Moving to Spain is a dream many people have, but often the sheer scale of the move can seem overwhelming. And one of the greatest hurdles, especially for the over 55s, is the healthcare issue. Even those in perfect health have a fear that leaving the UK and a health system they understand may be a rash move.

But the health system in Spain is reassuringly good and modern – social security payments are high, so the level of service is excellent, and the system has few of the under-financing problems that the UK system experiences. Private healthcare too is excellent, and retirees who have private health insurance can often transfer it to a Spanish policy (generally for similar or even lower premiums), that will cover them in the same way as it does in the UK. For an additional premium, some private health insurance schemes also cover repatriation for treatment in your country of origin.

Hospitals and medical centres:

Most cities have at least one hospital, others have several, some private, some public, most have casualty or A&E departments called ‘Urgencias’. Smaller towns have medical centres (Centro de Salud) – many of which are brand new and extremely well equipped and run. Some have such a range of specialists and equipment that visits to hospitals are a rare necessity. But in quieter rural areas, your local health centre may only be open for a few hours a day.

As in the UK, you will be registered with a local GP (Medico de Cabecera), who will normally work out of your local Centro de Salud. Assess the Centre in the area to which you are thinking of moving – does it have the requisite medical facilities that you need now? Or that you think you may need in the future? What are the opening hours? Where is the nearest hospital? The healthcare system in Spain is totally decentralised, so you need to check that everything you need is provided free under the regional healthcare system.

Unless you have a good grasp of the language, you should also check whether there are English speaking doctors, or whether there’s a voluntary interpreter scheme. The further away from the cities and the coast you go, the less chance there is of finding English speaking healthcare professionals. In many expat areas, hospitals and medical centres have voluntary interpreters who are expats themselves.

As in the UK you can wait a long time in A&E (Urgencias) to be seen. Those arriving by emergency service will be seen faster. A fantastic private emergency scheme available on the Costa del Sol is called the ‘Helicopteros Sanitarios’. It provides emergency call out and provision for immediate treatment or emergency transport to the nearest hospital.

Spanish culture:

Those unfamiliar with Spanish hospitals should be alerted to the fact that it is customary for someone from the immediate family to stay with the patient while he or she is in hospital – all day and all night! It isn’t essential, but if as a relative you pop in with some grapes and pop out again, it will be considered unusual!

Chemists:

Chemists are called ‘Farmacias’ and are identified by the large green cross signage. Every village, however small, has one, and they are open during normal shop working hours, about 09.30-14.00 and 17.00-20.30 Monday to Friday; half day Saturday and closed on Sunday. Each town will have a 24 hour chemist, but this may be on a rota and the location will change, so check the details on any chemist door.

Forms and Bureaucracy:

Your EHIC will only cover you in Spain for medical treatment on a temporary basis. If you are intending to live in Spain, and you are receiving a UK State Pension or Long Term Incapacity Benefit, before you move to Spain you should ask for your E121 from the International Pension Centre in Newcastle. You should also take with you all proper medical forms and instructions if specialist treatment is required on an ongoing basis. If you make the right provisions before you go, the process of registering for healthcare in Spain doesn’t have to be onerous. You will need originals and at least one copy of :

• Your passport
• A couple of passport size full colour photos
• Your residents permit / NIE number (ID number)
• Proof of Spanish address (normally your Certificado de Empadronamiento)
• Your E 121

Once you have your Spanish Social Security Number, you can then register with your local medical centre, where you will be allocated a local G.P. You will also be entitled to receipt of State Healthcare and free or discounted prescriptions depending on age. You will be issued with a plastic card at a later date (Tarjeta Sanitaria Individualizada Nacional). Full access to the state system starts from the day you register your E121 with the INSS. You should remember that repatriation costs are not covered under the Spanish National Health system.

So don’t let the healthcare system put you off retiring to Spain and enjoying all the benefits. There is a degree of bureaucracy involved, but if you allow yourself plenty of time and follow the guidelines, it does all fall into place. And once you’re in the system, you’ll find it’s a good system to be in!