you need to check that you have the correct documentation to be able to work in the first place). place).
There is another system which is the voluntary payment system, and that is the arrangement whereby you make monthly payments. There are eligibility requirements for that, so you can't choose to pay into that system automatically, you have to have been registered with your local council for a minimum of 12 months and have lived in Spain continuously during that time.
13. If in the future I am entitled to a pension in the UK then I can apply for the S1 form and reciprocal health care entitlement. When I start planning my pension, will I have the possibility to choose to pay into the Spanish health system to obtain coverage?
You can choose to list in the system, but there are requirements for it. One of them, probably the most important, is that you have to have lived continuously in Spain and be registered in your town hall for at least 12 months. That is, a whole year before being able to opt for that regime. There are also other requirements, for example, you cannot be entitled to medical cover from another EU country.
14. So if I am entitled to an S1 form from the UK, can't I choose to take the voluntary scheme instead of choosing the S1 scheme?
During that first year, before being entitled to the voluntary scheme, you would have to make sure that you are covered by private insurance for your health needs. To give you an idea of what the voluntary scheme covers, in general it covers the same services as someone who, for example, contributes to social security as a worker, but there are slight exceptions to this scheme: the treatment is the same, but the recipes, that's the difference. So you would have to cover 100% of the costs of the prescriptions, which is the big difference between being, for example, a worker and paying social security, compared to paying this voluntary scheme. In addition, since you are not contributing to social security, you are not entitled to the European health card, which is based on social security contributions.
15. When you live and work in Spain - assuming you have the corresponding official work visa - you have the right to free health care, true or false?
It's true. If you work legally in Spain, that is, if you work legally with an employer contract or as a freelancer, which is what many people do, then you will have full access to the Spanish social security system because you are paying into the system. In addition, you will be able to add your dependents as workers as well, as you mentioned earlier with S1 holders. And you would also be entitled to a Spanish health card that would allow you to receive the necessary care when you are temporarily in another EU Member State.
It should be added that when you reach retirement age if you have worked for a year or more you can also have access or rights or a Spanish pension.
Get a health insurance quote
At Telework Andalucia we offer insurance for expatriates in Spain in all the cases described in this article. Contact us for a personalized budget without commitment at: [email protected] or view our specially negotiated insurance packages here.
Links of interest
- Health care for British nationals residing in Spain
- Visa requirements to travel from the UK to Spain
- Apply for health coverage abroad (GHIC and EHIC)
- NHS: traveling or relocating to the UK
Contact us
For any questions regarding health access if you are British with connections to Spain, contact us below:
