Which Options Do Foreigners Have in Healthcare?

All Spaniards, as well as foreign citizens who have established their residence in the national territory, are entitled to the right to health protection and healthcare in accordance with the provisions of Article 1.2 of Law 14/1986, of April 25, General Health Law, thereby establishing the universality of the right to healthcare in Spain.

What happens to those that do not have their residence in Spain? Here you have some options in public and private healthcare.

Overview of Public Healthcare in Spain for Foreigners

The Spanish healthcare scheme ensures that all individuals, regardless of their situation, have access to emergency medical services and some basic services, while legal residents have broader and continuous healthcare coverage.

Visitors for Less Than 90 Days Without a Visa

• Access to Public Healthcare: Tourists from European Union (EU) or European Economic Area (EEA) countries can access public healthcare with the European Health Insurance Card (EHIC). This card covers emergencies and necessary treatments during their temporary stay.
• Travel Insurance: Visitors from non-EU/EEA countries are advised to have travel insurance that covers healthcare, as non-urgent services are not covered by the public system.
• Emergency Care: In case of emergencies, all visitors are entitled to receive medical care in public hospitals. However, without the EHIC or insurance, costs can be high.

Visitors for Less Than 90 Days Requiring a Visa

• Mandatory Health Insurance: To obtain a Schengen visa, it is mandatory to present health insurance that covers a minimum of 30,000 euros and is valid throughout the Schengen area. This insurance covers emergency healthcare and other necessary treatments during the stay.
• Emergency Care: Like the previous case, visitors with a visa can receive emergency care in public hospitals, but costs may not be covered without appropriate insurance.

People Illegally Staying for More Than 90 Days

• General Public Healthcare: Some foreigners in illegal situation are entitled to have assistance, which has to be granted case by case. They have to go directly to the Health Service of the Autonomous Community where they reside, who evaluates each case. They must prove evidence of 90 days in Spain through “empadronamiento”, aka, register at the City hall.
• Access to Emergency Services: People in an irregular situation are entitled to receive urgent medical care, assistance in cases of pregnancy and childbirth, and healthcare for minors under 18.
• NGOs: There are non-governmental organizations that offer free or low-cost medical care for people in an irregular situation.

Digital Nomad Visa & Non-Lucrative Visa

• Healthcare Rights: Generally do not have automatic access to Spain’s public healthcare system.
• Requirements Private Health Insurance: Required to obtain the visa and must cover the entire duration of the stay in Spain.
• Public Healthcare: They can access public healthcare by registering and paying into the Spanish social security system, although this is not commonly done due to the nature of their visa.

Legal Residents (Temporary & Permanent)

• National Health System (SNS): Legal residents in Spain are entitled to healthcare through the National Health System (SNS). This includes primary, specialized, hospital, and pharmaceutical care.
• Individual Health Card (TSI): To access these services, legal residents must obtain the Individual Health Card (TSI), which can be requested at health departments in the respective autonomous community. They must already have their NIE (Spanish ID for foreigners).
• Access to healthcare in other European Union (EU) or European Economic Area (EEA) countries: Legal residents can access public healthcare with the Global Health Insurance Card (GHIC). This card covers emergencies and necessary treatments during their temporary stay.

Options in Private Healthcare Providers

In the context of private health insurance in Spain, a copayment is a fixed amount that the insured must pay for each medical service or consultation received, in addition to the monthly payment of the insurance. Here are the estimated rates in table format for a healthy person with no pre-existing conditions, at the ages of 60, 70, and 80, for each of the three types of policies (high copay, low copay, and no copay).

We have also created this basic calculator, extracting data from Spanish health insurance companies with artifical intelligence. The estimated amount is with non-preexisting conditions.

Key Companies

These are the largest private health insurance companies in Spain, with some figures in number of customers.

Healthcare may be provided in the private sector in the following circumstances:

Patient Choice: Some patients might have decided to have also private providers at their own expenses. for certain treatments, with costs covered by the public health system.

Concerted Care Agreements: The Spanish National Health System (SNS) may establish agreements with private healthcare providers to deliver services that are not sufficiently available in the public sector. This is common in areas with high demand or where public facilities are lacking. In some cases, the public health system may refer patients to private facilities for specialized treatments or surgeries to reduce waiting times.

Emergencies: During emergencies or exceptional situations, such as natural disasters or pandemics, private hospitals may be utilized to supplement public healthcare services.

Companies Agreements: Some corporations may choose to provide compulsory social security healthcare services to their employees through private companies. It is no unusual that big corporations assist in their own facilities with general practitioners, and use private companies for specialists, hospitalization, and others.