Do pensioners pay for prescriptions in Spain?

Spain is widely recognized for having one of the world’s best healthcare systems, in both the public and private healthcare sectors. Moreover, Spain is a top destination for retirees due to its climate, culture, and cost of living. Therefore, it’s no surprise that pensioners living in Spain would be curious about their healthcare costs when choosing to make their move to Spain as someone who’s work life has come to an end.

In this article, we will discuss whether pensioners pay for prescriptions in Spain, how to get a prescription, prescription costs, and prescription coverage with Caser Expat Insurance. Continue reading to discover all the details.

Do pensioners pay for prescriptions in Spain?

Unfortunately, prescription costs for pensioners in Spain are not free, but the Spanish government subsidizes costs up to 70% for many medications that require a prescription and heavily regulates their prices. Since 2019, income brackets determine the cost you pay for medication, and this happens on a sliding scale.

Anyone given a prescription in Spain should notice that it will include the percentage of the cost that they have to pay, according to Abaco Taxes. This income information will be taken from the annual Spanish resident tax declaration. If you have not made an annual resident tax declaration there will be no indication on the prescription of how much you must pay towards your Spanish prescription. Instead, blanket charges will be made of 40% for non-pensioners with low incomes and 10% for pensioners. However, it is important to note that no income information means no cap on your monthly contribution.

So while pensioners do pay for prescriptions in Spain, you will pay a minimal amount.

How to get a prescription in Spain

If you have been paying into the Spanish system and have public healthcare coverage, you will go to your doctor (médico de cabecera) for a prescription. This prescription will either be loaded onto your public healthcare card or you will be given a piece of A4-sized paper with the drug information that is signed by your doctor. This is then given to the pharmacist at any pharmacy and they will have all the information they need about the prescription, dosage, usage, etc.

If you haven’t been paying into the Spanish system, the most straightforward way to access healthcare in Spain as an expat is to take out a private health insurance policy. As a pensioner, remember to first consult conditions for pre-existing conditions or age restrictions. Private health insurance largely works the same way as public coverage, with a doctor within your insurer’s network offering a written prescription that can then be turned in at the pharmacy. Some insurers also offer digital prescriptions or virtual consultations (more on that later).

If you’re looking to get a prescription from your home country filled in Spain, this is a more difficult task. The best thing to do is to take your original prescription and get it translated into Spanish so that your doctor in Spain can give you an equivalent prescription in Spain. Even for Eurpoeans, European Health Insurance Cards (EHIC) do not cover prescriptions for EU citizens, though you can ask your doctor for a cross-border prescription that includes active ingredients and doses to be filled in Spain. Or alternatively, if you’re worried about up picking up a Spanish prescription in another European country while traveling, the Spanish government website’s healthcare section has all the details.

Over-the-Counter Medications vs. Prescriptions

Not everything you see at the pharmacy requires a prescription, which is great news if you’re picking up something for a mild cold or shallow cut, for example. Most pharmacies offer over-the-counter medications for common ailments and illnesses. Cough syrup for a sore throat is a good example of a medicine you can purchase without a prescription at a pharmacy. Spanish pharmacists are also trained to recommend common over-the-counter medications based on your symptoms, or instruct you if you need to see a doctor for a prescription to be able to access that medication. Antibiotics are a good example of a common medicine that requires a prescription.

If your medication isn’t in stock at the pharmacy, not to worry. Pharmacies can order your medicine for you, and it is usually ready for pickup within 1-2 days–sometimes even the same day!

Prescription Costs in Spain

According to the Spain Ministry of Health, pharmaceutical pricing and reimbursement policies are as follows:

OUT-PATIENT (no hospital stay)

Co-payment (applied to retail selling price):

• 60% of medicine price for people earning ≥100,000 €/year
• 50% for people earning ≥18,000 and <100,000 and,
• 40% for the remaining employed citizens.

Specific medicines for long term treatment benefit from reduced co-payment of 10% of selling price with a max. fee of 4.24 €/pack.

Co-payment for retired people is 10% with a max. monthly co-payment depending on earnings (4.24€, 8.23€, 18.52€ and 61.75€ respectively).

Special vulnerable collectives are exempt from co-payment.

IN PATIENT (hospital stay)

• Full public coverage. (No co-payment apply)
• In terms of coverage and reimbursement, consideration of in-patient medicines is given to drugs dispensed only in hospitals regardless of whether the patient is formally admitted or is ambulatory

Keep in mind that if you’re not paying into the public system and you don’t have private healthcare coverage for prescriptions, you will likely need to pay full price for your prescription, and prices can vary from one pharmacy to the next.

If you have a chronic condition or disability, you may be eligible for further reduced costs, exemptions, or even full coverage. Get in contact with your doctor or pharmacist to learn more.

Caser Expat Insurance prescription coverage

The Integral and Prestigio plans are ideal for those looking for prescription coverage. Under both plans, you’ll get reimbursed 50% of the total amount of pharmacy bills and children's vaccines up to a maximum of € 100 per insured person per year. We refund 50% of what you spend at your optician up to € 100 per insured for the year.

Wondering which plan is best for you? Prestigio is a health insurance with reimbursement that lets you choose the doctor you want and get reimbursed up to 90% of the cost. Integral is a family health insurance that can be contracted with or without copayments.

And with Caser’s telehealth service that’s included in both plans, during your virtual check-ups, you can also share reports with specialists and receive prescriptions for diagnostic tests or medication. So you’ll get your prescription from the comfort of your own home, and later be partially reimbursed for your pharmacy expenses!

Private health insurance is a good option for pensioners in Spain that want fast, personalized services, doctors that speak your language, and affordable yet comprehensive coverage. So while pensioners do pay for prescriptions in Spain, the advantages of the Spanish healthcare system far outweigh any disadvantage. To discover all of your healthcare options with Caser, read our free guide below:

If you are searching for health insurance in Spain, Caser Expat Insurance has the right policy for you!