Healthcare cover advice please

Buenas noches T&S 😁

I was in pretty much the identical situation to you, including age, so I’ll offer what I went through.

There is a lot of misinformation about this very thing ... and I note that your arrival is going to be post-Brexit, so I can only hope that my experience now will carry forward.

There are two options for health cover in Spain, the first is to pay for private health cover ... I don’t know what the cost is for that, but it will not be cheap.

The second, and probably preferable route, will be to register with Seguridad Social and pay Autónomo.  One person paying Autónomo of a married couple WILL entitle both parties to health care under the Spanish health system.

I speak from experience, my wife has a business and pays Autónomo and as such, BOTH of us were eligible to apply for and receive Tarjeta Sanitaria.  The cost of Autónomo, as you are over the age of 48, is 77,00 € per month for the first 12 months, rising incrementally every 6 months thereafter until the full amount of about 325,00 € per month is being paid.  

Paying Autónomo will also entitle you to unemployment benefits after 6 months of payment and a Spanish State pension after 15 years of payments.

Proof of health cover will be mandatory for any Residencia application.  You will also need to prove an annual average balance of 9.000,00 € EACH in a Spanish bank account to be considered for Residencia.  (Unless you own property here then that is taken into consideration) Again, having just completed the process, I speak from experience. 

I expect others on the forum may have different views and may even contradict what I say, but I would respectfully ask anyone who may to please remember that the rules are shifting and changing - even evolving - and I have just last month completed this entire process.

I would also endorse, advise, encourage and indeed entreat you to get a good Asesora or Gestor here to help you with the process - it really will be worth the money you spend on them.

Like everyone else, I really couldn’t say how  rules will change post-Brexit - the safer option would be to come out pre March 2019 and organize the bureaucratic side before then, even if you don’t actually permanently take up residence in Spain until the end of 2019 as is the plan; I recognize though that that just may not be an option for you.

If I can be of further help, please don’t hesitate to ask, or send a Private Message - I shall be glad to offer whatever help and advice I can.

Saludos, Darío

Many thanks.

We will not be working in Spain, simply living off savings until we get our small pensions at 55.

Do you mean to say that you pay 325.00 Euros a month for health cover ?

That is outrageous.

I can't believe so many people relocate to Spain and suffer such costs - is this really the case?

Once again - many thanks for the input of your experience.

Well, that’s the cost after the first three years if you are not on a pension and want Spanish healthcare.  (Again, you start at 77,00 € a month for 12 months, then rise incrementally until you pay the full amount after 3 years) Once you receive a pension, I believe the rules change and Autónomo is no longer required - perhaps one of the residents who’s on a pension can advise further?

As I said though, Autónomo isn’t just healthcare, it’s the Spanish equivalent of National Insurance, but there is no real equivalent of NHS here.  You need either private health cover, or to be on Spanish health system (UK Pension or pay Autónomo), again, one or the other WILL be mandatory for Residencia and again, that’s how the rules stand right now .... in 11 months time ..... ? Who can say.

Also, dental and optical treatment is privately paid (pensioners may be different - I really don’t know) but certainly for the period you are here before transitioning to pension, dental and optical costs will be borne by you.  That being said, dental and optical care I’ve found to be very very very affordable.

Saludos, Darío

Hi there. The replies I see here are when one of you are working with a contract of employment. You can join the Convenio Especiale which costs €65 per month each. This entitles you to full medical cover, except prescription charges. There are some things you just do first.  1. Take,our your full residentia but before you can do this, you must fill certain criteria - you must be able to,prove that you are financially able to live in Spain, eg back account monies, your house, if bought outright, any personal,p pensions you may have, and you MUST have some kind of medical cover (I.e. private medical cover each which can cost upwards of €90 per month each). When you take out private medical cover it is normally for a minimum of 12 months. As suggested, get a beat or who knows procedures correctly to do all the paperwork for you and not do as we did (ourselves) and avoid all the stress and heartache !!!. When you get your residential you can then apply to join the Convenio Especiale, until one of you starts to physically receive your state pension, which I would assume from your age is 66/67. When one of you starts to receive state pension payment, then the other partner can “piggy back” on the other so you both then are registered on the spanish health system. Hopefully this helps. The quotes noted on here going up to €325 are for those on a contract of employment or who choose to get health cover that way.

Good Morning,

Excellent info yet again from Dario.We are pensioners & have been here since 2002/3. My wife moved out first. Luckily I was on Disability ex. Army & my wife was working, so she had healthcare & I was allowed Healthcare under Reciprocal arrangements. At that time there was no means test.

To reiterate, Dental & Optical is private as is now almost solely the case in UK. However fees are generally cheaper.

Many out here, including some of my acquaintances, live outside the system, pretend they are visiting or on holiday and use their EHIC & Passport, local GPs & the A&E Units at the Hospital/ Healthcentres. However things are tightening up and will probably do so even more post-Brexit. The bureaucracy out here is mind blowing, far worse than India.

You will need to be an OAP under UK guidelines to have Reciprocal healthcare if that still exists. 

Private Healthcare - I see SANITAS advertising. Perhaps you could get a quote from them?

Also 2 'fixer agencies' that might help,-

CAT SERVICES in La Alfoquia .AND

GL EXPAT SERVICES, Turre.

If we were coming out now we would rent and just spend 6 months here..Have grave concerns re. THE BREXIT EFFECT. I can see us spending more time at our homes in Oz, UK & Goa.

Best Wishes,

Dr. Bob and Sandra

Mojacar Playa and Puerto Lumbreras

Sorry about some of the grammar on my reply - using my iPad with predictive text. Most important I was making was to find a gestor who will do all the donkey work for you. Jan, who manages this forum, also manages other ones - join the forum call Talk Quesada and do a search for the Convenio Especiale. One member called Marcliff knows all the answers and is always spot on. He has commented many times on the Spanish Health System. Good luck

With regards Convenio Especial, I note the following from Citizens Advice Bureau:

“If you do not qualify in any of the ways described in the document then you can pay to access the "Special Agreement" scheme. This scheme was launched by the Government in 2013 and is managed by the Autonomous Regions, although it is not yet available in all the Regions. Currently it is available in Canary Islands, Castilla y León, Galicia, Madrid, Murcia and Valencia with information available on the Regional webistes. It is also available in Andalucia, but there is no online information, so you have to ask at the local health center. This is a post about to members experience of obtaining cover in Andalucia.

To qualify to join the scheme you must have been registered as being resident in the 12 months before your application (registration, L'Union Citizen Registry etc) The cost of joining the scheme is € 60 if you are under 65 and € 157 if you are over 65. There is no exclusion for pre existing conditions.”

Please note you will need private health cover to obtain Residencia and for a 12 month period following the granting of Residencia before being eligible for Convenio Especial.

EDIT: The link above giving the persons experience is excellent and describes in detail what they had to do to be registered.  I thank Beauly for highlighting this - I am as certainly not aware of this.  It has its own set of hoops to jump through, but will be cheaper than the Autónomo route.  We elected to go that route as there is a pension after 15 years, and like I say, we’re not made aware of Convenio Especial.

Like all rules etc in Spain I would advise staying on top of this because rules can change seemingly from day to day - hell - hour to hour!

All the very best

Saludos, Darío

Hi Dario. We are both on the Convenio Especiale as mentioned in my post above. Can you pay to join the Autonomo which costs €325 per month - or do you have to have a contract of employment or be self employed to join. On the Convenio Especiale, as I have mentioned, you have to 100% of all medication. One of us is type 1 diabetic- the cost of insulin and related medications is in excellent of €400 per month, plus my own medication at €40 per month + €60 each for the Convenio Especiale. This comes to a whacking total of around €600 a month between us. The other question is, do you pay for your prescriptions whilst being on the Autonomo or do you pay a % of them. We are both under State pension age (63 and 61). Many thanks Dario. 

Hola Beauly,

You don’t have to be employed or self-employed to pay Autónomo - you can elect to pay.  Like I say, the cost is EVENTUALLY 325,00 € per month, but starts off at 77,00 € per month for the first 12 months, and rises incrementally every 6 months thereafter until the full amount is reached after 3 years paying.  Only one needs to pay for both to be covered.

With regards medication, if the medication is on the list of subsidised medications, then you pay around 30% of the cost. The list of subsidised medications is apparently shrinking each year, but if your medication is listed - about 30% of cost.  You need a prescription from your GP here in Spain.

Hope that helps

Darío