Anyone considering moving to Spain — temporarily or permanently — will have to deal with the question of how healthcare is organised here. The Spanish healthcare system is good, but organised differently than in the United Kingdom. This causes confusion for many newcomers, especially when it comes to the SIP card, public healthcare and private insurance.

The SIP card (Tarjeta Sanitaria Individual) is the Spanish health card that gives you access to public healthcare. In Spanish, SIP stands for Sistema de Información Poblacional. With this card, you can visit your assigned GP, public hospitals and public specialists. You will only receive a SIP card if you are entitled to one, for example because you work in Spain, are covered by social insurance here or are affiliated through a treaty arrangement.

Public healthcare in Spain is of high quality, especially for emergency care, serious conditions and operations. However, the system works differently than in the United Kingdom: you are linked to one permanent GP and one regional hospital, and there may be waiting times for non-urgent care. You have less freedom of choice, but you can be sure that serious care is well organised.

Private health insurance in Spain is separate from public healthcare. It is not a supplement, but a parallel system. You can therefore be fully privately insured without being affiliated with the public system. This is particularly relevant for people who are not (yet) entitled to public healthcare, for example because they do not work in Spain and do not yet receive a pension.

In addition, private insurance is sometimes required when applying for a residence permit (residencia). In particular, people without a Spanish income or pension often have to prove that they have full private insurance, without excess or copay, so that they do not have to rely on public funds.

There is also a government scheme, the Convenio Especial, which allows you to join the public healthcare system for a fee. Conditions apply, including legal residence and often a prior period of private insurance. The exact rules vary from region to region.

Where things often go wrong is that people think that one system covers everything. In practice, you may encounter waiting times with public healthcare and still be referred to a public hospital in serious situations with private healthcare. It also happens that people move to Spain without having their healthcare formally arranged.

Finally, your residence status plays an important role. Anyone who stays in Spain for more than 183 days a year becomes a tax resident. This has consequences for taxes, but often also for your access to social services, including healthcare. Permanent residence is therefore different from temporary residence, for example to spend the winter or to rent out a property.

The bottom line is that healthcare in Spain is well organised, but works differently than many people are used to. Those who inform themselves well in advance can avoid unnecessary stress and live more peacefully in Spain.

Are you considering moving to Spain — temporarily or permanently — and want to be well prepared? Feel free to contact us if you have any questions or would like to share your experiences.