14 May 2019

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Spain is considered as an attractive destination for expats and retirees. In fact, expats living in Spain will be offered a diverse natural environment and a range of cultural experiences to enjoy. They will also be able to take advantages of high quality of life including heathlcare system, and relatively low cost of living.

Subsequently, healthcare system in Spain is ranked among the world’s best guaranteeing universal coverage and no upfront expenditure from patients apart from paying a proportion of prescription charges.

For instance, a 2015 World Health Organisation survey showed that Spanish women outlive all other nationalities (living to 85.5 years) apart from the Japanese — so they must be doing something right.

In fact Spain spends 10% of its GDP on health insurance, a system that is funded by social security payments.


According to Spanish resources, the current system consists of 3 organizational levels :


The central administration is in charge of issuing health proposals along with planning and implementing government health guidelines. It also coordinates activities that are attempting to reduce the consumption of illegal drugs.

  • Autonomous community :

There are 17 autonomous communities in Spain. Each one is in charge of offering integrated health services to the regional poppuulation through the centers,services and establishments of that community.

  • Local :

The Local areas (or the areas de salud) are responsible for the unitary management of the health services offered at the level of the Autonomous Community. They are defined through factors of demography, geography, climate, socioeconomics, employment, epidemiology and culture. To increase operability and efficiency, the “areas de salud” are subdivided into smaller units called “zonas basicas de salud”.

Primary healthcare Services in Spain

Primary Healthcare services are close to any place of residence. As a matter of fact,  the latter has a wide network of hospitals and healthcare centres throughout the country known for their knowledgeable and well-trained staff.

Actually, the principles of maximum accessibility and equity mean that community primary healthcare also provides home care, whenever necessary and also deal with health promotion and disease prevention.

Specialist care centers and hospitals provide specialist care that includes outpatient and inpatient care. Consequently, patients having benefited from this care and treatment are sent back to their primary doctor. The latter is in charge of any crucial check-out treatment and care, ensuring the provision of continuous care under equitable conditions, irrespective of the patient’s place of residence and individual circumstances.

Private healthcare system in Spain 

Spain is famed for the quality of its public health services. In that, Private healthcare insurance at private hospitals and clinics is rarely used only to avoid the long waiting lists.

In fact, only 10% of the population choose to have non-mandatory private insurance even-though some private services are contracted by the public sector.

Nevertheless, due to historical reasons in Catalonia, non-profit and semi-public entities are widespread.

The private sector usually provides faster services to patients along with valueadded advantages including private rooms, express mailing of test results and keeping patients updated through emails and text messages.

However, in Madrid for instance, in spite of the impressive range of the public hospitals, and the large network of healthcare centers and pharmacies, many expats prefer to use the private sector in order to have a choice of specialists and practitioners.

Who can benefit from the healthcare system in Spain 

Anyone working or living in Spain can benefit from both public and private healthcare system which free and provided through tax payments and social security.

EU, EEA and Swiss nationals who reach retirement age can benefit from free healthcare in Spain. In order to make use of that need a certificate of entitlement of healthcare if you live in another EU country.

On the other hand, EU, EEA and Swiss residents staying in Spain on a temporary basis can use their european health insurance card which entitles them to receive medical treatment at the same cost as a spanish national. Whereas third country nationals need to provide proof of private health insurance in Spain before being granted a Spanish visa.

Public healthcare system in Spain is funded by contributions to the country’s social security funds which are based on minimum and maximum rates set by the government.

As a matter of fact, General employees contributes 4.7% of their annual salary to the social security system, while Employers contribute the equivalent of 23.6% of the employee’s earnings (28.3%). Consequently, self-employed workers pay between 26.5% and 29.3%.

Moreover, Spain has bilateral agreements such as Peru, Paraguay, Ecuador, Chile, Brazil, Tunisia and Andorra which aim at providing access to its citizens to government hospitalization and medical care in cases of medical emergencies or accidents.



Right after settling in Spain, the expat should register their address on the « padron » at the local townhall which will provide them with a healthcare card, and a social security number issued by the employer. As for self-employed expats, they will need to pay their own social security contributions. Hence the registration will grant them a document entitling them to medical assistance.

Note that should you be going to live and work in Barcelona, you can apply for CatSalud, the public medical aid that allows you to have appointments with doctors and have exams done for free.


061 is the specific local medical emergency number for Spain. Nevertheless, it is possible for Expats in Spain to use the general EU emergency number, 112 which will direct them to English speaking operators in order to communicate with the relevant local emergency service.

On the other hand, people who live in rural areas may go through extended wait times or might probably have to drive themselves to the hospital.


In conclusion, Public and private healthcare systems in Spain are known for their high quality and services. While the former provides free basic healthcare to those who contribute to the Spanish social security system and their families, the latter offers free healthcare for retirees, including those from other EU countries.

Even foreign employees working for Spanish companies or self-employed foreigners in Spain can benefit from healthcare system in Spain.

In that, Spain has an excellent system of private and public medicine that exists easily alongside the state system with a list of foreign language speaking doctors.


More details : info@embacity.org

Sources : https://ambrelia.com/en/2019/05/07/an-insight-into-the-healthcare-system-in-spain/