Since Brexit, healthcare access in Spain for British expats has changed significantly. It has become more complex, and many people don’t have the right information prior to moving to Spain.
Currently, not all British citizens living in Spain can access public healthcare automatically, even under the agreements signed between the two countries.
Their situation depends on several factors, including residency status, whether they hold an S1 form, whether they are registered with the Spanish Social Security System, and specific requirements of their visa.
Proper understanding of all options could mean saving thousands of euros and avoid legal or healthcare problems.
How Healthcare Works in Spain for British Expats
To fully understand how healthcare works in Spain for British Expats, it is key to learn how the Spanish Public Healthcare System works, who is entitled to public health care, the S1 form, visa and residency options and requirements and what changed after Brexit.
The Spanish Public Healthcare System (SNS)
Spain’s public healthcare system (Sistema Nacional de Salud, also known as SNS) is often considered one of the best in Europe.
.Spain has a tax-funded public healthcare system and is managed at a regional level, but entitlement depends on legal basis and registration.
Who Is Entitled to Public Healthcare?
Access to public healthcare in Spain is not automatic for expats and depends on having a legal basis for entitlement. You may qualify in the following cases:
- Being employed or self-employed in Spain and registered with the Spanish Social Security system.
- Being a pensioner with a registered S1 form issued by the UK.
- Being a dependent (beneficiary) of someone who is insured under the Spanish system.
- Being a student, in some cases, through a valid GHIC/EHIC or specific arrangements.
In all cases, entitlement must be formally registered with the Spanish authorities (INSS) before access to the public healthcare system is granted.
What Changed After Brexit?
After Brexit, UK nationals no longer have the same automatic rights to live in Spain under EU free movement rules. Access to healthcare in Spain now depends on a person’s legal status and the basis on which they are entitled to cover.
- UK nationals protected by the Withdrawal Agreement generally keep their healthcare rights if they were legally resident in Spain before 1 January 2021.
- Those who are not covered by the Withdrawal Agreement must qualify for healthcare through another route, such as employment, registration with the Spanish Social Security system, a valid S1 form, or private health insurance.
- A GHIC gives access to medically necessary state healthcare during temporary stays in Spain, but it is not intended to cover long-term residence and does not replace travel insurance.
The S1 Form Explained (And When It’s Not Enough)
The S1 form allows certain UK nationals (mainly state pensioners) to access Spanish public healthcare funded by the UK.
Who Qualifies?
UK state pension recipients and some export benefit holders apply.
How to Register It in Spain
To register it in Spain, the S1 form must be presented at the INSS office to obtain a Spanish healthcare number.
Common Mistakes
Some common mistakes related to the S1 form consist of assuming the S1 works automatically without registration, not updating residency status or even failing to register dependants correctly.
What S1 Does NOT Cover
S1 does not cover private healthcare, medical repatriation and other extra services.
Regional Issues
Because healthcare is regionally managed, the experience with Spanish healthcare system can differ between areas like Valencia, Catalonia, or Andalusia.
Do British Expats Need Private Health Insurance in Spain?
British expats often require private health insurance in Spain, in some cases, it is mandatory.
When It’s Mandatory
Mandatory situations include applying for residency permit like non-lucrative visa, digital nomad visa, or initial residency applications, where applicants must demonstrate full medical cover that meets specific requirements..
When It’s Highly Recommended
Private health insurance is highly recommended to avoid long waiting lists for specialists, to easily access English-speaking doctors, to get extra services or for families who want to make sure they get fast and high-quality attention.
Public vs Private Healthcare in Spain: What’s Better for Brits?
The answer to the frequently asked question “it is better to get public or private healthcare in Spain for Brits?” does not have a single answer. Depending on their needs, people often combine both to get the best healthcare.
How Much Does Private Health Insurance Cost in Spain?
Prices vary depending on several factors, but often range from 50€ to 200€ a month, depending on the insurance-taker age and selected cover.
Key Factors That Affect Cost
Age, pre-existing conditions, co-payment vs no co-payment policies, level of cover, dental cover or other extras change significantly its cost.
Important Concepts
Waiting periods, no co-pay policies, full cover policies and repatriation cover are concepts to consider when buying a health insurance policy.
Best Health Insurance Options for British Expats
Spain has several well-known insurers, with long experience and reputation, such as DKV, AXA, Sanitas, Adeslas,, Asisa, Mapfre, or Salus. Depending on the area, there may be more facilities, such as hospitals and clinics, and therefore a wider range of services available.
However, not all policies are suitable for expats, so it is important to make sure to select the right plan, as not all plans are visa-compliant and many insurers impose age limits or underwriting restrictions.
A specialist expat insurance broker like Just Insurance can help you understand exactly what you need and find it for the best price while getting high-quality services.
Health Insurance Requirements for Spanish Visas
These are some of the requirements for Spanish visas regarding health insurance.
Non-Lucrative Visa Requirements
For a non-lucrative visa, it is required to show proof of health insurance with no co-payments, full cover (equivalent to the public system), and no waiting periods. It must be issued by a Spanish-authorised insurer.
Digital Nomad Visa
Requirements for a digital nomad visa are in most cases similar to those applying for a non-lucrative visa. Insurance must cover full duration of stay.
Student Visa
For students applying for a student visa, Spanish authorities generally require proof of private health insurance issued by an insurer authorised to operate in Spain. The policy is typically expected to provide full coverage, without co-payments or waiting periods, and valid for the duration of the stay.
Common Mistakes British Expats Make
Relying only on the Global Health Insurance Card (GHIC), assuming the S1 covers everything, buying travel insurance instead of health insurance or choosing the cheapest policy are common mistakes that can result in visa rejection, denied treatment, or major costs.
What’s the Best Option for You?
Your ideal solution depends on your situation, so make sure you find the right partner to help you find the right plan and the best insurance company in Spain.
At Just Insurance, we can help you get the peace of mind you require and make sure you purchase the right plan for your situation.
