From family doctors to emergency hospitals, here’s everything you need to know about healthcare system in Spain.
Spain boasts one of the world’s top-ranked healthcare systems. It provides nearly universal coverage and is primarily funded by taxpayers through social security contributions.
However, for specialized care—such as dental or mental health services—private health insurance is often necessary.
Let’s take a closer look at how the Spanish healthcare system works.
How Does Healthcare Work in Spain?
The Public Healthcare System
Spain offers a high-quality public healthcare system, known as the National Health System (Sistema Nacional de Salud – SNS), which provides coverage to over 99% of residents.
Healthcare services are managed at two levels:
- National level: Establishes laws and regulations.
- Regional level: Administers healthcare across Spain’s 17 autonomous regions.
The Spanish Ministry of Health (Ministerio de Sanidad) oversees policy development and the national health budget.
Over 70% of Spain’s healthcare system is publicly funded, making up around 11% of the country’s GDP. Many residents also opt for private health insurance (seguro de salud privado) to supplement their public coverage.
Spain’s healthcare system consistently ranks among the best:
- 8th globally (2021 Health Care Index)
- 4th in Europe, following Austria, Denmark, and France
However, some areas still face challenges. The Foundation for Research on Equal Opportunity (FREOPP) rates Spain’s healthcare effectiveness as moderate overall.
Who Can Access Spanish Healthcare?
Public healthcare is free for residents who are employed (salaried or self-employed), children, pregnant individuals, and students under 26. Other eligible groups include those who:
- Have recently divorced or separated from someone covered by social security
- Receive certain state benefits
- Are retired and receiving a state pension
EU/EFTA nationals can access free healthcare with a European Health Insurance Card (EHIC), while non-EU citizens must have private health insurance as part of their visa application.
Undocumented migrants can receive medical care but must cover at least 40% of medication costs.
For further details, visit the Spanish Ministry of Health website.
Healthcare Costs in Spain
Spain’s healthcare system is mainly funded through social security contributions from working residents. This coverage extends to their spouses and dependent children. Certain groups, such as pensioners and students, also benefit from free public healthcare.
Healthcare Spending:
- Public healthcare: €90.3 billion/year (€1,907 per person)
- Drug prescriptions: €12.8 billion/year
- Private healthcare: €32.5 billion/year (€687 per person)
- Total healthcare spending: €122.8 billion/year (€2,594 per person)
While primary healthcare is mostly free, residents contribute to prescription costs and public health insurance. Specialized medical care may require additional payments, making private insurance a valuable option.
How to Register for Spanish Healthcare
Legal residents can access public healthcare with either:
- A European Health Insurance Card (EHIC)
- A Spanish health card (Tarjeta Sanitaria Individual – TSI)
How to Apply for a Spanish Health Card:
- Visit your local primary healthcare center (Centre d’Atenció Primària – CAP).
- Apply for your TSI card.
- Receive your card by mail within 2–3 weeks.
- Register with a doctor or health center in your district.
To consult a specialist, you’ll need a referral from your primary doctor. Always carry your health card for access to services and pharmacies.
Private Healthcare System in Spain
Spain has a dual healthcare system, meaning public and private services coexist. Many health centers (centros de salud) offer both public and private options.
If a medical procedure is not covered by public healthcare, private insurance can help cover the costs. Many residents opt for private insurance for faster and broader medical access.
Alternative & Complementary Medicine
Public healthcare does not cover most alternative treatments. Some private insurance plans offer add-on coverage for services like:
- Acupuncture
- Homeopathy
- Chiropractic treatment
- Reflexology
Spanish law requires alternative medicine practitioners to have full medical qualifications.
Emergency Medical Services
For serious, life-threatening emergencies, dial 112, the pan-European emergency number. This service is free of charge, and operators speak multiple languages, including Spanish and English.
Spain’s healthcare system is among the best in the world, offering comprehensive public coverage and high-quality private alternatives. Understanding how it works ensures you can access the best medical care available to you. If you need legal assistance with healthcare access, insurance, or residency requirements in Spain, contact us for expert legal advice.
Foto de Etactics Inc en Unsplash
