Spain provides a free public healthcare system which all residents have access to. On some occasions, individuals may opt for or require private health insurance, but generally the public Spanish health service is sufficient for most situations.
According to the World Health Organisation (WHO), Spain ranked 7th among 191 countries in a study which measured the overall performance of the health systems within those countries.
Who is covered by the Spanish National Health Service?
The Spanish healthcare system covers the following groups of people:
Employees: employers are obligated to make contributions to the Spanish Social Security (Tesorería General de la Seguridad Social) on behalf of their employees. This entitles the employees to cover from the Spanish healthcare system.
Self-Employed workers and Company Owners: self-employed workers and company owners are responsible for paying their own monthly contributions to the TGSS. This entitles the self-employed workers (Autonomo) and the company owners to cover from the Spanish health system.
Spouses and children of Employees, Self-Employed workers, and Company Owners: Providing they are resident in Spain, the spouses and children of those who contribute to the TGSS are covered by Spain’s healthcare system.
EU/EEA/Swiss nationals: EU, EEA and Swiss nationals who have reached pensionable age are entitled to free healthcare in Spain. They need to produce an S1 form (previously E121) which they must present to the INSS (Instituto Nacional de la Seguridad Social). The INSS look after welfare and other social services including social security and employee / employer’s rights and regulations, benefits and other state subsidies including health care, maternity, paternity, family benefits and school insurance. The INSS will issue a Social Security number. If the visit to Spain is only short-term or temporary, EU, EEA and Swiss nationals can use their European Health Insurance Card (EHIC) which entitles them to receive medical treatment at the same cost as a Spanish national.
How to register for the healthcare system in Spain
If you are resident in Spain and work or pay social security, you are eligible to register for public healthcare. In order to apply for your health card (SIP card) you will need to visit your local health center and provide them with the required documentation. This includes:
Your empadronamiento: This document is a certificate which confirms that you are registered on the padron at your local Ayuntamiento (Town Hall).
S1 Form (previously the E121):