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Healthcare in Spain, including the Balearic Islands and Canary Islands

Each country's health system is different and might not include all the things you would expect to get free of charge from the NHS. This means you may have to make a patient contribution to the cost of your care.

Visitors to Spain

Finding help in an emergency

If you find yourself in a serious, life-threatening emergency, you should call 112. This number is free of charge and valid in all Spanish territories. The Spanish word for A&E department is "urgencias".

Be aware that if you ask a hotel or travel representative to call a doctor, you may be treated privately. If you wish to be treated under the state system you must call 112 and ask for an ambulance to take you to the nearest state hospital.

Other important phone numbers to note down:

  • 112 – ambulance (ambulancia)
  • 091 – national police (policía nacional)
  • 092 – local police (policía municipal)
  • 062 – civil guard (guardia civil)
  • 080 – fire brigade (bomberos)
  • 900 202 202 – sea rescue (salvamento y seguridad marítima)

Healthcare up until the UK leaves the EU

The government always advises UK citizens to take out travel insurance when going overseas, both to EU and non-EU destinations.

Emergency medical care is provided to anyone requiring urgent attention. You can expect to be charged in full for any care provided without an EHIC (European Health Insurance Card). You should always buy enough travel insurance and make sure you have access to funding to cover any medical treatment abroad. Remember to keep all receipts and any paperwork (make copies if necessary) as they might be needed by you or your insurance company to apply for any refund.

Currently, your EHIC enables you to access the necessary state-provided healthcare in Spain at a reduced cost, or sometimes for free, if you are staying there temporarily. If you are asked to pay for health services upfront, it is likely that you are not being treated under the state health system.

EHIC does not cover certain costs, including:

  • private treatment
  • being brought back to the UK
  • mountain rescue services
  • cruises

Be aware that in some parts of the country, particularly the outlying islands, you may have to travel some distance to find a state healthcare provider.

Be careful if healthcare arrangements are made by a hotel or travel representative. They might reassure visitors that they can claim back whatever is paid out, but they are referring to private insurance and not the treatment given under the EHIC.

Some hospitals and health centres (centro de salud) offer both private (privado) and state-provided healthcare (asistencia sanitaria pública). It will be up to you to tell them which service you require. They may also have separate surgery times for private patients and those treated under the state healthcare system.

Spanish health authorities are decentralised, so systems can differ between regions. A directory to all regional health bodies in the autonomous communities can be found on the Spanish health ministry's website (information also available in English). Select your region on the map provided and look for the section marked Servicio de Salud (healthcare system).

Provisional replacement certificate (PRC)

A PRC is a certificate demonstrating a person’s entitlement to EHIC. If you need healthcare but do not have your EHIC with you, you can call Overseas Healthcare Services and ask them to send a PRC to show to the hospital. This will avoid you being directly charged.

Contact Overseas Healthcare Services:

UK: 0191 218 1999
Outside UK: +44 191 218 1999
(Open Monday to Friday 8am to 6pm, UK time)

People with pre-existing health conditions

If you have a pre-existing health condition, you should buy medical travel insurance before visiting Spain. You must tell the insurance company about any pre-existing health conditions you have, to make sure you can get the cover you need. If you have an EHIC, this will be valid until the UK leaves the EU but may not work after that.

If you have a pre-existing condition that will need treatment while abroad, ask your doctor in the UK for advice before you travel. Make sure you take with you any documents about your health condition or medication.

If you are travelling for the express purpose of obtaining medical treatment, see our section about seeking medical treatment in Europe.

Dentists

Dental treatment is not covered by the state healthcare system unless it's an emergency. Most emergency departments or health centres have a dentist attached that can deal with dental emergencies.

Hospitals

Just like in the UK, you'll need to be referred by a doctor for any hospital treatment. Make sure you are referred to a state hospital as only these provide treatment free of charge. Even in a state hospital you will need a valid EHIC. Double check you are not treated as a private patient.

In the state healthcare system, you have the right to insist your EHIC is accepted. You do not have to provide travel insurance details unless you choose to do so.

Prescriptions

Once you have a prescription from a Spanish state doctor, you can take it to any pharmacy (farmacia) in Spain. They can be identified by a green cross. There are prescription charges in Spain. Prescription charges are non-refundable.

When using your EHIC, people of working age are charged 50% and pensioners are charged about 10%. Pensioners will have to declare they receive a UK state pension in order to pay the lower rate.

If you are told by a hospital that you need medicine after being discharged, you must take the hospital medical report to a doctor, who will give you a prescription. This is because doctors in state hospitals will prescribe medicines on the appropriate medical report but do not issue official prescriptions.

Bringing your own medicines to Spain

If you have a condition that requires you to bring your own medicines to Spain, you should have a letter from your GP stating what the medicines are and why you need them. If possible, have the letter translated into Spanish, as this will also be useful in case you need to see a health professional during your stay.

If any of your medicines fall into the controlled drugs category, you need to comply with regulations on drugs exports in the UK. In addition, you'll need to apply for the Spanish import licence at your nearest Spanish consulate with the following documentation:

  • licence for exportation of controlled drugs
  • full name, current address and contact telephone number of applicant or drug unit
  • flight details (dates) and destination address in Spain
  • fax number or address details to send the Spanish Import Licence once received from Spain
  • ask your doctor in the UK for advice before you travel and make plans for how to manage your condition when you are abroad. You should also take your health condition identification or letter saying what medication you are taking

After the UK leaves the EU

If the UK leaves the EU without a deal, your access to healthcare when visiting Spain is likely to change. If you are planning to visit Spain after the UK leaves the EU, you should continue to buy travel insurance so you can get the healthcare treatment you need, just as you would if visiting a non-EU country. If you are using an EHIC issued by the UK, this will still be valid until the UK leaves the EU.

The UK government is seeking agreements with countries, including Spain, on healthcare arrangements for UK nationals after the UK leaves the EU.

This guide will be updated with further information on travelling to Spain as the circumstances change.

Working in Spain

Healthcare up until the UK leaves the EU

If you plan to live or work in Spain, make sure you register with the Spanish authorities.

If you are going to work in Spain and make national insurance contributions, you'll be entitled to state-run healthcare on the same basis as a Spanish national. For further information, visit the Seguridad Social website (information available in English) and register with your local Treasury of Social Security (TGSS) office.

If you are a worker posted by a UK company to Spain, you may be entitled to health cover funded by the UK in the country you are posted to. Contact HM Revenue and Customs (HMRC) for more details:

National Insurance Contributions and Employer Office
HM Revenue and Customs
BX9 1AN
United Kingdom

  • Telephone: 0300 200 3500
  • Outside UK: +44 191 203 7010

Opening times: 8.30am to 5pm, Monday to Friday – closed weekends and bank holidays.

For more information, see Planning your healthcare when moving abroad.

After the UK leaves the EU

If you are paying social security contributions to Spain, you will still be able to access state-funded healthcare.

If you are a UK posted worker, you may need to buy additional healthcare insurance in Spain so you can receive the healthcare treatment you need.

Pensioners in Spain

Healthcare up until the UK leaves the EU

If you live in Spain and receive an exportable UK pension, contribution-based Employment Support Allowance or another exportable benefit, you may be entitled to state healthcare paid for by the UK. You will need to apply for a certificate of entitlement known as an S1 certificate.

You may need to liaise with a different team, depending on the exportable benefit. Further information is available under Claiming benefits if you live, move or travel abroad on the GOV.UK website. Please note that different exportable benefits can have different rules in terms of healthcare cover.

S1 certificate (formerly known as E121)

An S1 certificate helps you and your dependants access healthcare in Spain. If you have an S1 certificate, it will be valid until the UK leaves the EU.

After this date, the certificate may not be valid, depending on decisions by member states.

You should continue to apply for an S1 certificate until the UK leaves the EU.

You may be eligible for an S1 certificate, if you:

  • have worked and paid contributions in the UK
  • receive some UK benefits such as pensions

Apply through the Business Services Authority for an S1 certificate.

For exportable UK pensions and contribution-based Employment Support Allowance, you can apply for your certificate via the International Pension Centre in the Department for Work and Pensions on 0191 218 7777.

Further information is available under Claiming benefits if you live, move or travel abroad on the GOV.UK website. Please note that different exportable benefits can have different rules in terms of healthcare cover.

The Foreign and Commonwealth Office (FCO) provides information about what UK and Spanish benefits are available to Britons living in Spain and information on driving regulations in Spain.

After the UK leaves the EU

People who have lived in Spain for more than 5 years continuously may be able to apply for a permanent residency that will allow access to state-funded healthcare under the same conditions as Spanish citizens.

If you have lived in Spain for less than 5 years but you have been registered with your local town hall for at least a year, the Convenio Especial is a pay-in health insurance scheme offered by the Spanish government that allows people who are not employed to "buy into" the Spanish system.

It provides access to the state healthcare system for a monthly payment of €60 per person under the age of 65 and €157 for those aged 65+. It covers all pre-existing medical conditions but it does not cover prescriptions.

You may need to do this if you are resident and have been registered there for a year or more, but do not pay for social security via employment or self-employment, or if you are a pensioner.

Convenio Especial

The Convenio Especial costs €60 a month for those under 65, and €157 a month for those over. It is administered by regional authorities and provides the same level of access to healthcare as Spanish residents. It does not include the cost of prescription medicines.

Please note that in the region of Andalusia it is no longer possible to apply for the Convenio Especial. To register for access to healthcare in this region you can approach your local healthcare centre and ask to register for access to healthcare under the new Universal Healthcare Law (Royal Decree Law 7/2018).

Anyone who has been registered with their local town hall in Spain for less than a year will need private health insurance to access the Spanish healthcare system.

Students in Spain

If you are a UK resident and studying in Spain, and you have an EHIC, this will be valid until the UK leaves the EU.

You should continue to buy insurance to cover your healthcare, as you would if you were visiting a non-EU country after the UK leaves the EU.

Page last reviewed: 28 January 2019
Next review due: 28 January 2022