Spain

In Spain, health care is public and not universal, and it depends on the requirements of each Autonomous Community. From 2012, only insured persons or beneficiaries have the right to public health care. 

Insured persons are:

• Employed or self-employed, affiliated to Social Security.
• Pensioners of the Social Security system.
• Persons who receive any other periodic social security benefit (including unemployment benefit).
• People who have exhausted the unemployment benefit or other similar ones, are unemployed, do not accredit the condition of insured person by any other title and reside in Spain.
• Minors subject to administrative guardianship.

Beneficiaries are: 

• Spouses of the insured person or someone who lives with the insured person as a civil partner.
• Ex-spouses or person who is legally separated, receiving a compensatory pension from the insured person.
• Descendants of the insured person or their spouse under 26 years of age or, in the event of being older than this age, who have a recognised disability to a degree equal to or greater than 65%.
• Minors subject to the guardianship or legal protection of an insured person or their spouse.
• Siblings of the insured person.

Exceptions exist for:

• • Foreigners from a country in the European Union, the European Economic Area or Switzerland who are residents in Spain.
  • Political asylum seekers with authorised residence in Spanish territory.
  • Victims of human trafficking, during the period of recovery and reflection. 
  • Persons requiring urgent health care due to serious illness or accident, pregnancy care, childbirth and postpartum care.
  • Children under 18. 

If you are an insured person or a beneficiary, you are entitled to receive health care benefits provided by the National Health System, which in Spain includes: 

• • Medical care: In health centres and hospitals, public or private, and home care.
  • Emergency: If you need urgent care, you can be treated at any medical centre and receive hospitalisation if necessary. If you need an ambulance service, it will also be covered by the Spanish system.
  • Rehabilitation: If you need rehabilitation due to a doctor's prescription, the national system will cover the cost.
  • Medicines: Costs are covered depending on the status of the insured person. As a rule, insured persons have to pay between 10 and 60% of the final price, depending on their income and the autonomous community.
  • Health transport.

• Temporary migrants coming from another European country:
  • With the European Health Insurance Card, anyone from another EU country has access to state-provided healthcare during a temporary stay in another European country.
  • Since 2018, according to RDL 7/2018 Art. 3.1, foreigners who are not registered or admitted as residents in Spain are entitled to health protection and health care under the same conditions as persons with Spanish nationality. 

• Under the new rules, the right to public health care is decoupled from social security contributions. This means that it is not necessary to be a holder of a Spanish health card or be registered in a particular place to benefit from this service.

• Temporary migrants coming from outside of Europe:
  • When migrants are not insured in any EU country and decide to move to Spain, it is mandatory to have travel medical insurance for 90 days, as you are considered to be in a "temporary stay" situation. 
• If you are planning to stay longer than 90 days in Spain, the following aspects must be considered:
  • Foreigners, regardless of their situation, can be treated by the National Health System, but without regaining the right to a health card.  
  • To be able to apply for a health card, the following requirements must be met:
    • To be of legal age at the time of application.
    • To not be receiving any other benefits.
    • To prove residence in Spain for more than 90 days (this is the main aspect that varies from one autonomous community to another). 
    • To not reach 100,000 euros of income.
• If these criteria are met, you will obtain a document that acts as a health card, which is only useful in the autonomous community in which you are registered and is valid for one year. Your application is made through the social workers at health centres.
• In addition, it will always be necessary to meet the requirements established by each autonomous community. Each of them applies the law in a different way, and this results in significant differences between them.

• This is a contributory benefit granted to people who are unemployed, but with a commitment to work and who have paid a minimum of 360 days of contributions in the 6 years prior to becoming unemployed. You will receive this benefit if:
  • you are affiliated to and registered with a social security system.
  • you are legally unemployed, registered as a jobseeker with the public employment service, actively seeking employment and willing to accept suitable employment.
  • you have paid at least 360 days of contributions in the six years preceding your unemployment or before the end of your obligation to pay contributions.
  • you are older than 16 years and have not yet reached retirement age.
• If you are fully unemployed, you are entitled to unemployment benefit:
  • In the first 180 days - 70% of the regulatory base
  • From the 181st day - 50% of the regulatory base
• The amount of the benefit may in no case be higher or lower than certain established limits, depending on the number of family members that the unemployed person has in their care.
• Here you find more information: 

https://ec.europa.eu/social/main.jsp?catId=1129&langId=es&intPageId=4800

• If you are unemployed, but have not paid enough social security contributions or find yourself in certain situations, you may be eligible for some of the non-contributory unemployment benefits that exist in Spain:
  • Welfare level unemployment benefit: you can apply for this if you are not entitled to contributory unemployment benefit because you have not paid the necessary contributions to the Social Security System, or because you have exhausted the contributory benefit you were entitled to but are still unemployed.
  • Active Insertion Income: you can apply for this if you are a long-term unemployed person between the ages of 45 and 65. Migrant workers over 45 who have returned from abroad, disabled people and victims of gender-based violence can also apply.
  • State programmes instead of financial support to enable young people under 30 years of age, who never worked before and do not meet the minimum contribution requirements to enter the labour market.
  • Minimum resources: If you do not have enough income to live on and have not previously paid, or not enough, the Spanish social protection system offers you a series of non-contributory benefits (housing aid, social services benefits, non-contributory disability pension, benefits for families with financial difficulties)

Further information: www.imserso.es

• In Spain, if you fall ill and must stop working temporarily, you are entitled to claim temporary incapacity benefit. This will cover any daily loss of income that you no longer receive while you are not working, as well as health care.
• You can claim the allowance for any common illness or non-occupational accident, provided that three days have passed since the onset of the illness or since the accident occurred. You may receive the aid for a maximum of 365 days, which may be extended for a further 180 days if cure is expected during that period.
• To receive the allowance, you need to register with any social security scheme and have paid a total of 180 days of contributions in the previous 5 years.