Can expat retirees access free healthcare in Spain?

Yes, is the short answer. But there are conditions. If you don’t meet those conditions, however, don’t worry because Spain offers an economical way of accessing their full medical system without taking into consideration your current or past state of health, as a private medical insurance company would.

Healthcare is free of charge to anyone living and working in Spain, but be careful as the Spanish healthcare system is not centralised, and you will need to check the conditions in your autonomous community for using healthcare services. These conditions can vary, as can the requirements.

According to the WHO (World Health Organisation) Report and many other studies, Spain’s healthcare system has consistently ranked in the top 10 in the world. Spain is also a country that has one of the highest rates of life expectancy, so it’s not a surprise that expats in Spain wish to access it upon retiring to Spain.

Access to free state healthcare in Spain is possible if you meet one of these requirements:

• You are a resident of Spain who is either employed or self-employed, thus paying social security contributions.
• You are recognised as a resident of Spain and receive government benefits
• You are a resident of Spain, and your partner is registered with Social Security. This is valid even if you have just separated or become divorced.
• You are a state pensioner.
• You are a dependent of someone entitled to state healthcare in Spain.
• You are a UK Citizen by registering a UK-issued S1 form with the social security office.
• You are a permanent resident after having lived in Spain for 5 years.
• You are using a European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC) for temporary stays of less than 3 months.
• You are paying directly into the public health insurance scheme - effectively a private health scheme run through Spain’s National Health Service - this is called the “Convenio Especial”. If you are under the age of 65 and retired, you will have to pay a monthly fee of €60. However, those who are over the age of 65 must pay a monthly fee of €157. This doesn’t take into account previous illnesses or current health issues.

How to sign up for the 'Convenio Especial'

You will need to have been registered on the Padrón (civil registry at the town hall) in your local town or city for at least 12 months. If you have lived in different places during that period, you should present copies from the different registries to prove your length of stay in the country.

The next step is to apply for the Convenio Especial in your autonomous community. You can get up-to-date instructions by contacting your regional health board on this government website. That said, here are some direct links to the most popular autonomous regions in Spain for expats:

Murcia

Valencia

Andalucia

Balearic Islands

Canary Islands

Bilateral Agreements

Spain also has bilateral agreements with many countries that allow citizens of these countries to visit Spain for short periods of time and have access to free emergency medical treatment. By following this link you can read in Spanish the bilateral agreements that are currently in place. We would advise you to check with your local Spanish Embassy or Consulate to find out if there is a bilateral agreement between your country and Spain. If it turns out that you don’t have the right to free state healthcare, you will need to contract private medical insurance.

Depending on your circumstances, you may need to contract private health insurance before being able to access state healthcare, or you may even decide to maintain both at the same time.

Health Insurance for US Expats in Spain

If you are a US citizen moving to Spain, you can choose between private health insurance or benefit from the Spanish national health system, if you’re eligible. Medicare and other types of US health insurance will most likely not cover you while you are abroad. But, if your insurance company has an international plan, you can check with them and ask in advance. Once you have been a resident for 12 months you can apply for the Convenio Especial as explained above.