Healthcare for short term visitors


My situation is that I am working in Morocco but not a permanent resident inasmuch as I leave the country to go back home every 3 months precisely not to lose my health care benefits there.

I was recently in Madrid for a short, 5 day break and needed to see a doctor for an acute problem that I was sure I needed antibiotics for. The hotel referred me to the University Hospital, where I was triaged and then seen, even though I was the lowest priority, within an hour. I was given a prescription for 2 strong antibiotics.  I paid a proportion of the cost for these at the pharmacy.

Now, some months later, the hospital has written to me saying that I owe consultation fees of 180 Euros. I had my valid European Health Insurance Card with me, which I had assumed gave me the same costs and services as a Spanish person would get. I understand that a Spanish person would not be paying 180 Euros for this service.

My question is, why should I pay this? Is this normal?

I'm actually not inclined to pay at all. To be honest, I would have preferred to see the private doctor in the clinic across the road from the hotel for 80 Euros if I had known I would have been landed with such a stinging bill from the public sector - the result would have been the same, it was a simple diagnosis and I would have been given the same very specific drugs.

Is this a mistake? As I said, I am not amenable to paying this. No one mentioned to me that there would be a bill for emergency treatment at the time, nor gave me any form warning me that this was a possibility. What can they do if I simply don't cough up?

I don't know the answer as to whether this is normal or fair. Certainly the headlines here in Spain say that emergency health care is available to everyone and there is a suggestion that means free. So far as I know EHIC cards cover emergency treatment too so it sounds as though you should have been doubly covered with your home health service picking up the bill.  The only thing I can think of is that the treatment was not considered as emergency treatment so either your home service or the hospital decided you should pay.

There's an interesting linguistic point here. What I would call emergency cover is called Urgencias here. A Spaniard explained to me that something I might consider urgent may or may not be classified by the health service as an emergency so they chose a linguistically correct name.

If you don't pay they are going to have a lot of trouble chasing you!

Thanks. I think it was pretty urgent as if I had not had the antibiotics the sequels could or would have been grave seeing as the place where the infection was is a delicate spot and could have infected my blood.

I've been thinking about this. If they had asked for 60 Euros or thereabouts, I would probably sent the money transfer and put it down to experience. However, I am certainly not going to send them 2 or 3 times the cost of a private consultation! As you say, they are going to have quite some trouble getting blood out of a stone over in the UK.

Hi Persika, The problem was that you were sent to the University Hospital for a prescription, not a matter of life and death at the time. 

If you had gone to a public medical centre there would have been no cost involved to see a doctor for a prescription, and if they had referred you as an emergency to the hospital there would have been no cost involved. The public health hospitals will charge a walk-in patient with an EHIC as you are getting a private consultation from their specialist doctors.
If you had gone to a private clinic you would pay a fee of 50-80€ to see a doctor and get a prescription.

Trust this helps clear up why you have been charged.

Having written this I see from another post that you appear to live in New Zealand, thus you will have private insurance cover.  I will however, leave my post as it may be useful to others )

In Andalucía the ‘Rights and Obligations’ of the National Health Service state that one has the right to be communicated with in a language which you understand.  In practice that does not always happen even for English speakers.

At least some medical centres in the main tourist areas of the Costa Del Sol have volunteer translators, however, they may ‘work’ irregular hours and some may not speak very good Spanish/English.

20 years ago I set up a voluntary translator service with  a National Police Station as I did not have sufficient  Spanish to be confident that in a medical centre I would not ‘kill’ someone.    Despite that I was accepted as a potential volunteer.

If you can afford it I would suggest you have private medical cover. That way you will have a good chance of finding a fluent English speaking medical service.

PS    When reporting some crimes one can do so in English by calling 902 102 112.The info you give is then used to make the crime report when you visit a National Police Station. That said, the results are often incorrect in the report, which is written in Spanish.

In one case a person said on the phone their house been burgled, the report in Spanish said a theft had occurred in their motorhome. 

Thus, if you make a report using that MO, take care to check as best you can that the report,  in Spanish, is correct.

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