Expat Guide

Spain's Healthcare

Spain’s universal healthcare system is ranked highly both internationally and in the EU.  So, whether you are using private or state healthcare in Marbella you can expect to experience quality care and treatment. Many families residing in Spain opt for private healthcare as package deals are offered, giving a range of benefits to both parents and their children. In particular, private health insurance allows access to multilingual services, dental packages, and reduced waiting times for specialists in comparison to the public service however with the Public services being so highly ranked worldwide it is most certainly worth families utilising them if you are resident.

Healthcare for children for example in Spain includes:

• Pre-natal and post-natal care
• Pediatric care up until age 15 (and standard care from a general practitioner afterwards)
• Free vaccinations until age 14
• Dental care in Spain until age 15
• Access to 23 different types of speciality practitioners
• Prolonged benefits in both standard healthcare and dental care for children with physical or mental disabilities
• Dental and physical health education, including information on nutrition
• Free emergency services, including free emergency dental care

To access public healthcare in Marbella, you need to have a social security number and be entitled to healthcare provided by the state. If you are a non-Spanish national living permanently in Marbella, generally you are entitled to state healthcare, if you are:

• Employed or self-employed and paying social security in Spain
• In receipt of certain state benefits.
• A dependant of someone who pays social security.
• A child or pregnant.
• Under 26 and studying in the public system
• A state pensioner 

You can apply for a Social security number and get a certificate of healthcare entitlement from the main social security office in Marbella if any of the above apply and once you have your entitlement certificate or are in possession of proof of your social security number, you take this, along with your TIE to your local Public health centre.  Read here for a step by step guide to the process. You can then register with a doctor and apply for a health card (Tarjeta Sanitaria Individual or TSI).  This card has a number, which you use to book medical appointments when needed, download the Salud Responde APP to do this easily, and it is also used to access your medical records and hold prescriptions which can be accessed at the pharmacy.  Prescriptions are heavily subsidised with a Tarjeta Sanitaria.

In the Marbella area, there are public health centres in:

• San Pedro de Alcantara
• La Campana, Nueva Andalucía
• Marbella - Las Albarizas
• Elviria

All of this process is possible to do with limited Spanish however we would strongly advise using a lawyer, gestor or just an experienced bi-lingual administrative expert to help you with the process!

Healthcare When Visiting Marbella as a Tourist

If you are a visitor to Marbella from the UK, and EEA country or Switzerland, and covered by the social security scheme in your home country, you are entitled to healthcare in Spain free or at a reduced cost, for treatment that becomes necessary during your visit, e.g. due to illness or an accident.   This is accessed via the EHIC – European Health Insurance Card scheme in the case of countries from the EU.  The card is issued free of charge and gives travellers access to healthcare in all EEA member states for the duration of validity of the card.  The term of validity of the card varies according to the issuing country.  

 

Social Security

You pay social security in Marbella if you are employed (paid by you and your employer) or if you are self-employed (paid by you).    Apart from access to healthcare, social security payments go towards other benefits such as accident or unemployment cover, and pensions.  
Paying contributions entitles you to healthcare immediately and other benefits after a qualifying period. Pensions are granted after you have paid into the system for 15 years.

Social Security In Marbella If You Are Employed

Most workers fall into the ‘general regime’ for social security in Marbella, although there are special schemes for people in the military or civil servants.  If you’re an employee, your employer will register you with the Spanish Social Security authorities  (Tesorería General de la Seguridad Social or TGSS), and pay your social security contributions.
The employer pays the majority, around 85% of the contribution.  The rate of social security is high in Spain at around 35% of salary.

Social Security In Marbella For Self-Employed

If you are self-employed (Autónomo) you come under a special scheme known as the régimen especial Trabajadores autónomos.  You pay all of the social security contributions yourself each month by direct debit– which means self-employed workers personally pay more than employees do – and there is a minimum monthly amount regardless of your earnings.