As a lot of expats living in Spain tend to be older people, and naturally the question of medical services whilst there has to be considered, and in fact for some is one of their top priorities.
When you move there, you do not register with a Doctor until you need his services. This could be either when you are calling in because you are sick, or need a prescription. You need photostat copies of your European Health Insurance card and apply for a Spanish medical card for further treatment. A Spanish Lawyer will do the application for you for about 40 euros.
The UK is included in an agreement which allows free treatment to non-Spanish pensioners. This requires UK pensioners to take their S1 form. The S1 (previously E121) can be applied for from the International Pension Centre (IPC) in Newcastle. Then pensioners register at their local social security office, Instituto Nacional de la Segurada Social (INSS). Residence Certificates must also be taken along. Further information can be obtained from the Foreign & Commonwealth Office website which has a section on medical in Spain
Emergency treatment in Spain is good in that you do get seen quickly (though with the usual hospital waits experienced in hospitals we’d expect in the UK). That does not stop the better off Spaniards taking out private health insurance with all the benefits that can bring though. A lot of expats also prefer the benefits of having private health insurance, though if a private clinic is a long distance from where you live it might not be worth having, especially if, for example, you are about to give birth and having contractions!
If you are on repeat prescriptions, then you have to phone the doctors’ surgery for an appointment to go in to apply for the prescription, and then call back later in the day to pick up the prescriptions. If they have a green border then you have to pay but a red border is free. If either member of the household is over 60 then both of the patients get prescriptions free.
If you have private health insurance you have the advantage of not having to use the Spanish Health System in full. So, rather than seeing a Spanish-speaking doctor you are likely to be able to see an English-speaking specialist whilst in Spain. If you were with BUPA in the UK you would be able to transfer your account to Sanitas in Spain. Your cover continues there with all the same conditions as when you were with BUPA.
The doctors in Spain refer people to hospital consultants a lot more than is the case in the UK. The hospitals in Spain allow visiting almost any time of the day or night and they like to watch television whilst they are there, which is disconcerting if you do not feel well and you just happen to be in the next bed at three o’clock in the morning.
Whilst Spanish nurses are well-trained, they aren’t expected to carry out the same tasks as their British counterparts. As far as personal care of the patient is concerned, the patients’ visitors (often relatives) are expected to help out in the feeding, changing some dressings and washing them. When you go to the doctors or hospital an interpreter is required and this costs approximately 12 euros per hour. The new hospital on the Costa Blanca in Torrevieja recruited only staff that could speak fairly good to very good English, so an interpreter would not be required here. There are always Private Health plans to fall back on and these cost a similar rate those in the UK.
Most medicines in Spain that are on prescription can also be bought from the chemists over the counter. A lot of them are available at a cheaper price than in the UK. The costs of many medicines reflect the lower cost of living in Spain. Expats will be surprised to see big differences. One example is a well known cold sore treatment cream. Zovirax costs over £5 in the UK, yet it is sold in Spain for around the equivalent of £2.
There has been a recent change as far as prescriptions are concerned. To save on costs, doctors will be prescribing the active ingredient in a medicine rather than a brand name. The savings to the taxpayer are estimated at a huge 2.4 billion euros a year.
I have known of situations where people have been involved in accidents and had to be picked up by ambulance to go to hospital. The best way I could describe the actions of the ambulance personnel would be ‘rough and ready’ to say the least.
For those going to Spain on holiday, or say to view properties prior to making a purchase, it is essential to have some form of travel health insurance. The first thing to do is get hold of the European Health Insurance Card (EHIC), which is free. This card allows you free or reduced-cost medical treatment. In addition, it is also worthwhile taking out travel insurance to ensure that you are covered for all possible eventualities.
The EHIC is supposed to cover the cost of emergency treatment and cover patients for pre-existing long-term medical conditions, and applies to all 27 EU member states, plus a few other countries which have reached agreement to provide treatment.
Beware though that Spain is facing action by the European Commission for refusing to treat some foreign holidaymakers even though they have a valid EHIC.
Instead some hospitals are asking holidaymakers for insurance details, or insisting the patient pays for treatment. Naturally insurance companies are angry and have complained, as it means they are having to fork out money for their clients’ medical bills they shouldn’t have to.
Anyone visiting Spain from outside the EU will need to check the relevant information pertaining to their normal country of residence. As an example of some of the differences which may apply to non-EU residents here is what the US government website advises for Americans visiting Spain -
“The Department of State strongly urges Americans to consult with their medical insurance companies prior to traveling abroad to confirm whether their policy applies overseas and if it will cover emergency expenses such as a medical evacuation. U.S. medical insurance plans may not cover health costs incurred outside the United States unless supplemental coverage is purchased. Further, U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States. You should contact your insurance provider before departure so appropriate arrangements can be made. Many travel agents and private companies offer insurance plans that will cover health care expenses incurred overseas, including emergency services such as medical evacuations.”