A Look at Spanish Healthcare

The World Health Organization ranks Spain’s healthcare among the best in the world. Facilities tend to be modern, with state-of-the-art equipment, and Spanish doctors must pass rigorous qualifying exams to get their license to practice. The central government used to be the sole regulator of healthcare, but now each of the country’s 17 Autonomous Communities takes individual responsibility for implementing and executing healthcare.

Spain has both private and public healthcare systems.

Spain’s public system, known as the seguridad social, is widely used by Spaniards and others who live and work in Spain. Many wealthier Spaniards (middle class and above) also have a private health insurance plan. Sanitas (a subsidiary of Bupa International) is the largest private health insurer in the country, though numerous companies offer private insurance plans.

For those who live in Spain, the public-system hospitals provide much of the first-line healthcare and emergency services. Public hospital facilities are well equipped, and Healthcare-system employees are efficient and well educated. Most hospitals employ personnel who speak English or offer the services of interpreters.

Many of Spain’s top medical school graduates choose to practice in the public system, and that, plus fierce competition for postings, helps keep quality high. Unlike in many other health systems, Spanish doctors will try to find you the cheapest drug to use, rather than one that gives them a rebate.

There are also numerous private doctors and clinics throughout Spain. And many public-sector doctors keep hours a few days a week in a private clinic. This gives patients the option to continue treatment under a particular doctor across both systems if they choose. Many expats (and Spaniards) like the private system for its convenience, as waiting times for appointments can be shorter than in the public system.

Expats from European Union countries generally have access to Spain’s public healthcare system through agreements between their countries. Citizens of non-EU countries (including the U.S. and Canada) must have private health insurance valid in Spain as a requirement for obtaining a residence visa. Non-EU retirees may apply to join the seguridad social once they legally reside in Spain, through the Autonomous Community they live in. Each Community therefore sets its own rules regarding how long you must be a resident before signing up for the seguridad social, the cost you’ll pay, and other details.

Private health insurance—which non-EU citizens must have to get their residence visas—tends to cost less than in the U.S. As a rough guide, a mid-range plan for a 65-year-old with Sanitas, the largest private insurer, can run under $150 a month. For a healthy 55-year-old, monthly premiums can be under $100. As with any private insurance, however, pre-existing conditions are likely to be excluded.

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