The quality of health care in Spain is very good, especially in the large metropolitan areas. There is also a private sector and it is estimated that around 15% of the population, mainly in Madrid and Barcelona, use it.
Every person in Spain is entitled to treatment without exception – and that includes EU residents – even free of charge!
As a welfare state, Spain is obliged to provide treatment to every sick person.
A pensioner from Germany, for example, who pays into a German health fund as a compulsorily insured person, continues to do so even if he has moved his main residence to Spain. He remains insured with the German health insurance fund, he keeps his usual health insurance card and can notify the health insurance fund of his change of residence without suffering any disadvantages.
In addition, the pensioner is now entitled to free treatment in Spain, just as he would be a Spaniard. He even receives his medication with no additional payments. The registration with the Spanish social security , which gives him access to the Spanish healthcare card and assigns him a family doctor. Now the pensioner has two cards: the German card for treatment in Germany and the Spanish card for treatment in all public hospitals and health centers.
Those who are voluntarily insured in their own EU countries also have free access to the Spanish public health system. This insured person is only accepted for a period of six months and must always reapply for membership after six months. In the case of voluntarily insured people, there is often no guarantee that the medication co-payment will also not apply.
Pensioners who were already privately insured in their home country do not have free access to public health care in Spain. You are in a difficult situation: If you disclose to your home country insurance company that you are moving out of the country, they may, under certain circumstances, terminate the insurance contract. A new contract with a Spanish insurer is cheaper, but pre-existing illnesses and the resulting consequences are not also insured – a decisive disadvantage, especially for older people.
But this group of people is also absorbed by the public system: by concluding a service contract with the Spanish provider. To do this, you must have been registered with the municipality’s registration office for at least 6 months and be able to present the foreigner’s certificate. Care by the public institution costs 270 euros for those under 65 years of age and 330 euros for people of retirement age.
Incidentally, those who are voluntarily insured in EU countries can choose whether to give up their health insurance and sign up for a care contract in Spain. This option is not available to those with compulsory insurance.
Anyone who leaves their EU country health insurance or private insurance no longer has to fear that they will no longer be accepted into an insurance policy if they return to their home country at a later date. The legislature has now standardized a right to admission.