An introduction to the healthcare system of Spain

Healthcare in Spain: situation up to date

Spain is a country with a long tradition for public welfare. The National Health System (Sistema Nacional de Salud - SNS) was founded at the beginning of the 20th century, in 1908, and subsequently extended to the entire Spanish population. By 1989, the public health service was made free and available universally to all residents of Spain.

The excellence of the Spanish National Health System even attracts several expats and visitors. Some of them have second homes in the country, to benefit from the cures offered for free by the Spanish public healthcare system while enjoying shorter waiting lists compared to what they can expect in their home countries. It is worth noting that, in 2018, Spain’s healthcare system ranked 3th in the world for efficiency according to a study published by Bloomberg, way above Great Britain and other European countries. 

Today, Spain sets itself as one of the world healthcare superpowers, grossing over € 10 million a year in the health tourism sector, with the British and German markets leading the demand. 

What does the public healthcare system cover? 

The National Health System in Spain has widespread coverage that includes education, prevention, diagnosis, therapy, rehabilitation, and assistance of the population, guaranteeing everyone’s right to health. The front line of the health system is the Centros de Salud (Health Centres), widely distributed on the territory. This is where the residents go for their routine visits, and where they go in case of urgencies and emergencies.

The National Health System covers the specialistic visits, subject to the requests from the GPs(General Practitioners). In other words, if the GP prescribes an in-depth specialistic visit, the citizen is entitled to have it for free through the National Health System. Furthermore, citizens will also receive - for free or at a reduced price depending on the medicine and specificity of the case - the medicines and/or prosthetics they need to be healthy and functional.  

Differently from other European countries, the prescribed medicines are the only element of the Spanish health system that may require additional payment by the patient.

The public healthcare system also covers for the dental cures; however, the typical approach to cavities, for example, is to remove the aching tooth. In a private dental clinic, the doctors would usually try to conserve as many natural teeth as possible. 

Is the public healthcare coverage enough, or should I do an insurance to cover the costs of private healthcare?

While the National Health System might be sufficient to cover most of the possible health problems people might incur into, several Spanish residents opt for integrating it with private insurance, to benefit from quicker and better services. For example, the main downside of the public hospitals is that they tend to be saturated, and have long waiting times for surgical operations. Sometimes the waiting times are double compared to the private centres. Besides, public hospital rooms are shared, and this may cause some minor or major annoyance to the patients.

Quality and prices throughout the country: private and public healthcare

The level of the hospitals is high throughout the country, but the prices are dear for those who don’t have the right to free healthcare. A hospital bed in Spain can cost up to € 400 - € 600 per night. Intensive therapy beds cost up to € 2.500 per day. The price of the surgical operation and hospitalization for treating cataracts, one of the most common ailments cured by the public hospitals, is approximately € 1.500. Treating hallux valgus costs between € 800 and € 1000.

Several private clinics throughout Spain offer good healthcare at reasonable prices. They represent a valid alternative to the National System. In a private clinic, the typical cost for a general visit fluctuates between € 70 and € 100; a specialistic visit may cost between € 150 and € 200. More complex services and hospitalization tend to be more expensive, hence medical insurance becomes almost a necessity to cover the costs. Medical insurances with health and dental coverage in Spain cost approximately € 40 to € 50 a month.

The country’s private dental clinics are usually clean and efficient. They are the residents’ choice when it comes to curing their teeth. They tend to have shorter waiting lists and a more conservative approach to interventions. A general visit with dental hygiene costs between € 70 and € 100; curing a complex cavity costs between € 80 and € 90.

Am I covered as an EU citizen?

EU citizens who are regularly inscribed as temporary or permanent residents of Spain benefit from the same coverage as the Spanish-born citizens. They will be assigned to a GP to take care of the general visits for free. Should it be necessary, they will receive all the cures, specialistic visits, and hospitalization for free. Foreigners without the NIE (tourists for example) who happen to need urgent medical attention during their stay in Spain also benefit from the cures provided by the free National Health System.

This applies in case of serious illnesses and accidents, independently from the causes. The cures last until the patient can be dismissed from the hospital. Foreign pregnant women who require medical attention during their stay in Spain will also be assisted in all the phases of the pregnancy.

EU citizens who aren’t residents of Spain are not entitled to free healthcare if they are specifically travelling to the country to treat a pre-existing medical condition. In this case, they will have to use private healthcare infrastructures, or go through specific paperwork in their country of origin to be able to access the cures of the National Health System.