How does healthcare work in Spain, and what travel insurance, health insurance or expat insurance do you need?

How does the healthcare system work in Spain?

In Spain they have SNS (the Sistema Nacional de Salud), which is one of the best health care systems in Europe.
Out of three hospitals, two are public and one is private.
Pharmacies (farmacias) in Spain are reliable and provide advice on medicines. Look for the green crosses that indicate that a pharmacy is open. Some pharmacies in cities are open 24 hours a day.
Mental health care leaves much to be desired, but it is being worked on. There is a great shortage of specialists, especially in the public sector. It is therefore not without reason that the country is one of the world's largest consumers of anti-anxiety medication and the EU's largest consumer of psychiatric medicines.
In case of an emergency, you can call 112.

With Seguridad Social you are obliged to be insured for (usually) free primary care. Due to the compulsory health insurance, health care is accessible to every resident of Spain. Everyone, even those on a low income, can receive medical care in this way. Healthcare in Spain comes from social security contributions that are deducted from your wages.
To be eligible, you must be registered with the Instituto Nacional de la Seguridad Social (INSS) and then apply for a health card (tarjeta sanitaria individual). You must take this with you every time you visit a health institution.
You will find hospitals and health clinics throughout the country. The doctors are well-trained and the care is of good quality.
Be prepared for long queues in public hospitals. It can also be a difficult and time-consuming process to get a referral to a specialist. Some public hospitals do not have English-speaking doctors, so it is important to be able to speak Spanish.
The public health insurance system also covers the immediate family of the insured.
EU residents can use the public system with their European Health Insurance Card (EHIC), residents of the United Kingdom can use their Global Health Insurance Card (GHIC). Spain also has agreements with a number of countries outside Europe on healthcare. This means that residents of these countries can use public healthcare in Spain in the event of an emergency or accident.

Despite the fact that the quality of public healthcare is good, many locals and especially expats (also) use private healthcare with private health insurance as a supplement to the coverage of public healthcare.
The advantage of using private insurance is that access to healthcare is easier and waiting times are shorter. Private healthcare uses a private network of clinics and hospitals. The clinics are more modern and everything is more comfortable. There are often English speaking specialists present or an interpreter (of the language of your choice) is at your disposal.

The first care, as well as a prescription for medication, is provided by the GP (médico de cabecera). You can generally find this at health centres, where several GPs work. It can sometimes happen that you have a different GP in front of you.
Expats must register with a local GP via the public healthcare system or a private network.
Consultations with public GPs are free. The price for private consultations can be quite high.

Dental care for people aged 15 or over is usually not covered by the public system, except in emergencies.
To find a dentist, search online for dentistas near you. Often, the first consultation is free and there is a charge for each visit after that.
Most expats visit private dental clinics, which are quite expensive.
Many expatriates therefore opt for additional insurance that covers dental care.

Pregnancy checks, ultrasounds and tests are fully covered by the public system and care by gynaecologists and midwives is standard.
Births can take place in public or private hospitals. Under the public system, you will be assigned a hospital.
Public hospitals offer excellent care, but less privacy and luxury than private institutions.
After the birth, there is follow-up by midwives and general practitioners. Home care is less common than in some other countries.
Contraceptives are widely available, most via a prescription from your GP. The emergency pill (la píladora del dia despues) can be obtained from the pharmacy without a prescription.
Abortion is possible up to 14 weeks into the pregnancy and if there are health risks up to 22 weeks.

Crime rates are low, especially for violent crime. Pickpocketing does occur in popular cities and especially in busy places such as markets, metro stations and tourist attractions.

Due to the strong sun in Spain, especially in summer, it is important to wear sunscreen and stay hydrated.
In summer, temperatures can exceed 40°C, especially in the south. Look out for symptoms of dehydration or sunstroke.
In some regions, such as the Costa Blanca, tiger mosquitoes can be present, causing itchy bites. Although they do not transmit diseases in Spain, they can be annoying.
In spring, pollen allergies can flare up, especially in rural areas.
Tap water is safe to drink.

Spain has an excellent road network, with modern motorways and regional roads. Some motorways (autopistas) are toll roads, especially in Catalonia and around Madrid. Tolls can be relatively expensive.
EU expats can use their own driving licence. Non-EU expats may need an international driving licence.
Always wear a seat belt.
Do not use a mobile phone while driving, except hands-free.
Avoid drinking and driving; the limit is 0.5 per mille (0.3 per mille for new drivers).
Spain has an excellent network of trains, buses and metros. The AVE high-speed train system is one of the best in Europe.
Taxis are reliable, and platforms such as Uber and Cabify are widely used.
Cycling is becoming increasingly popular, especially in cities such as Valencia and Seville, which have extensive cycle paths. Wear a helmet, especially outside urban areas, where it is mandatory.

Is the trip to Spain and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

For some visas, it is mandatory to have private health insurance in the first instance, because registration for the public system can take a while. Even when it is not mandatory, many emigrants still take out their own private health insurance for full coverage of healthcare costs.
Read more about insurances for abroad on Expatinsurances.org.

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