Healthcare in Spain

Hi Julien,

Public healthcare in Spain is actually quite good, especially for emergency attention and ordinary doctor's appointments.  In general, they are quite efficient and the quality is excellent.  However, it cn be slow when it comes to getting tests done or an operation which is not urgent.  There can be a waiting list.

That's when having private care can come in handy.  You can get more things done quickly.  It's also helpful when it comes to traveling outside of Spain, since most have their own international service. 

Hope this helps

Take care

Hi,

In order to help expats and soon-to-be expats, we would like to invite you to share your experience on this topic, with updated info on the healthcare system.

Thank you in advance,

Julie
Expat.com Team

I was hospitalized in Ibiza in emergency for Pneumonia overnight. While the equipment was not shiny and new as in the US, I found the people more helpful and interested in their work. It was covered by my insurance, and the price was about 10% of what it would have been in the US.

The healthcare system here was modelled on the UK but all doctors are employed by the State. GPs dont have separate contracts.
The Regions run the system for the State. But your health card works all over Soain. My region has total electronic records and test results. In my region of Valencia small health centres are only open in tbe morning but there is always a 24 hr clinic nearby. 
The hospitals in our opinion are excellent.  Ive been in as an emergency twice and my husband for an elective procedure.  Waiting times as a result of the financial crisis are not good now.
We have ftiends who have had treatment way beyond the level in the UK and have never regretted our decision. Best if you speak Spanish of course.

Pur experience of private health care was so unsatisfactory that we stopped it after 2 years, formally complained sbout our treatment and the system and spent the money on Spanish classes. We've never looked back.

Are you retired? You must change formally from the UK system to the Spanish. The paperwork has changed since we came but it was easy.
Please either use the UK system OR  the Spanish system.
If you are not retired then once you have a job and pay you nationsl insurance you get the State treatment.

Bit of a pain in the a** getting it all setup but it is run very well and efficiently!

I have the chance to travel a lot to Belgium. As a person with a Schengen (or is it EU?) passport I can have equal health assistance all over Schengen (or is it EU?) as a resident of that member country, just by paying social security (health care) in Spain.

So I use the Spanish system for everything that is urgent (like a broken limb), "small" health problems and to get prescriptions of my medicine that I need to take on a regular base. And it is quiet good if you arm yourself with a nice book (be prepared to wait one or two hours in cities like Barcelona or Madrid, even with appointment).

I use Belgian healthcare system for my teeth, to see specialists  (as for my longs) or to do total checkups.

In Spain when you have problems with your teeth they are not covered (except when they pull one out) also if you need to see a specialist that needs to take some radio of your longs this can take ages. Even if they're both in the same hospital. First you need to go to see you general doctor, who gives you an appointment for in 3 to 6 weeks, then you go to see the specialist, that gives you an appointment to have the radios (again 3 to 6 weeks) and to come back with the radios (this can be 4 to 7 weeks later). Also the medicine in Spain, although more open to alternatives, is not preventive.

my partner had a severe astma attack and literally could have been fatal. The local medical centre refusd to assist because we hadnt the correct dam form in that moment...

Also I had heart attack 18months ago. The hospital were fantastic.. I was lucky to make it to the hospital tho as the ambulance took over an hour.

Private all the way! If can afford it

This is a good website: gov.uk/healthcare-in-spain

If you are on holiday, got travel insurance/or the European Health Card,  I don't think you can worry, I live in the Valencian Province and I seem to remember that without any insurance the hospitals  have set up cash machines to enable you to pay for your treatment. I am not sure whether they actually put this into force.  But, If you are reading this and coming on holiday, don't forget, we the taxpayer in Spain (i.e. the government)  pays for your treatment if you haven't got insurance.

when I came to Spain as a pensioner, I wanted my health to be spot on. No-one wanted to help me at doctor level and the pain clinic told me that I was putting the pain on. We were fed up and so we chose to go private in England which cost over £7,000 and as we discovered he didn't do a proper job. Ultimately we got an appointment with the pain clinic, he told me I was putting the pain on. To be honest, I can't go around grinding my teeth and looking as though I have just lost a million which I think has been my downfall.

So here I am in Spain, in absolutely in agony to apply for a SIP card:  I stood in the queue for my SIP card -  they only would let 20 people into the office at a time (people would sit in the cafe and jump up as soon as the counting began or asked someone to take their place to wait) and so it took 3 mornings to complete the trip.

My local doctor in the medical centre I registered with is pretty much the same as England.  they refer you to a "doctor" (as in my case) at the hospital  who you initially see before you get referred to the hospital where there are consultants who deal with your problem.  Its been 5 years since I came to Spain and 3 years since I registered with a doctor at my local medical centre..If you don't speak Valenciano, you are frowned on and so we had to learn Spanish PDQ. She referred me to a general orthopaedic doctor who mainly dealt with all sorts of breaks etc. not one who specialised in backs. But every 6 months I have been going for cortisone injections until he has told me he doesn't want to see me for 2 years.  Luckily I have a friend who referred me to a good private spinal consultant who sent me to Benidorm for X Rays and MRIS. This cost just over £2,000. It resulted in 3 herniated discs and other things that were wrong with my back and a very long explanatory letter.

In between having cortisone injections I have been to the pain clinic. A chatty man who told me he loved England and gave me different pain reliefH - the second time I was supposed to have a spinal injection but they had forgotten about it.  Third time, a male nurse gave the computer a real beating at which time I walked out - absolutely fed up. In the meantime, we consulted another private spinal consultant who gave us the same answer as the first one. Oh I know it was 120€ a time but well spent.  He quoted me about 15,000€ which ate into a good bit of our savings.

Our spanish friends heard that we were selling our house and were worried that we were selling to provide the cash for my op (she is a physiotherapist) they were appalled at the treatment.   And so, tomorrow I am off to the hospital - arranged by the computer to see a doctor who might refer me to a spinal consultant.

If you have a bad back, don't come to Valencia - there are not many social spinal consultants. 

It is very hitty missy whether you get good treatment here, but as you can see, England was just as bad as the Spanish system.  I know what should happen to my back and have been told to keep my mouth shut by my partner as by now I know too much.

I also know one or two people who have been referred to big hospitals for their operations in Alicante and Alzira that have had their bodies messed up so I am just praying that I will not be in that queue.

There is no such thing as research here, there is not a lot of information on whom and treatment here unlike England.  After thousands of pounds, if I were to go private however, I now know who I would have to open me up .......

I needed hospital treatment in Barcelona and found it to be excellent. I used the E1-11 (the EU card) and wasn't charged anything. I also found the cost of prescription medication to be ridiculously cheap compared to Ireland (it's heavily subsidised in Spain) though some meds that usually require a prescription in Ireland were available without prescription in Spain. Language wasn't a problem either as most medical teams had someone who spoke excellent English.

Edit: I didn't have my EU 'medical card' with me at the time but the Health Service in Ireland faxed a copy of the number to the hospital in Barcelona and they accepted it with no problems.

Hi
My husband and I are both pensioners so we have tarjeta sanitarias entitling us to free healthcare, and very cheap prescriptions.  I have three experiences of Spanish healthcare, all of them good. 

My husband developed an ulcer on an artery in his stomach and unknown to us was slowly bleeding to death.  When he started to become weak I rushed him to casualty.  Within ten minutes of registering him in, a nurse had taken his pulse and he was on a gurney with two drips and within twenty minutes was in bed having a blood transfusion.  They told him that he had probably had less than an hour before total organ failure.  When he was discharged and we were back in England one of his legs started to ache so we went to casualty.  He was triaged after 3/4 hour and his leg was slightly swollen so they thought he may have a blood clot.  At ten pm he still had not been seen and they sent him home to go back the next day.  He could have had a stroke during the night.  The comparison between the Spanish hospital and the British hospital was stark.

About five years ago (in Spain) I tripped and broke my wrist.  A friend took me to casualty where they straightened my wrist and plastered it.  Because I was going to England shortly after they put all the details including the Xrays on a disc.  I took it to my GP who did not even look at the disc.  He told me he would arrange a specialist appointment.  I eventually received an appointment for three weeks later.  When I saw the specialist he said I may have to have my wrist re-broken and reset because I should have seen him ten days after I broke it.  Again a stark contrast between the Spanish and British medical care.

My husband developed quite severe arthritis.  Again in Spain.  He had his first consultant appointment within a couple of weeks of seeing the doctor.  This would have more likely been months in the UK.

What I am actually saying is that my experience of our local hospital has been good.  A lot of people think that Spanish healthcare is behind UK healthcare, but my experience says different.

I have used both the private health and NHS here in Spain.

The main difference that I have found between the two, is the language, Private health provide a translator, NHS you have to provide a translator.

The actual care.....private health was good, but you are never sure whether they are just trying to run up the bill as much as they can, but never had a problem with them.

NHS ..... they are obviously not going to waste money, I had a major operation on my eye about 2 years ago and I am still receiving treatment for an infection in that eye which I have had for 30 years,
In the UK the private heath company that I was with told me that there was very little that could be done and eventually I would lose the sight of that eye, the NHS here in Spain just won't give up with the treatment and have tried one thing after the other at this point they have improved the sight of that eye by 70%.

Yes I know technology improves over the years, so probably the UK would have got there, but as far as I'm concerned  the health care here in Spain is great

Sorry about your experience but you should have gone to a casualty department.  Clinics are not so good as hospitals.

I think that if you have an emergency all will be well.  If you have private insurance, they won't cover an existing illness - and its a good idea to have both social and private and dental. 

Since my last post, I visited the hospital as an initial visit before being referred to Valencia which was the plan. You do or you don't get referred.

Yes, I did get referred and a young doctor told me that I am going to have abotox for pain and i will do without tramadol, well we will see...... I'm not exactly jumping for joy.  In the meantime I will wait for the referral.  It takes some time to get out of bed and get going and glad to have my bed in the evening.  But then I was just like this in the UK, they were absolutely useless so Spain can't get worse can it.   

The only thing that made me shudder was when I told him that my sciatica was caused by herniated discs. to which he said herniated discs don't cause sciatica.  I am hoping it was his bad English...... but i will find out next week.... Looking back now, I don't think i would have come to Spain at my age 65 at the time.  Its too old to enjoy everything, unless you have excellent health

Interesting about abotox for pain as my husband was on tramadol, which is addictive.  He spent much of the day sleeping when he was on it.  When he came off it he had several days of really nasty withdrawal symptoms.  Hallucinations, depression etc.  The doctor did not tell him he should come off them slowly and replace with prednisone slowly.  Prednisone does not really help, but he swears he will never go back on to Tramadol.  If you have been on it for a while come off it slowly.

I belong to the arthritis Osteoarthritis forum on facebook, if you are interested I can tell you more.

I couldn't take 100% tramadol and that was years ago.  I am on Pazital now - my dr will only give me a certain amount, I think she thinks I will do myself in or take an overdose bless her.  Pazital has something like 38% Tramadol and the rest is Paracetamol.  A recent study proved that paracetamol doesn't help back pain lol. I think the dr gave me enough for 1 x 3 a day  whereas I take 2 x 3 times a day (the rest i buy over the counter (I worked it out I probably have spent over 70€ since I was prescribed them but... the consultant at the hospital told me that I can task up to 8 a day. I also take Lyrica which I am not happy about taking either, but what option do i have.  I take 2 at night and 1 in the morning but I have had times when I have sneaked 1 in when I have had bad pain.

I read on the internet some people crushing tramadol down and sniffing it..... no comment there.  Luckily I am near my time going to Valencia hospital but I thank you so much for pointing these things out and I have to think about coming off Tramadol and Lyrica at some time.  I think actually the Lyrica will be the worst.  My partner says my character has changed, I forget things, peoples names etc. I almost thought i was getting the dreaded disease. I hope that your husband is OK now. you don't say.  I am really glad that you have told me about prednisone too I will keep all these things in mind.  Bless you - you don't say where you live?

Hi Barnie. Thanks for the info about the arthritis forum.  I will look it up.  My husband has not improved but not got too much worse recently.  We have half a hectare of land and he has to strim and mow occasionally.  (I would do it but I have spent all winter cutting a ten ft wide by 840 feet overgrown hedge and training about 50 olives which had gone mad.)  Next winter I will be able to cut the grass)  He knows he will have puffed up hands the next day but not a lot of alternatives.  Like you he takes 2 prednisone a day although he is prescribed for one by the doctor.  Though the doctor did say he could take more if he needed to.  The has tried a few herbal pills as well but they do not seem to make a lot of difference.

here you are: ‎Osteoarthritis sufferers and rumatic arthritis suffers - Sharron is the - can't think of the name but you know looks after the group - think she has as quite a few people - have the same as your husband. Where are you in Spain?  Sounds lovely although as you get older, we say oh we would like this and that, but we should have done it years ago, you have a lot on your plate.and my little terrace is enough but wouldn't like to be without it. I'm growing a bit of veg - just for something to do and it keeps me busy dead heading.A clever cloggs Spanish retiree said he would grow us a lemon tree - Every year it grew a bit bigger but no fruit, guess what, we had oranges this year the Valencia lates and had 3 but 2 of them gave us a lot of orange juice.

I think he does really well, it takes me a bit to get going in the morning but we have travelled a lot in Spain and guess that ii would like to go back to the uk sometime.  I can appreciate what you are both doing though, most people round here just have a smallish plot, i suppose depending whether you bought your neighbour out. 

Well we are back to the uk tomorrow, so maybe I will meet you in the group..... A nne

Thanks. Have a nice trip.  I have started building a veg bed.  I want to include orange and lemon trees.

cannabinoids have proven very successful here for back pain, spondilitis etc.  Perhaps research this as is avaiable legally here in Spain

I have heard of cannibis being used for pain, but is it addictive/bad for you - I don't know, there are always the odd "cures" that you hear about and quite frankly the botox is being awaited with a question mark.  Not long ago, well probably 7 or 8 years they gave me chilli cream - yes it was HELPFUL (but only helpful) but if you put it on at night and although washing your hands is obviously I inadvertently put my hand near my eye and it was so so painful. So I think i will stick with this dr at the moment and bring on the botox and in the meantime wait for an appointment at Valencia.  You know he says and I know that movement will not be as good as I have now (I do yoga) but at 72 what do you expect?

Campogirl - hope your plants give you pleasure, I wasn't successful with a rhubarb plant but got lots of seeds I couldn't get in Valencia.  But my friend either forgot or didn't think my beans and peas needed so much water and they are in a poor way but there are some that have survived.  Take it easy won't you - you do have a hard job ahead of you but it does give you pleasure. Cheers. Anne

sorry didn;t see your note about fruit trees Campo girl. I have one of both.  You have lots of land where you won't brush past them and I find at the moment the little fruits are falling off.   

We have an exceptionally stupid man who lives next door.  my partner said he wanted an lemon tree so 3 years later he came round with a tree and we waited with anticipation. Guess what it was a Valencian late orange tree.  The pot was 60€ which is a laugh but we have agreed that we will keep it and I gave him a lemon tree for his birthday. I tend to brush past them too often.  The Vlencia late gives us lots of orange juice - 2 gives a litre!!!!  Good luck anyway.

Hi, healthcare is my greatest concern if I decide to live in Spain.  I understand when an expat reaches retirement age - me there are less options to choose because private health insurance becomes too expensive to afford.   Are there any tips that might help to seek out the best option if private health insurance plugs the gap between waiting times and getting treatment?

The other question is getting registered with a doctor.  What are the procedures and can one do this if renting for 3 months or more.   I understand I could not get the help of a local doctor if renting for a lesser period.

Just got a tablet and in the end thought i would use the pc, it was driving me mad.

All my pea seeds have died but just looked and a long white thing with lots of legs is in the tub so thats why I have no peas.

The beans are climbing now, but the tomatos have gone for a burton, but my friend has brought a plant round for me so i will wait till the heat has gone and buy some plants in Xativa on Friday.

Not really sure how many little fruits have survived me brushing past them but the trees seem ok.  I did think of you at the weekend.  Your husband couldn't take tramadol 100%, nor could I but Pazital has something like 38% and the rest is paracetamol.  They say though that paracetamol doesn't work for back pain. I also take Lyrica which I think I said. All I can say is "I get by" so I am hoping that the botox will keep me going until I go to Valencia hospital - I have it in my mind though that they are not going to be fussy about doing rods and screws but Cesar will be with me i hope that he will demand or we will go back to Dr Aguirre in Valencia. I know private surgeons have €s swimming around in their brains, I have been through that, I think I said that I paid £7,000 for the op and it didn't work but if you go onto the facebook arthritis group, introduce yourself and I will watch out for you.  Sharron is a hoot and cheers us up no end and there are lots of people around the world who are all in the same boat as your husband.

Good luck with the veg garden.  Wish I was a bit younger to do more gardening and considering I did have 3/4 acres in England I hated gardening.  Now I have a terrace of 100 square metres, I wish it was more but my partner keeps reminding me that its enough.

Hi, healthcare is my greatest concern if I decide to live in Spain.  I understand when an expat reaches retirement age - me there are less options to choose because private health insurance becomes too expensive to afford.   Are there any tips that might help to seek out the best option if private health insurance plugs the gap between waiting times and getting treatment?

The other question is getting registered with a doctor.  What are the procedures and can one do this if renting for 3 months or more.   I understand I could not get the help of a local doctor if renting for a lesser period.[

I hope this works with the colour.  Yes I understand your concern if you go onto https://www.gov.uk/government/world/spain it might explain a lot.

Some people do in fact use private health insurance - but you might not get it and if you do, as you say it may be expensive and it doesn't cover existing illnesses). I know someone who used it to take a bunion off her foot and she had to have it re-done. so much for private insurance.

I have gone private but have no insurance.  When I came to spain I was treated just like I was in England (disgustingly) and was very upset and in terrible pain. I have struggled on with tablet given to me by the dr but they can be bought over the counter so don't let on that I take more than she said.

I did a hell of a lot of research before I went private and luckily I hit the right surgeons but it cost over !,500€ for MRIs and X Rays and then consultatiosn with surgeons 110€ a time.  But, when our friends thought we were selling our house to pay for the operation they took me in hand and as he said "the mafia took control) i was seen in a week and having botox next week - i hope. Meanwhile I will wait for a referral to Valencia.  I think though perhaps I had a dr who didn't udnerstand, I don't go to the doctors looking ill, if you know what I mean.

If you are only here for 3 months, why don't you email the embassy?  they are extremely good.  They give talks near us now and again. europa.eu/youreurope/citizens/health/unplanned-healthcare/temporary-stays/index_en.htm
Expat articles are v good and in Valencia if you are ill and have no insurance or means of paying, they take you to a cash machine before they do anything. However, some years ago my daughter has a slipped disc and suffered with sciatica when she arrived and they did a cortisone injection for her but that was travel insurance.   

They are really cracking down on what they call holiday health care so be careful. So plugging the difference with the spanish health system I would go private and pay.  I have found here in Spain its just like the UK, they are very careful on treatment and you can't blame them in a way - there is so much abuse and money is tight. Having said that I am at the moment thinking of suing the NHS in England in the way I was treated but thats another story.

If you are going to be permanently here, you go and get your SIP card which is a real pain as someone has already said.  We didn't know that they only took 20 applicants at the police station to get a SIP, our translator came with us 3 times and at 12€ an hour it was a costly business.  The second time we waited to get in, people were getting other people to wait in the queue for them - there are all sorts of scams.  Once you get the paperwork you go somewhere else, I can't remember where but they tell you - they give you temporary paperwork and eventually your card comes.  Every time I go to the hospital, I have to put the card in and out comes information about my appointment, and the room etc. etc.   I think once we got the sip through the post and I am talking about months, we just took the card to the medical centre.  My partner speaks fairly good Spanish now but to pay for a translator every time is expensive and at the end of every appointment - she used to say "Where should we go for breakfast"........  I have thought of going to try and find a dr who speaks English but to be honest, just going to the hospital and the dr is stressfull.  Once in, you get the full medical and have it every year and our nurse is funny, he is well over 6 foot and smokes like a trouper, so we got him an ecigarette - don't know whether he has stuck with me.  But people waiting in the drs is like a little social gathering - MOST of the people in the village are very sweet, there are just one or two who unfortunately live right next door that are horrible to us.  But the village know about them. They are immigrants themselves from Uruguay.... Well I hope you make a good decision.  Its a big one I can tell you that but with Cameron in now 100% i think things will change for the better......

“The healthcare system here was modelled on the UK”
That disappointment, I thought the Spanish health system has its origins in the 13th century by “Fuero Real” (royal charter) of Alfonso X “the Wise”, king of the old kingdoms of Castile and Leon, and developed with the various Spanish governments until today.
And you tell me that in fact "only" is inspired by British health system, my Spanish pride is devastated.
gestion-sanitaria.com/2-sistema-sanitario-espanol.htm