- Insured persons- those who are working or self employed and are making up to date Spanish national insurance contributions, plus their legal dependents.
- Retired 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 (and UK citizens in specific circumstances) who have retired and are entitled to health cover from their own member state via an S1 document. 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 phased out after the 31st December 2019 and replaced with a GHIC card 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 or if you have been legally resident for 5 years or more.
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 security 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 now called “Universal 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 this 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: email@example.com ; have your UK national insurance number handy.
If you have never submitted a Spanish tax return then you may need to obtain a certificate from the UK tax authority to show your income or lack of income.
Application form here Hoja 01 AS-1 (seg-social.es)
Submission on line or via email(during Covid 19 emergency) Presentación de otros Escritos, Solicitudes y Comunicaciones INSS-Presentación de Solicitud (seg-social.es) OR email firstname.lastname@example.org
Further reading here Reconocimiento del derecho a la asistencia sanitaria (gobiernodecanarias.org)
Appeals process Solicitudes (gobiernodecanarias.org)
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.
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 could 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 and more recently (2021) British permanent residents in Tenerife completing 5 years or more of legal residency and having a TIE.
However in some areas 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.>> In the Canary Islands if you feel you have wrongly been denied access then you can attempt an appeal here Solicitudes (gobiernodecanarias.org)