Finding Healthcare in Spain >> Private vs Public Systems

Spain’s healthcare system (Sistema Nacional de Salud or SNS) delivers outstanding health outcomes for its people. And our experience is that healthcare in Spain for Expats is exceptional, with a catch. And while Spain has a free universal healthcare system, only some residents can use it. Read on for more details.

Note: There is no public or free dental care; all dentistry is private “user pays.”

How does the Healthcare System in Spain work?

Spain has both public and private healthcare systems, which run in parallel.

The free public system is run by the Ministry of Health and subsidized by taxpayers through the social security system.

Large companies and individual healthcare professionals deliver the private “user-pay” system. Most people using the private system use Spanish Private Health Insurance to cover their costs.

Private Healthcare in Spain

Most Expats use the private health system in Spain, either exclusively or with the public system. And many international citizens (including those who retire in Spain) need the insurance for their visa. Interestingly, around 25% of Spain’s population also pays for private health insurance to use private healthcare.

The private system includes:

• General Practice Doctors
• Specialists
• Clinics
• Hospitals
• Services like mental healthcare, physiotherapy, and ophthalmology.
• Dentistry and orthodontics
• Complementary or alternative treatment

Private Medical / Health Insurance

As an Expat, you’ll most likely have medical insurance in Spain. It may be as a visa requirement or for access to the private system. There are many companies offering a range of options; it is confusing. Check out our guide to private health insurance in Spain. Or, use the simple form below to get three quotes from leading companies that Expats love.

How To Access Private Medical Services

In general, you can go directly to a private medical professional, clinic, or hospital and book an appointment. You’ll sometimes need to pay a fee upfront. I occasionally use a private physiotherapist who I pay by credit card after each visit.

The process depends on your insurer if you have a private medical insurance plan. You may need to pre-authorize a visit or use an agreed provider. Our insurer has an easy-to-use web portal where I can find a medical professional near me or book an online telehealth appointment.

Note: Very few health policies cover complementary or alternative therapies. You’ll usually need to pay the full charge yourself.

Our Experience of Private Medical Care in Spain

We’ve been amazed at the high patient care and support levels when our family has used GPs and specialists for various issues. There were two exceptions. We were disappointed with the expertise and advice from an insurance company-recommended dentist and a direct specialist. In both cases, a single visit was enough to move.

3 Specific Areas That Need Special Attention

There are three areas where private health insurance in Spain can be complex. We’ve written detailed guides for each to help you navigate these areas.

1. Private Health Insurance for Residency and Visa Applications and Renewals.
2. Private Health Insurance for Over 75s.
3. Cover for Pre-Exisiting Conditions.

Public Healthcare in Spain

Spain has free universal healthcare for all Spanish citizens and some resident non-citizens. The Ministry of Health oversees the system, which is administered regionally and locally. This split means that the 17 autonomous regions of Spain each have an individual health system with local ways of working.

Who gets free healthcare in Spain?

All Spanish citizens have free healthcare in Spain. In addition, there are groups of non-citizens who are also eligible.

• Residents who pay social security contributions (employed or self-employed).
• Residents who receive qualifying benefits or a Spanish pension.
• Pregnant residents.
• Students under 26 who are registered to study in Spain.
• European Union (EU) citizens visiting Spain with an EHIC card.
• Retirement-age EU citizens resident in Spain.
• People who make non-employment contributions to social security via el convenio especial con la Seguridad Social.

What Services Are Available Through The Public Medical System?

• General Practitioners
• Emergency Care
• Primary Care, including pediatrics
• Nursing Services
• Physiotherapy
• Specialist Health Coverage
• Hospital and Surgical Procedures
• Medical Testing
• Prescription medicine subsidies (You pay some of the total cost.)

What services are not covered?

The public system does not cover dental treatment, including orthodontic treatment. You should have private medical coverage with dental included or a dental-only policy.

How To Use Public Medical Services

1. Sign up with your local public health authority. They’ll issue your healthcare card or TSI (tarjeta sanitaria individual ). You’ll need your social security number and your padrón. This is also sometimes refered to as a SIP card in Valencia and other regions (Sistema de Información Poblacional).
2. Be assigned a personal general practitioner (GP) or health center. They’ll be your pathway into the medical system and help you if you require specialist or hospital care.

In Catalunya I access CatSalud services via a webportal. I can communicate with a GP or nurse online to get assistance.

Emergency Care: In an emergency, due to illness or injury, you will receive vital primary healthcare regardless of your status. You can go directly to any hospital or medical center’s emergency room and will be treated. Call 112 in case of an emergency for assistance.

Challenges of the Public System

The Spanish national health system is world-class, but it does have challenges. If you are from the international community, you should consider these.

1. Unless you are fortunate, you’ll receive care in Spanish or the local language.
2. As a public patient, you have little choice over your physician or treatments.
3. Wait time for elective procedures and non-emergency care can be long.
4. The government doctor will not use certain expensive prescription medications and treatments.

Our Experience of Private Medical Care in Spain

The public system in Spain provides exceptional care in our experience. Our family has used different services and facilities in Catalunya over the years. The standard is kind, professional, and helpful staff and care. We’ve struggled with language and bureaucracy, and appointment wait time can be frustrating. As a result, we use our private care where we can.

Useful Terms For Naviagating The Spanish Medical System

Spanish Term	English Translation
Analítica de Sangre	Blood Test
Atención Primaria	Primary Care
Baja por Enfermedad	Sick Leave
Centro de Salud	Health Center
Cita Previa	Prior Appointment
Cuadro Médico	Medical Staff/Directory
Diagnóstico	Diagnosis
Emergencia	Emergency
Enfermedad	Disease/Illness
Especialista	Specialist
Farmacia	Pharmacy
Historial Médico	Medical History
Hospital	Hospital
Médico de Familia	Family Doctor
Radiografía	X-ray
Receta Médica	Prescription
Sala de Espera	Waiting Room
Seguridad Social	Social Security (Healthcare)
Seguro Médico	Health Insurance
Síntomas	Symptoms
Sistema de Salud	Health System
Tarjeta Sanitaria	Health Card
Tarjeta de Seguro Médico	Health Insurance Card
Tratamiento	Treatment
Urgencias	Emergency Room
Vacuna	Vaccine

Next Steps

Medical care in Spain ranks with the best in Europe and beyond. The vast majority of our interactions have been positive, and the care is as good as we’ve had anywhere in our Expat lives. The staff and care have been brilliant, from public emergency room hospitals to private specialist visits. You are in good hands with both private and public healthcare in Spain.

FAQ – Healthcare in Spain