Health Insurance in Spain

For some, the thought of moving to Spain conjures up images of retirees lined up along the seafront and a mini-England feel. Whilst many do enjoy their golden years in Spain, and there are large British expat communities, Spain is a diverse and cultural country.

Mainland Spain boasts incredible cities such as Barcelona, Madrid, and Valencia. Also, let’s not forget the cornucopia of Spanish islands, including the Canaries off the western coast of Morocco, and Ibiza, Majorca, and Minorca in the Balearic Sea.

Wherever you are moving to in Spain, you can guarantee that the people will be welcoming, the sun warm, and the food delicious. However, there is a lot to learn before you go and live the good life…

Spain offers residents a good standard of living, with relaxing and socialising with family and friends being of high importance. It’s known for a laidback lifestyle but also for its vibrant social culture, with busy nightlife even on weeknights.

Another benefit expats in Spain can enjoy is a relatively low cost of living, particularly when compared to other European countries. Spain also benefits from a great climate, with most of the country enjoying warm temperatures and sunshine for most of the year.

Expats may face some differences in culture that can take some getting used to. Bureaucratic processes can take a long time to complete, with multiple forms to fill out, offices to register with and queues to wait in.

Furthermore, a lot of places in Spain shut down for a month in August, with locals taking their summer holidays. At the same time, cities and tourist hotspots can become very busy with visitors, which can disrupt the peace that might be experienced outside of holiday time.

Overall, expats who can adjust to the relaxed attitude and laidback lifestyle can enjoy the many benefits Spain has to offer. Read our guide for a more in-depth look at the pros and cons of expat life in Spain.

EU citizens will be able to live and work in Spain through Freedom of Movement. This no longer applies to the UK, following its departure from the EU. So, UK citizens will need to obtain the relevant visa to live and work in Spain.

For non-EU/EEA citizens who plan to move to Spain for longer than 90 days, they will need a long-term visa. This is available as a combined work and residence visa, or as a student visa for those who will be studying. Applicants can also get a residence-only visa, for those that don’t plan to work or who are retired.

To be successful in their visa application, expats will need a clear criminal record and a certificate of good health.

Generally, to obtain a work visa in Spain you will need your Spanish employer to apply on your behalf. That means you’ll need an employment offer before you can apply. There is also a work visa available for freelancers, where the applicant can apply for themselves. Most work visas in Spain are valid for year and can be renewed for up to five years. After this, you will be eligible to apply for permanent residence.

If you are applying for a residence-only visa and won’t be working, you’ll need to prove you have at least €27,115 in your bank account plus €6,778 each for any dependents you have.

Residence-only visas will be valid for one year initially, and can then be renewed every two years. After five years in the country, applicants will be eligible for permanent residence.

Once you have lived in Spain for a year and successfully extended your visa for a further year, your family will be able to join you on a reunification visa. This will include your spouse, common-law partner, children under 18 or parents aged over 65. 

Spain has one of the highest rates of unemployment in Europe, so competition for jobs is high. The sectors with the most job opportunities include IT, engineering, finance, healthcare, and the service industry. Expats who can speak Spanish will also find their job opportunities increase. It can be beneficial for expats to secure a job before they move to Spain.

For expats looking for English-speaking jobs, there can be high demand for seasonal work in the tourist industry as well as services for expat communities around the country. Teaching English as a second language can also be a good role for English-speaking expats in Spain.

The average annual salary in Spain is around €27,400, putting it in the bottom 50% of average salaries in Europe. Minimum wage in Spain is €1,000 per month. 

The cost of living in Spain is, on average, 17.2% lower than in the UK. Rent is around 28% lower than in the UK and property prices are generally low. In cities and more popular areas, such as Barcelona and Madrid, accommodation will be more expensive.

Food in Spain is relatively cheap, especially if you are able to eat like the locals and avoid eating out at the tourist hotspots. In contrast, utility bills can be high, and expats may need to budget more than they are used to for electricity, water, and gas.

For more information on the cost of living in Spain, read our guide on how much does it cost to live in Spain?

Everybody working and living in Spain is entitled to public healthcare. In general, the healthcare services in Spain are seen as high quality, with knowledgeable staff and good facilities. Spain’s health services are regarded as one of the best in the world, with both public and private facilities providing a high standard of care.

State healthcare is free of charge to anybody living and working in Spain, but you must have a social security number. Those who are employed, a child, pregnant, receiving benefits, studying, a pensioner, or have an EHIC card can receive free healthcare.

Expats must register on the municipal register to receive a social security number and card, which can then be presented at the local doctor’s surgery to receive a medical card.

You cannot use the public healthcare system while you are applying for a visa. You will only be eligible once the visa is successful. Until then you will need private international health insurance.

The public hospitals in Spain are well equipped and the staff are very professional and often bi-lingual. If not, most tend to have interpreters. The only downside of general hospitals is the waiting time to see specialists and have procedures carried out.

Many expats prefer to opt for private services as queues tend to be shorter than the public system and there is wider access to different treatments and specialists. Single consultations within the private sector are very affordable, but prices can escalate if complications or an emergency arise. This is why it is imperative to take out health insurance for expats if you want to utilise the private sector.

For minor illnesses and injuries, many utilise the numerous 24-hour pharmacies dotted throughout Spain. Due to strict price restrictions, medicines are affordable in Spain, and virtually anything can be purchased over the counter. All Farmacia will have a neon green cross outside.

The emergency number in Spain is 112. Most operators are able to speak English and will dispatch the relevant emergency service, including private ambulances. Whether public or private, Spain is championed for its short wait times for emergency help.

As in most countries, there are two broad forms of healthcare on offer in Spain; public, state-funded facilities and privately-run facilities. Interestingly, while the queues in private clinics may be shorter, many expats report similar standards of care whether opting for private or state facilities.

Some expats moving to Spain will be entitled to “free” healthcare if they meet one of the following requirements:

Those expats who move to Spain in order to work will generally be registered for a social security number and will then pay into the Spanish system. Thanks to these payments working expats will then gain access to the state-run Spanish healthcare system.

Self-employed expats living and working in Spain can also gain access to the public healthcare system. In order to do so you will need to register yourself for local taxation. Under this system, you will then receive a social security number and will be entitled to free care at public hospitals.

Expats who do meet any of the above requirements will not have free or discounted access to the state-run medical facilities.

Instead, you will need to make use of two possible alternatives.

The first of these is a “buy-in” through the “convenio especial” system. Here you pay into the National Health Service and in exchange gain access to its facilities.

That said, this solution is far from perfect as it has a distinct number of limitations. A good example of this is that such individuals will find their prescriptions are not being subsidised so will need to be paid in full.

The second option is to opt for a fully featured expat insurance policy for Spain. Such policies are generally recommended as the best option due to the level of coverage provided.

Not only will such a policy grant you access to all the services that you require but they also cover medical repatriation and cost-effective attrition and cost-effective dental care.

Generally speaking, Spain operates a co-payments system for prescriptions. This means that you are unlikely to receive “free” medications while in Spain, though it is likely to be heavily subsidized.

It is interesting to note that, unlike the UK where most working adults pay the same fixed fee for prescriptions, in Spain, the policy is rather different. Here, the level of subsidy you enjoy depends on your taxable income; the more you earn the more you will pay in general. Furthermore, while some people’s annual contributions for prescriptions are capped at a maximum, others are not.

Therefore, if you expect to need prescription medication while visiting or living in Spain it pays to investigate how the system will work in your case to make budgeting for such eventualities much easier.

Lastly, be aware that as with many other Spanish businesses, many pharmacies maintain “Spanish” hours. In other words, many drug stores close for much of the afternoon (2-5pm typically) but then re-open after “siesta time” and work late into the evening.

As a result, it is wise when requesting a prescription to consider when you’ll be able to collect it. Try to avoid afternoons if possible in all but the most cosmopolitan areas or you may be disappointed to find the pharmacy closed.

Spain uses the Euro as its currency. Each euro is divided into 100 cents and there are 50, 20, 10, 5, 2, and 1-cent coins. There are also 1 and 2 euro coins and notes are available in denominations of 5, 10, 20, 50, 100, 200, and 500.

There are countless banks throughout Spain and most offer online banking with fast and easy transfers. The most popular amongst expats are HSBC and Barclays. However, there is a selection of banks with multi-lingual staff and documentation can be easily changed into your preferred language if banking with one of these.

One thing expats should be aware of is Spain’s variety of high charges that can be placed on debit card transaction fees, correspondence fees, and transfer fees. Most banks also charge a small sum of money for opening an account.

When living in Spain expats have the option of opening a non-resident or resident bank account. Resident bank accounts can only be opened with a Spanish tax identification number. Non-resident bank accounts do give users the option to hold in a foreign currency, but they usually have higher fees and a lack of services.

Expat life in Spain is usually trouble-free. Terrorism has no greater threat over the country than other European destinations and petty crimes tend to be the most sinister committed. Pickpocketing is relatively common in tourist areas and cities, so it is best not to have your valuables on show. Some thieves use distraction techniques, working in pairs or small groups, often targeting purses, wallets, and passports. Robbery of passports in airports has seen a rise over the years, so keep them out of sight.

Theft from hire cars has also seen an increase so holidaymakers and expats should always remove valuables from cars.

Although extremely rare, attacks and sexual assaults have happened to foreigners in Spain. Sometimes, drinks are spiked in nightclubs. Expats and holidaymakers enjoying Spain’s nightlife should make sure to buy and guard their own drinks.

There is an issue in Spain with individuals posing as plain-clothed police officers. They target foreigners by foot, or on the road, and will often ask individuals to hand over their bags, purses, and wallets. No official police officers in Spain will ever ask you to hand over your belongings and, if you are ever concerned, simply ask to see their ID.

Any child living in Spain between the ages of six and 16 must attend school. For expat children, there are five options: free Spanish public schools, bilingual schools, private schools, independent schools, or homeschooling. Whatever option is decided upon, after the age of 16 children can either go on to attend upper secondary (the Spanish equivalent to college) and university after that.

For families with children of primary school age or younger, a local public school could be a great option. Children are taught solely in Spanish, surrounded by Spanish children, which will help them pick up the language quickly and integrate into society. It must also be remembered that your child will be studying the Spanish curriculum.

Although public schools have their benefits, attending a new school is daunting for a child, and a school where everybody is speaking a language alien to you can be frightening. However, some public schools across the country offer British-Spanish programmes. Bilingual schools allow children to speak in English, but Spanish is a big part of their day. These schools allow children to feel in control and gives them a chance to settle in.

There are two types of private schools in Spain; semi-private and traditional private. Semi-private schools were once private schools, but have been taken over by the government. Fees in these schools tend to be very low or non-existent. Class sizes in semi-private schools are typically smaller than those found in public schools. Classes are taught in Spanish and follow the Spanish curriculum.

On the other hand, private schools have smaller class sizes still, higher-quality facilities, and an array of extra-curricular activities to supplement children’s learning. Unless the school is bilingual, the curriculum will be the same as that in semi-private schools, and lessons will be taught in Spanish.

If you want your child to study for the International Baccalaureate or follow the curriculum of their home country the only option is for them to attend an international school. Children can be taught in their mother tongue and follow teaching methods that they are familiar with.

Fees for international schools are notoriously high and children may have to commute to school. However, in the cities there are countless international schools, most of which are British.

Spain is generally considered to have a Mediterranean climate, but due to its geography, the regions do differ. The south coast of Spain, home to the likes of Valencia, Benidorm, and Barcelona, has the sort of weather we stereotypically envisage when we think of Spain. Winters are mild and rainy, but the summers are hot and dry.  Barcelona, which is close to the French border, is a degree or two cooler than the “sun, sea and sand” holiday destinations further down the coast towards Portugal.

The vast central plateau of Spain, home to the capital city Madrid, has a great difference between summer and winter temperatures, and significantly more rainy days than the southern coastal locations. This continental-style climate means that temperatures top out at around 25°C in the summer and drop to approximately 5°C in the winter.

The third climactic region in Spain is north of the Cantabrian Mountains, on the north coast. Holidaymakers flock to Bilbao, Gijon, and Santander easily by ferry. Also known as the Basque Country, the north of Spain has a maritime climate with summer temperatures averaging 20°C, and winter temperatures rarely dropping below 10°C.

  Barcelona Monthly Temperatures and Rainy Days

  Benidorm Average Monthly Temperatures and Rainy Days

  Madrid Average Monthly Temperatures and Rainy Days

  Santander Average Monthly Temperatures and Rainy Days

The official language of Spain is Spanish, sometimes called Castilian, which is spoken by 99% of Spaniards as a first or second language. Those who do not have Spanish as a mother tongue tend to talk in Basque, Catalan, or Galician.

Basque is a co-official language spoken mainly in the Basque Country, located in the northeast of Spain, and home to the city of Bilbao. Most Catalan speakers reside in the Balearic Islands, an archipelago off the south coast of Spain. It is a recognised language, but not official. Lastly is Galician, which is another co-official language of Spain. Galicia is located above Portugal, so it is unsurprising that Galician has Portuguese influences. 

Despite having a strong expat population, outside of expat communities and tourist areas, everybody speaks Spanish. It is best, at first, to learn some key phrases as a mark of respect. Most expats find that the Spanish language comes to them naturally over time.

Whatever your heart desires, Spain has it. Whether you want to experience idyllic coastal retreats, contemporary cities, or Spain’s varied past, expats and visitors are spoilt for choice. With influences from Portugal and France, as well as having its own unique spin on life, Spain is more diverse than the stereotype many place on it.

Barcelona

It may not be the capital of Spain, but Barcelona is one of the most-visited cities in Europe. The sandy beaches set against the unique architecture are a sight like no other. Some of Barcelona’s architectural treasures date back over 2000 years, with artists such as Picasso and Salvador Dali having been inspired by the city.

Seville

Ancient Seville’s history can be seen in the Roman ruins, medieval engravings, and colonial architecture that bequeaths the city. Seville’s Triana neighbourhood is famed for its flamenco dancing. Visitors can enjoy an evening watching the dances in many of the local bars and restaurants.

San Sebastian

Located on the Bay is Biscay, on Spain’s northern coast, is the seaside city of San Sebastian. Like Madrid, it is famed for its food, with countless restaurants boasting Michelin stars. Although San Sebastian is very much a modern city, the beaches and Cantabrian Mountains in the distance provide those who live there with an escape from the hustle and bustle.

Toledo

In a world where religion can cause so much segregation, Toldeo comes as a breath of fresh air. The city sits atop a gorge overlooking the Rio Tajo. Christian, Muslim, and Jewish people coexisted peacefully here in the Middle Ages. Known as the ‘City of Three Cultures’ due to this, the streets are lined with mosques, synagogues, and churches.

Madrid

The arts and fine-dining feature heavily in the lives of those who call Spain’s capital home. It is championed as one of the most exciting culinary hotspots in Europe and many nights are spent dancing until dawn after a delicious meal.

Madrid may not have the prestige of Paris or relics like Rome but its relaxed way of life and enchanting architecture make it a beautiful city in a very different way.

If you’re moving to Spain, you will need: