Health Care

PUBLIC HEALTH CARE

The majority of people in Spain take advantage of the tax-financed public health care scheme run by Insalud (Instituto Nacional de Gestión Sanitaria), similar to the NHS system in the UK. In order for foreign employees working for Spanish companies or self-employed foreigners in Spain to benefit from the Insalud system they must usually contribute to Spanish social security (Seguridad Social). This entitles both you and your family to free or subsidized medical care on the same terms as Spaniards.

After you have registered with Seguridad Social, you will receive a registration card (cartilla de la seguridad social or tarjeta sanitaria) usually by post around 4-8 weeks later or, in some cases, you might have to collect it from your nearest medical centre (Centro de Salud).

Under the Insalud scheme you register with a primary care doctor, usually at your local Centro de Salud, and will have access to the rest of the healthcare system from there. It's best to register with the Centro de Salud as soon as you can to avoid any delay in getting treatment the first time you need their services. The system seems to be pretty efficient and most registered patients can get an appointment with their primary care doctor within a day or two. There are generally no out-of-pocket expenses as they are covered by Insalud.

If your doctor advises that you need to see a specialist, they or the administration staff will usually make the appointment on your behalf via computer while you wait. In order to see a specialist, patients must be referred by their primary care doctor (except in emergencies). As in many European countries there can sometimes be a waiting list to see specialists or for elective and non-emergency surgical procedures. Though in our experience we have found the Insalud system to be very efficient and well organised. Dental care is not included in the Insalud sysytem and should be covered privately.

PRIVATE HEALTH CARE

The popularity of private health care insurance is growing and it can be used either to supplement or as an alternative to public health care. Anyone is eligible and companies often offer both medical and dental schemes. Prices vary significantly so it's best to shop around, however remember to check what is being covered and not just the price of the premium.

The advantage of private insurance is that the companies have their own network of hospitals, clinics and laboratories. Policyholders don't usually have to wait long for treatment. The only downside is that these companies can insist that patients use only doctors who are members of their group. However, many have programs that refund 80% of the fees charged by physicians outside the group. To avoid any excess bills and paperwork, make sure you check with your insurance company prior to receiving treatment from an independant private surgery to ensure your treatment will be covered.

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