Who is entitled to Spanish National Health cover and how can I apply?

To check the quick guide to getting your healthcare entitlement click here

  • Insured persons- those who are working or self employed and are making up to date Spanish national insurance contributions, plus their legal dependents.
  • Retired EU citizens who were working legally in Spain and have now retired
  • Unemployed in receipt of unemployment benefits.
  • Unemployed who have exhausted their unemployment benefits and others of a similar nature and not having insured status on any other grounds and residing in Spain.
  • EU citizens who have retired and are entitled to health cover from their own member state via an S1 document. S1s are set to be withdrawn for UK nationals after the 29 March 2019 as yet replacement arrangements are unclear. Check here for latest information as developments happen http://www.lamoncloa.gob.es/lang/en/brexit/
  • British Visitors who have a valid European health Card issued by the UK can get emergency assistance whilst on holiday. The EHIC card is set to be withdrawn after the 31st December 2019 Check here for current situation https://www.gov.uk/guidance/healthcare-in-spain-including-the-balearic-and-canary-islands

What happens if I stop working?

If you have paid contributions in Spain for 90 days during the previous 365 preceding days (ie you have worked legally or been self employed and paying Spanish national insurance contributions for at least 3 months in the preceding year), you are ONLY covered for the next 90 days after you stop work. This can be extended while you are unemployed if you register as job seeking.

If you were being attended to before you ceased paying contributions then your cover is extended to 52 weeks for the worker and 39 weeks for the dependant and 39 or 26 weeks if the assistance commenced after you stopped paying contributions . source: http://www.seg-social.es and http://www2.gobiernodecanarias.org/sanidad/

If you use up your period of entitlement, do not have a partner of family member who can cover you as a beneficiary, or are not registered as unemployed, then from July 20th 2018 you can apply for Universal Healthcare – (previously referred to as personas sin recursos económicos suficientes” which is basically says you do not have the means to provide your own health cover). This application is processed through your local CAISS social seciurity office and previously was  available to Spanish Nationals and Foreigners alike provided they have been resident and working in the Canaries or were resident before 24 April 2012 (amended 27 Jul 2018 see final paragraph below) , and do not have access to entitlement by any other means- but it is means tested.

When British Nationals apply for ‘sin recursos‘ healthcare, as well as having to provide information about income levels, and proof of residence, they will have to provide a letter which states they do not have entitlement to healthcare cover from the UK is produced by the Department of Health in the UK. You can request this certificate written in Spanish (as required by the authorities here), from the Overseas Healthcare Team on 0044 191 218 1999 NHS Business Services Authority:  option 5. Email: nhsbsa.ohsregistrations@nhs.net ; have your UK national insurance number handy.

If you have not submitted a Spanish tax return then you will need to obtain a certificate from the UK tax authority to show your income or lack of income.

What about common law partners?

Common law partners can only be covered by the contributions of their partner if they have been registered as living together for a minimum of 1 year IN SPAIN and can prove this in writing with a certificate of convivencia from their local town hall.

Check List of documents needed to apply – click here


In Tenerife Children ARE NOT attended by the same GPs that deal with adults. There are often shortages of trained pediatricians, so you may be registered at a “sub” health center, but your children may have to travel to the central health center Or the pediatrician may have split surgery hours between several locations. Check with your local doctor’s receptionist when you register as to what the procedure is in your area, and make sure you keep up with new developments and seasonal variations.

Universal Health Care Legislation 27 July 2018

For some years IF you have no other means of establishing entitlement (ie not working not a pensioner and did NOT subsequently re register using a private health policy) AND have been legally resident (Green Residencia Registration) since before 24th of April of 2012 and your income is below 750K then you can apply for what is known as “Sin recursos” (without means) A legislation letter is required from the UK together with a negative income letter or declaración de la renta. I have processed this for a number of pre 2012 residents. However the latest 2018 legislation is open to interpretation by each autonomous community…  to quote the CAB<< We think that with this new (2018) royal decree, the INSS offices may find it difficult to continue with their internal agreements of denying healthcare to those post April 2012 residents.>> At the time of writing I have yet to attempt to process a test case to see if this works for post 2012 residents – but what is almost certain is that the proofs required will be the same ie legislation letter etc. quote << The CCAA (Autonomous Community), within the scope of its powers, will set the procedure for the application and issuance of the certification document that accredits foreigners rights in order to receive assistance.>>