Health is something most of us take for granted but, like it or not, at some point or other all of us are going to require some kind of treatment.
That was recently underlined when a family member was rushed to Figueres Hospital on Christmas Eve, transferred to Girona Hospital on Christmas Day and operated under emergency conditions on Boxing Day, neatly putting the whole festive period into perspective.
While it wasn’t much fun to go through the the nursing staff and doctors were all excellent throughout, doing a difficult job made more difficult by cuts in funding and salaries and when, let’s face it, they would rather be at home with their loved ones and the operation, hospital stay, ambulance between hospital and treatments were all provided by the Spanish national health system.
Given this recent experience I thought it was time to take a look at healthcare in Spain and how to get treated whether through the Spanish health service or privately.
Private healthcare in Spain
While in the case above it was through the national health service, not everyone is eligible for the national health system, in which case you have two options; private health insurance or pay for for treatment as you need it. That latter option could get really expensive though.
When I moved to Catalonia I took out private healthcare insurance as I didn’t believe I qualified for treatment under the Spanish health service. Under current rules I would have qualified, so either I was wrong at the time or the rules have changed.
However, the quality of service provided by private healthcare insurer DKV has been excellent, including four weeks of daily physiotherapy. They provide a list of clinics and hospitals that accept DKV clients and you book an appointment at one of these, paying a euro or two for each appointment.
DKV is just one private healthcare insurer in Spain, you can compare what they offer with other companies to find one that suits you (and that is not an affiliate link, I earn no commission through the recommendation).
There are also clinics that offer their own insurance, although think carefully about these as they may have limited facilities.
Emergency treatment and the Spanish health service
Although there was a case in the summer of Figueres Hospital refusing a man treatment for cuts and bruises, after being escorted there by police, as he was unable to pay after being robbed at a service station the Spanish health system is supposed to take care of emergencies; this is true whether you have a Spanish health card or not.
It may be that the hospital decided that the man didn’t qualify as an emergency and he would be okay without seeing them anyway but it does underline the effect of budget cutbacks over the last few years thanks to the ongoing economic crisis.
I have no experience of this and haven’t heard anyone complain to me directly about not getting treated when they were in a life threatening condition in Catalonia, but that may not be the case in some areas of Spain and this report makes uncomfortable reading.
How to get a national health card in Spain
If you qualify for the Spanish national health system you will be issued with a health card to access treatment, which you get by first being issued a social security number and then registering at a local health centre or CAP (Centre d’Atencio Primaria in Catalan or Centro de Atención Primaria in Castilian) which will issue the health card.
Registering for a social security number
The first step towards getting a health card is getting a social security number. It is compulsory for Spanish residents who are employees or self-employed to have a social security number and pay a percentage of earnings to the social security system. In the event of unemployment the social security office should be notified otherwise you will continue paying into the social security system.
To get a social security number you need to complete the TA1 social security form (which you can download here) and present it and a copy at your local social security office (Tesorería General de la Seguridad Social) along with your NIE and a residency certificate or your passport.
This will get you a registration certificate (documento de afiliación) and social security number.
Registering at your local CAP
Your local CAP will be able to issue you with a healthcare card when you present the social security registration document (tarjeta de seguridad social). The application will typically take a week or two to process but after that you’ll be able to collect your healthcare card from the clinic and obtain healthcare on the Spanish national health service.
Remember though that if you are issued with a prescription you’ll need to pay a percentage towards it which is currently 10%. Also, if you receive treatment in a hospital you may be required to pay a proportion of the drugs used during your treatment, depending on your exact circumstances.
