Worried about healthcare when you move to Spain? You needn’t be. Spain’s National Health System (SNS) is comprehensive, free for anyone living and working in the country and straightforward to access – once you’re registered. This guide shows you exactly how it works and how to get set up fast.
Here you’ll find who qualifies for state care, how to register with social security and your local health centre, what EHIC/GHIC cover on short stays, how prescription costs are calculated and how GP appointments and referrals work.
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Contents
How the system works
Spain’s national health system is tax-funded, decentralised across the autonomous communities and provides virtually universal coverage. Care in the public system is predominantly free at the time of treatment, with prescriptions subject to charges that vary by income.
Who is entitled to state healthcare
You can usually access state-funded care if you fit into one of these categories.
| Category | What qualifies you |
|---|---|
| Employed or self-employed resident | Registered for Spanish social security and paying contributions |
| Resident receiving state benefits | Recognised entitlement via social security |
| Dependent family member | Registered under a contributor’s social security |
| UK state pensioner (resident in Spain) | S1 form issued by the UK |
| Student under 26 | Enrolled at a Spanish institution |
| Temporary visitor | Short stay with valid EHIC or GHIC |
How to register
- If you’re employed: your employer registers you for social security and contributions are deducted from your salary. You’ll still need a social security number (número de afiliación).
- If you’re self-employed: register as self-employed (autónomo) and pay monthly contributions, often arranged through a gestoría.
- If you’re not working but eligible: register in person at the Social Security Office (TGSS).
- If you’re a dependent: provide a marriage or birth certificate to be included under a social security contributor’s number.
- If you’re a UK state pensioner: request an S1 from the Overseas Healthcare Services.
Once registered with social security and received your card, take it to your local health centre to register for healthcare.
Hospitals and emergency care
Public hospitals are clean, efficient and generally provide high-quality care. A&E (Urgencias) is usually quick and thorough, though facilities like coffee shops and family rooms are less common than they are in the UK.
Visiting hours tend to be more flexible and visitor numbers are not limited, which can make wards livelier.
Many clinicians speak some English, but it’s best not to assume this.
Registering with a local doctor
First get your padrón (address registration) from the town hall. Take your padrón (issued within the last three months), passport, NIE and social security card to the local health centre to register and receive your health card. You will need to show this card at GP visits, hospitals and when collecting prescriptions.
Note: dental treatment is not covered by the state system; most people use private dentists.
EHIC and GHIC for visitors
The EHIC (until expiry) and UK GHIC give access to basic state healthcare during a temporary stay. They do not cover private treatment, repatriation or routine planned care.
Private healthcare
Many expats choose private insurance alongside public care to access wider hospital networks and shorter waiting times. You can buy cover directly or use an independent broker. Policies vary in how they treat pre-existing conditions and dental care, so check benefits carefully.
Prescriptions and pharmacies
Medicines are dispensed only by pharmacies (farmacias). What you pay for prescriptions depends on your income and status under national rules:
| Income/status | Standard patient contribution |
|---|---|
| Active workers < €18,000 | 40% |
| Active workers €18,000–€100,000 | 50% |
| Active workers > €100,000 | 60% |
Useful emergency numbers
- 112 – pan-European emergency number (ambulance, police, fire)
- 061 – regional medical emergency line in many communities
FAQs
How does Spain’s healthcare system work?
Spain’s healthcare system is funded through taxation and run by the autonomous communities. Residents register for social security, enrol at a local health centre and receive largely free care at the point of use. Visitors on short stays can use EHIC or GHIC for medically necessary state treatment.
How is Spain’s healthcare system different from the UK?
Spain’s system is decentralised, with regions managing services and income-based prescription co-payments for most adults. Dental care is not part of the public package. The UK has separate NHS systems in England, Scotland, Wales and Northern Ireland, with different rules for prescription charges and wider primary-care structures. Both typically require a GP referral to see most specialists.
How does a GP work in Spain?
You register with a GP at your nearest public health centre. Appointments can be booked online, by phone or in person. Your GP provides routine care and referrals to specialists; you can request a change of GP through the health centre if needed.
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