Spain and your health
Thinking of moving to Spain but worried about the quality of healthcare available? Don't concern yourself, according to the World Health Organisation Spain boasts one of the best healthcare systems in the World and second only to France.
If you are about to leave the UK to live or even holiday in Spain you will be pleased to know that the country boasts one of the best health services in the World. It is rated sixth by the World Health Organisation and is second in Europe after France. Its hospitals, both state and private are well equipped and pristine. UK citizens moving to Spain are entitled to free treatment as long as they can produce the correct form. In this bureaucratic age it is all about rembering your E numbers, in this case the E121.
In Spain there is an established system of cooperation between its national health service and its private medical institutions whereby national health patients can be treated in private hospitals which rent out their operating theatres and beds. It is this cooperation between state and private medicine that prompted Britain's Secretary of State for Health Alan Milburn to go to Spain on a fact finding mission last winter.
As a result of this reciprocal arrangement within the European Union, Britons who have reached state pension age, women over 60 and men over 65; those with long-term disability pension; and those working and therefore paying national insurance contributions, are entitled to free treatment. But, if you retire early, say in your fifties, you are not entitled to free medical care. You may however, be able to claim health care cover back from the UK for a limited period. This "short-term incapacity benefit" depends on your most recent National Insurance contributions while you were still working. Maximum entitlement is two and a half years. To claim you need E106.
A department of health spokeswoman said; " Our advice to early retires who cease to be eligible for health care under E106 is to pay voluntary contributions to the national insurance scheme in their new country or take out private medical insurance until they reach state pension age." Occupational pensions, she points out, do not equate to social security pensions and are not covered in the reciprocal arrangements. Form E111, available from the Post Office, is primarily to provide health care for tourists. If you have a house in Spain but do not use it all the year the E111 will cover you for up to 90 days. If you stay more than 183 days you are regarded as a resident.
You should be able to get relevant forms from your nearest British consulate, but it is advisable to take them with you when you go. They are available from the Overseas Benefits office in Newcastle-upon-Tyne. As solicitor Mrs Sally Worthington, who works in the Spanish department of Champion Miller and Honey in Tenterden, Kent says: "Your nearest consultant could be some miles away and might have run out of the relevant form."
If you are not entitled to free health care you can either take out private medical insurance with international companies such as BUPA or PPP or you can join one of the schemes run by groups of doctors themselves where for an annual premium you get a number of consultations per year. When you reach UK state pension age you have a choice of staying in a private scheme or opting for the free medical care under reciprocal arrangements, form E121.
A Spanish Embassy spokesman says: "Our national health scheme is very similar to the UK`s. You register with a GP of your choice who will refer you to a consultant or to a hospital if the need arises. In an emergency you will be taken directly to hospital. However, just because we are all in the EU does not mean that everybody is entitled to free medical care. Essentially it is for those of full retirement age and those working and contributing."
Nursing homes, private and state, are a growth industry in Spain. "If you are British and over 65 you can apply for a room in one. You will need form E112 from your local Spanish social security office who will check to see whether the UK will pay for your nursing home care." Sadly some British who end up in home care feel isolated and unhappy because of the language problem.
It is language that leads many British entitled to free health care to join private schemes where they can guarantee being treated by an English speaking doctor.
David Rose, author of , So You Want To Live In Spain, says: "It is okay if you speak Spanish or the doctor's English is good. There are a lot of English doctors in Spain who run their own schemes whereby you pay a fixed annual sum and it entitles you to a number of consultations." With private insurance, David warns, you have to check what you are covered for and what you are not. "You may find you're covered for a tooth extraction but not a filling."
John Scott, group director of Spanish on show, which has been selling Spanish homes for 18 years, says : "My neighbours in Torrevieja, just south of Alicante, moved there when they retired because of bronchial problems. Their ages entitled them to free treatment. However, because of the language problem, they don't speak Spanish and their Spanish GP had to keep referring to a Spanish-English dictionary - they preferred to join a scheme where they paid £150 a year to see a doctor who speaks good English. It all depends where you go to. In the Marbella area , for example, every GP not only speaks English, they also speak German and French."
Carl Marodeen, a partner in Casa del Sol Properties, which has been in Spain 23 years, says : "Most doctors are excellent and speak pretty good English. If you take private medical insurance it works out cheaper than it would in the UK and medicines are half the price."
One of Spain's biggest health insurers is Sanitas, an arm of BUPA. It has more than a million members including several thousand British expats. Its most popular package is Multi, 1,338 Euros per annum, which gives primary, accident and emergency and hospital care through a panel of doctors and hospitals. If you pay a little more, 1,836 Euros pa, gives you the same panel plus the possibility of a 80% reimbursement of bills from any doctor or hospital in Spain or any other country.
For couple, aged 55, retiring to Spain but still wanting to travel, BUPA International Lifeline Classic would cost £1,306 each per annum. With the exception of the USA and Canada they would get worldwide cover.
In the past, the main reason British said they moved to Spain was the weather. Two years ago a survey found this had changed to the quality of the medical treatment. The weather came second.
GUIDE
British of pensionable age retiring to Spain.... free treatment E121
British of pensionable age visiting Spain.............E121
Those with long-term disability pension...........E121
Working in Spain and paying N.I. contributions........E121
Early retired British living in Spain.......Not free.. E106
May be able to claim health care cover for a limited period
This benefit depends on your most recent N.I. contributions.
Maximum entitlement two and a half years.To claim you need. E106
Tourists primary health care cover for up to 90 days......E111
People staying in Spain for more than 183 days are regarded as residents.
Always check with the Department of Health to ensure you are aware of the very latest requirements.
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