The Spanish state health system offers an excellent standard of care. If you are a EU citizen living in Spain permanently, you will be entitled to free health care for yourself and your dependants provided you are in receipt of a state or disability pension or if you are working and contributing to the Spanish social security system as a self employed person or via your employer as an employee.
In April this year the Spanish government introduced changes in the requirements to obtain residency and you may now be required to prove that you have either public or private health insurance, which must provide cover in Spain equivalent to that provided by the National Health System.
Pensioners will be considered to meet this condition if they can prove, by means of the relevant certificate, that they are entitled to health care paid for by the State from which they receive their pension. In the case of UK state pensioners the form S1 (available through the DWP International Pensions Centre) should be sufficient. The European Health Card is only intended for UK residents who are in Spain temporarily and their treatment costs are reimbursed by the UK.
If you are living here permanently, this card is not intended to be used to obtain state health care here and local health centres now appear to be enforcing this ruling more strictly than in the past. Additionally, returning to the UK for treatment may no longer be an option. Once you have established residence in Spain you may lose the right to free NHS treatment unless you can prove residency in the UK.
If you live in Spain and are not entitled to free care, private health insurance is an essential. Without it you could find yourself facing substantial, and possibly even financially crippling, medical bills. However, arranging insurance - particularly health insurance - is something that we often put off.
For many of us health insurance was not a necessity in the past. But if you do wait until you need it, you may find cover difficult to arrange. Clearly, most insurers will not insure you for an illness you already have. BUPA International and Sanitas will consider providing cover for pre-existing medical conditions. This does not apply to serious medical conditions and
terms and conditions do apply.