The public healthcare system in Spain – Sistema Nacional de Salud (SNS) – offers universal access to healthcare services for all residents and citizens, as well as their immediate family members. The SNS is mainly funded by social security contributions. People with a Spanish employment contract or who are self-employed are entitled to public healthcare, regardless of their income.
In addition to primary care in public health centers (PACs) with general practitioners, hospitalization and emergency care are also covered by the public healthcare system. The choice of doctor is determined by the local health centers (Centre de Salud), primary care is provided in the PACs closest to the place of residence. Referrals to specialists as well as for hospital care are made by the family doctors. Costs for dentures and glasses are usually not covered by public health insurance and without private health insurance, you will have to pay for these yourself.
(Source: Spain’s Ministry of Health, Social Services and Equality)
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Foreigners moving to Spain are generally required to show proof of health insurance in order to obtain a residence permit. This requirement ensures that all expatriates are covered in the event of illness. For those who are not yet working in Spain, there are several options: They can either voluntarily enroll in the Spanish healthcare system or take out private health insurance. Spanish health insurance for Germans can be taken out using the German health insurance form S1.
(Source: Spain’s Ministry of Health, Social Services and Equality and Federal Office of Administration, Information for emigrants to Spain)
The public healthcare system in Spain (SNS) is universal and accessible to all, but it does not offers sufficient coverage in some areas, such as dental and optical care. In these cases, private health insurance is particularly advantageous because it covers these important services.
In addition, private healthcare allows a free choice of doctor, access to private clinics with high quality, attentive service and excellent facilities, as well as avoiding waiting lists and long waiting times in public hospitals and health centers. This ensures more comprehensive and individualized medical care.
(Source: Spain’s Ministry of Health, Social Services and Equality)
Choosing Between Local and International Health Insurance
There are significant differences between local and international health insurance, as well as their costs and coverage, which should be taken into account when making a comparison. Local health insurance plans in Spain, such as private policies, offer comprehensive coverage within the country at a potentially lower cost than international plans.
International health insurance plans, on the other hand, offer extended benefits, including worldwide coverage that includes visits to Germany. This makes them particularly advisable for those who commute between Spain and Germany or plan to return regularly.
Costs vary depending on the provider, level of cover and personal needs. A detailed consultation with an insurance specialist is recommended in order to find the best option for individual needs and budget.
(Source: Spain’s Ministry of Health, Social Services and Equality)
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PassportCard insurance is relevant if you are planning a long-term stay in Spain lasting longer than 3 months. It should also be noted that PassportCard is only available up to the age of 64.
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In general, Spanish health insurance only provides comprehensive coverage within Spain. For necessary medical care and emergency treatment during a temporary stay in Spain, you can use your European Health Insurance Card (EHIC). However, the EHIC does not cover all medical services and is not intended for long-term stays.
Private health insurance is necessary for complete and rapid care both in Spain and during stays in Germany.
Statutory health insurance in Spain is mainly financed by social security contributions, which are paid by both employees and employers. Contributions are based on the insured person’s income and generally amount to around 4.7% of the gross salary for employees, while employers contribute around 23.6%.
The cost of private health insurance in Spain varies depending on factors such as age, health status, level of cover and the insurance provider. On average, monthly premiums range from €50 to €200 per person.
International health insurance is not mandatory when moving to Spain. However, it is strongly recommended that you take out an international health insurance policy. This offers more comprehensive coverage, including stays in Germany, and includes additional benefits such as faster access to specialists and private hospital rooms. Especially for people who regularly commute between two countries or plan visits to Germany, international health insurance is a sensible form of cover that guarantees flexible and comprehensive healthcare.
In principle, employers of German expats are not obliged to provide their employees with health insurance. However, Spain has a social security system (Seguridad Social) to which employers and employees must contribute in order to finance basic healthcare services. Typically, employer-provided health insurance in Spain covers basic medical care that goes beyond the public healthcare system. This may include medical consultations, hospitalisation and in some cases additional benefits such as dental care. However, this can vary from company to company and agreement and may not cover all individual needs. It is therefore recommended that German expats take out additional private health insurance to ensure more comprehensive and tailored healthcare.
As a German student in Spain, you are required to have health insurance. International students must either be enrolled in the Spanish social security system or have private health insurance to cover their healthcare costs during their stay. Private health insurance offers additional benefits such as faster medical appointments, better hospital accommodation and more comprehensive medical services compared to public healthcare. Further information and details on the legal requirements can be found on the official websites of the Seguridad Social and the Spanish Ministry of Foreign Affairs (https://www.seg-social.es/wps/portal/wss/internet/HerramientasWeb/9083f0b1-1cf1-411e-b483-7551440fa1a7/0dbcafb0-4418-4f59-85e2-cd2a5c180fb9).
For families moving to Spain, there are several health insurance options to cover their healthcare needs. One option is to enroll in the Spanish social security system, which covers basic healthcare once family members are employed or earning an income. In addition, taking out private health insurance is a recommended choice. Private insurance policies offer families extended benefits such as faster medical appointments, access to private clinics and additional healthcare services such as dental care and eyeglasses.
PassportCard offers special policies for families where all family members are covered. Medical care is guaranteed both in Spain and when visiting other countries, such as Germany. In principle, all medical services are paid for with the PassportCard, which is linked to the finances of the insurance, so there is no need to pay in advance.
As a German pensioner planning to move to Spain, you should take the following steps to obtain health insurance in Spain for pensioners:
– European Health Insurance Card (EHIC) for temporary stays.
– Apply for an S1 form from your German health insurance company to gain access to the Spanish statutory health insurance.
– Register with the Spanish social security system using the S1 form.
– Purchase private health insurance for more comprehensive benefits such as faster medical appointments and access to private clinics.
Regular reviews and adjustments to the insurance policy are important to ensure that it continues to meet all needs and complies with the legal requirements for retired people in Spain.
PassportCard offers individual and comprehensive coverage, including for Spain. However, it should be noted that PassportCard is only relevant up to the age of 64.
If you have a pre-existing medical condition, it is extremely important to disclose this when applying for health insurance. Failure to disclose a pre-existing condition may result in a claim being denied or the insurance policy being voided. There are special insurance plans that also cover pre-existing conditions, but premiums may be higher or there may be waiting periods for coverage. It is important to ensure that the chosen insurance policy covers all relevant pre-existing conditions and that all conditions are clearly stated in order to be adequately covered in the event of need.
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