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Healthcare in Spain: What you need to know

Tapas, sangria, flamenco…all these wonderful Spanish clichés await you in your new life in Spain.

Healthcare in Spain: What you need to know
Photo: monkeybusiness/Depositphotos

Just one thing before you grab your castanets and go. You should really take the time to look into the healthcare system in your new country. It’s always good to know the basics, just in case.

Unless you’re already fluent in Spanish and familiar with Spain, knowing where to start can send your head spinning. That’s why we’ve pulled together this nifty guide to help you get sorted, so if you feel la fiebre coming on, you know who to call.

Registering for healthcare

You’ll be pleased to hear the Spanish healthcare system offers free or subsidised health services and prescriptions for official residents and their family members. That means once you’re a legal resident and pay Spanish social security you get access to the same healthcare as Spanish citizens. ¡Olé!

Don’t panic if you’re not paying social security. There are also deals if, for example, you’re a retired British pensioner living in Spain and not paying into the Spanish system. 

When your situation is clearer, you can start the process of registering with a doctor. But first, you’ll have to register with the state healthcare system. Spanish healthcare is decentralised, and each of the 17 regions is responsible for itself. That means you should check with your regional health authority to find out what services are available to you and how to access them.

You’ll also have to register your address on the padrón at your local town hall, or ayuntamiento, where you will be given a certificate of empadronamiento. When you first register with your doctor, remember to take this with you – it also comes in handy for other situations where you may need proof of address.

If you’re living or staying for an extended time in Spain but not eligible for state healthcare, you can take out private healthcare insurance. Insurance companies like Cigna Global offer excellent packages that include access to its global network of hospitals, clinics and doctors, as well as a 24-hour helpline so you have support around the clock.

Finding a doctor

Most likely you’ll have a health clinic, centro de salud, or an individual practice, médico de cabacera, nearby. These offer all the regular primary care services, and you can usually find one through the phone book under medicos or your local healthcare authority.

In some of the more remote or less populated areas, you may have to travel to find a healthcare provider, or there may be a doctor or nurse available on specific days. If you know people in the area they might be able to recommend a doctor, and your embassy may also maintain a list of English-speaking doctors in your area.

Once you’ve found a doctor, you will need to register before you can make an appointment. This is when you’ll need to show your empadronamiento – which must have been issued within the last three months.

You should also take your TGSS (Tresoreria General de la Seguridad Social) certificate, passport, and Foreigners’ Identity Number (N.I.E.). All three are needed to apply for your health card, or tarjeta sanitaria individual, as well as a Sistema de Informacion Poblacional, which is a non-transferable card that gives you access to Spanish healthcare.

Each time you visit the doctor, hospital, or pick up prescription meds you will be required to show this card. It will mean you are entitled to receive state health without charge, so make sure to keep it somewhere safe!

Emergency care

If you need urgent medical care you should go straight to your nearest hospital’s emergency room, or urgencia (there’s a nice easy word to remember). Most chemists, or farmacias, will also be able to tell you where to go if you need urgent medical treatment.

Spain’s general emergency number is 112, so if you need a paramedic or require an ambulance then dial that number straight away. It’s a good idea to learn the Spanish translation if you suffer from an existing medical condition or allergy so there’s no confusion over how to treat you.

In case of emergency, you will be required to show your health card to receive state treatment. Or if you have private health insurance make sure to keep your details handy.

Cigna Global’s International Health Insurance covers emergency medical care, including reasonable transportation costs to the closest centre of medical excellence in the event that the correct treatment is not locally available in an emergency. It’s good to have this peace of mind while living abroad, so there’s no doubt over what care you and your family are entitled to in case of an emergency.

Find out more about Cigna Global health insurance

Specialist care

To see a specialist through the state system you will need to get a referral from your doctor. If you have private health insurance in Spain you can often skip this step and make an appointment directly with a specialist clinic, saving you time spent potentially worrying or in pain.

With a private health care provider like Cigna Global you will get an appointment faster than if you go through the state system. Cigna can also find you an English-speaking doctor so there’s no language barrier throughout the diagnosis and treatment.

Get a free quote from Cigna Global

Pharmacies

Spanish farmacias are easy to spot, just look out for the flashing green cross in or outside the window. Unlike in some other countries, all medicine, including over the counter painkillers like paracetamol and ibuprofen, must be purchased in a farmacia. If you are new to your area and not sure where your closest farmacia is, you can find it here.

If you have a minor ailment or common illness, the highly-trained pharmacists can provide you with treatment. In the bigger cities where there are more tourists this can often be done in English; however, further inland or in remote areas this may not be as easy. If your problem is more serious or ongoing, you should still see your doctor for a proper diagnosis.

Make sure to take your health card along with you when you pick up any prescription medicines. You still have to pay 60 percent of the cost, but in general, medication is fairly reasonable. If you are a pensioner you are entitled to free prescriptions.

Something to keep in mind is that you are living in the land of the siesta, so most farmacias close for a couple of hours in the afternoon and re-open around 5pm. On weekends they can close earlier, so make sure to check and visit early on in the day if necessary. Some regions have emergency pharmacies that are open 24 hours so if it’s urgent you can pick up medicine out of regular hours.

Insurance

Although the Spanish state healthcare system is one of the best in the world, it’s always useful to have access to private healthcare. Cigna Global specialises in healthcare for expats, offering flexible coverage at every level so you can enjoy your paella without worrying about all that cholesterol in the prawns.

This article was produced by The Local Client Studio and sponsored by Cigna Global.

 
For members

RENTING

Do I have to pay the estate agent a commission if I rent in Spain?

Who has to pay the real estate agent commission (usually equivalent to one month's rent) in Spain: the landlord or the new tenant? And are there exceptions to the rules or underhand tricks agents use to get tenants to cough up more money?

Do I have to pay the estate agent a commission if I rent in Spain?

Up until 2023, the general rule in Spain was that both the landlord and the tenant would both have to pay estate agency fees when a rental contract was processed through them, although in some cases it was just the arrendatario (tenant) rather than the arrendador (landlord) who had to foot most of this commission.

Tenants often had the sense they weren’t getting much in return out of it, as it was common to find apartments hadn’t been cleaned, filled with broken furniture and other appliances that weren’t working.

On top of a commission to the agency equal to one month of rent, tenants had to pay one to two month’s deposit and a month’s rent, meaning they had to pay a total of three to four months’ worth of fees upfront, which would rack up to a lot of money. 

READ ALSO: The cities in Spain where people fight most over a place to rent 

Thankfully, Spain’s housing law, brought into force in May 2023, put an end to this and now it’s solely down to the landlord to pay the agency fee as they’re the ones who hired them.

The law, which modified part of the Urban Leasing Law of 1994, now states: “The expenses of real estate management and formalisation of the contract will be borne by the lessor,” that is, the owner of the property.

READ ALSO – Renting in Spain: Can my partner move in with me?

One of the main problems is that agencies have been doing this for so long that they stand to lose quite a bit of money and may continue to ask tenants to pay on the side. 

Alejandro Fuentes-Lojo, a lawyer specialised in real estate law explained to Spanish news site Newtral: “Many professionals will try to circumvent this prohibition, and in some cases they will try to make the tenant pay out of pocket, but we must warn that if they agree, they will be unprotected by the law”.

Be aware, even though tenants shouldn’t have to pay the full agency fees anymore, there are certain circumstances in which they may still have to pay something.

The Rental Negotiating Agency (ANA), states that there are a series of exceptional cases where real estate agencies can pass some of these expenses on to tenants, specifically when they are offered a series of additional services that directly benefit them.

These expenses could include house cleaning services at the end of the lease, repair services and legal advice during the duration of the contract, or other services where it can be proven that they have a direct benefit for the tenants. These expenses can only be collected after the contracts are signed.

READ ALSO – Q&A: When can you legally leave a rental property in Spain? 

The general director of ANA and a lawyer specialised in leasing, José Ramón Zurdo, states: “The new Housing Law does not regulate or limit the impact of expenses that accrue after the signing of the contracts, because the limit of expenses that can be passed on is closed after this time”.

According to the new housing law, expenses that can’t be passed on to the tenant include management expenses charged by real estate agencies for intermediating, searching for tenants and showing the homes. Tenants can also not be charged for expenses of formalising contracts or paying any lawyers or notaries involved.

There are also four exceptional cases where agencies can still charge fees to tenants, when they are not habitual residence leases and, therefore, are not regulated by the Urban Leases Law.

These include:

  • Tourist accommodation
  • Rental of commercial or office space
  • Seasonal rentals
  • Luxury housing leases – Properties whose surface area exceeds 300 m2 built, or whose rent exceeds the interprofessional minimum wage by 5.5 times.

READ ALSO: Spanish court rules buyer can purchase property directly from seller without paying agency fees

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