Healthcare in Spain

Spain is not just a dot on the map with beautiful resorts, paella and sangria. It is a country of long-livers: for many years the kingdom has firmly held leading positions in terms of average life expectancy. In 2022 this figure stood at 82.4 years, 1.6 years less than in 2021, but of course this drop is entirely linked to the pandemic.

So what is the secret of a long and happy life in Spain? Of course, the mild climate, siesta life, “no stress” attitude and Mediterranean diet with fresh fruit and seafood all year round have a great positive impact on people’s health. But an equally important factor behind these impressive results is the high standard of healthcare.

When you visit a local doctor for the first time, you might even think they are not very competent: more often than not, the recommendations you receive will be “Worry less, rest more, eat well and take long walks by the sea.” But in fact, this is one of the core principles of Spanish medicine: “don’t over-treat”. In many CIS countries, for example, as soon as you step into the consulting room the doctor is already writing out a prescription. That is not how it works in Spain. Here they genuinely believe (and put into practice) that your immune system is capable of dealing with most minor illnesses by itself. And judging by the statistics we see, they are right. But rest assured: if there is a real and serious threat to your health, every possible effort will be made to help you recover.
Hospitals in Spain are equipped with state-of-the-art technology, and public hospitals regularly appear in rankings of the best medical centres. For example, Torrevieja hospital has been awarded the prestigious Gold Seal of Approval from Joint Commission International, which evaluates medical institutions according to 1,200 criteria. Only three hospitals in Germany and just one in the UK meet these very highest standards, while in Spain there are four.

Most Spaniards fully trust the public healthcare system, and only about 19% of the population has private health insurance. Access to free medical care is based on the fact that you or your employer pay social security contributions in the Kingdom of Spain. Therefore, if you are not officially employed in Spain, your route to healthcare will most likely be private insurance, which typically costs around 400–500 euros per year. We’ll talk about the advantages of private policies later in the article; first, let’s continue with the public system.

Doctors in public health centres avoid not only unnecessary treatments but also excessive check-ups: you will only be referred to a specialist by your GP and only when it is actually needed. This is done to reduce waiting lists, which are already quite long – in many regions you may have to wait six months to a year for an appointment. You can imagine how long the queues would be if everyone who “just wants to get checked” could see a specialist directly.

One unquestionable advantage of the Spanish public healthcare system is that the insurance can cover between 40% and 100% of the cost of medicines. This means that when you buy drugs prescribed by a doctor from the public system, you receive a significant discount or even full coverage. For example, many medicines for children and pensioners are dispensed free of charge at the pharmacy, and this applies not only to life-saving drugs but also to common antipyretics and antibiotics.

All Spanish citizens have access to free public healthcare. There are some exceptions, such as the long-term unemployed who have been receiving unemployment benefits for a very long time. Spanish citizens who leave the country for more than 90 days a year may also lose their entitlement to free public healthcare.

If you are a foreigner, you can access free public healthcare in Spain if:

1. you are legally resident in Spain, work under an employment contract and pay contributions to the Seguridad Social;
2. you are officially registered in Spain as a pensioner;
3. you are registered with the employment office as unemployed or actively seeking work;
4. you are a citizen of an EU/EEA country or Switzerland, registered in the Spanish foreigners registry, and Spain is your permanent place of residence;
5. you are married to a person entitled to public healthcare, or have recently divorced such a partner;
6. you are a child under 18 years old, and at least one of your parents has access to the public health system;
7. you have a recognised disability of 65% or more and are dependent on a person who pays contributions to the Seguridad Social;
8. you are a pregnant woman – prenatal care and childbirth are free of charge;
9. you are a refugee with a valid residence permit in Spain;
10. your life is in danger and you require urgent emergency care;
11. your financial situation is very vulnerable and you cannot afford private insurance. In this case, you must contact a “trabajador social” (social worker) and provide proof of your difficult financial circumstances. In most cases, this will give you access to free medical care.

If you belong to one of the categories entitled to free public healthcare, you simply need to obtain a SIP card – this is your health card. With it you can go to your local health centre (centro de salud) and to the corresponding hospital if necessary.

If you are not eligible for free public healthcare, you will need to take out private insurance. Otherwise, a single visit to a doctor will cost you 100–200 euros, not including tests and examinations. A simple “slipped, fell, woke up in a cast” situation can end up costing you several thousand euros. It is much better to spend money on insurance and have peace of mind. In return, you are not limited to public centres only and can choose any private specialist you wish, whereas in the public system all referrals go through the GP.

A major advantage of private insurance is that it can include dental care. We all know how expensive that can be, and public healthcare does not cover dentistry at all, except in emergencies. Private insurance is therefore a way to save on these costly services. Policies that include good dental coverage are more expensive, but they are still worthwhile for many people.

Waiting times to see a specialist, even with private insurance, can be up to two months. In some clinics and cities you can get an appointment as soon as the next day – it all depends on the provider and the location. If you need hospitalisation, the level of comfort in private clinics is generally higher, although public hospitals are also very good. In critical situations, emergency departments in both public and private hospitals are available 24/7.

Many pregnant women come to the Spanish coast specifically to give birth. There are excellent doctors, comfortable rooms, anaesthesia options, partner-assisted births – all of this is available, along with good food and a mild climate, which is especially important during pregnancy. And the cost is below the European average and significantly lower than in the United States.

In summary, healthcare in Spain is genuinely of a high standard, although the public system can be “Spanish-style” slow. In any case, you can be sure that no one will leave you without help in a serious situation, and that doctors will take care of your health.

As with many other aspects of life here, the key is to tune in to the local rhythm and enjoy the moment. As Spanish doctors like to say: less stress, daily walks by the sea – and you won’t need a doctor at all. If you are not yet living by these rules, come and try it – or better still, move to Spain. And Granfield Estate will be happy to help you find the property of your dreams on the sunny Spanish coast.