Everything you need to know about Spain's healthcare system

When you move to a new country for work, or even when you travel on holiday to a new and unfamiliar place, it is normal to think about the healthcare system. Questions such as: How good is the public health system here, or how much does each visit to the doctor cost? Even more important: Is there a hospital near where I live?

If you have recently moved to Spain, or if you are not yet fully familiar with Spain's public

healthcare system, please read on because in this article I will try to introduce you to its basics. I'll tell you how it began, who can benefit from it and how it works nowadays. Whether you have arrived in Spain alone or with your family, this information is of interest to you.

The origin of Spain's public healthcare system

Spain's public healthcare system as we know it today has its roots in the 20th century. Before it came into being, at the beginning of the 20th century, the healthcare of the Spanish people depended basically on charities, the church and mutual systems for different guilds of workers. There was no unit as such, but that changed during the 1940s, after the end of the Spanish civil war.

During the dictatorship of Francisco Franco, a compulsory health insurance scheme was created, which initially covered only salaried workers. It remained so until 1978, when, thanks to the Spanish Constitution, the right of all citizens to healthcare was enshrined in its legal system. From that moment on, Spain's healthcare system began to evolve until it became what we now call the Sistema Nacional de Salud (SNS).

How it works today

After several modifications, we have reached the 21st century with a universal healthcare system which is financed through taxation, in other words, it is a contributory system. The most important thing is that health coverage is guaranteed for all residents, regardless of whether they are employed or not.

Spain currently has a decentralised health system, which means that each autonomous community has competences on healthcare. Thus the system is administered by the 17 autonomous communities, and each citizen must be registered in the healthcare system of the community of residence. This can sometimes be confusing for foreigners arriving in Spain, as a citizen residing in Andalusia will not be registered in the health system of Asturias, for instance. Is this a problem for the citizens? Not exactly. Let's see how it works in more detail.

Every citizen with their own health card

In order to access public healthcare services, every citizen must have a healthcare card, with an identification number. Although some details vary from region to region, there is a unified format according to which each patient has two codes. On the one hand, the CIP-AUT, which is a number assigned by the autonomous community that issues the card. On the other hand, the CIP-SNS, also known as the Unique Identification Code.

The healthcare card gives access to basic and specialised services, such as consultations with the family doctor, hospitalisations, vaccinations, prescriptions, etc. If you have a card and a CIP, you can be treated at healthcare centres, hospitals and pharmacies in Spain. Once you have a card, you can be treated at hospitals at zero cost and you will be able to have your prescriptions by paying just a fraction of their price.

To have a medical consultation with your general practitioner or access to medical tests, you will have to use the healthcare services of your community. But if you have an emergency in any other autonomous community, you can be treated through the emergency services, or as a displaced person if your stay in that community is prolonged for a period of time.

To apply for the healthcare card, you must go to your nearest healthcare centre and present your NIE, your passport and your census registration certificate. Once you have it in your possession, as a foreigner with a valid residence permit you will be entitled to the same benefits as national residents. This card will be valid for two years and you will be able to request its renewal after this period.

Spain's healthcare system and private insurance

Spain's healthcare system has great advantages such as those we have described: easy accessibility, free of charge, great specialists, etc. Furthermore, Spain is a world leader in organ donation, another symptom of the excellence of Spanish hospitals. In a nutshell, Spain´s public healthcare system offers first-rate services at a very reasonable cost.

However, since the great crisis of 2008, and even more so after the pandemic that reached Spain at the end of 2019, the Spanish healthcare system has deteriorated. The budget cuts, the lack of doctors and precarious contracts have resulted in an increase in waiting times. And this not only affects surgical interventions, but also diagnostic tests and consultations in primary care.

This is why many Spaniards have decided to take out private healthcare insurance in recent years to complement their health care. The great advantage of healthcare insurance lies in the shortening of waiting times and access to excellent clinics throughout Spain. An example of this is Caser Health Insurance, an insurance policy designed for expats like you who need coverage that adapts to your needs at all times. If you still don't know about it, I encourage you to visit their website, where you can see all the coverage and ask for a quote over your morning coffee.

As you can see, Spain is a safe destination when it comes to looking after your healthcare and that of your loved ones. Whether through Spain's public healthcare system, or through private insurance, you'll be in good hands. It only remains for you to weigh up your priorities and needs to make a decision and choose your best option. I hope this article has been helpful, and if you have any questions, don't hesitate to write to us - we'll be happy to help you!