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Spain Guide Health

Health Matters in Spain – we all like to go travelling but one of the major concerns, is, what we happen if we fall ill or have an accident whilst we are abroad. If you are going to Spain for a short period of time, you should obtain an E111 card. This used to be a form but from 2006 it has been replaced by a credit card sized piece of plastic, that you can keep in your wallet. This card also known as a EU medical card contains your name, date of birth and your national insurance number. It entitles you to free or reduced charged medical treatment whilst you are abroad from the state run national health You can obtain your card by completing a form from the post office or you can go on line EHIC. You should allow a period of up to 3 weeks for your card to be delivered and on receipt, carefully check the information. If you are taken ill and need treatment, you will also be asked to produce your passport and the information on the card and your passport must match or you may be refused cover. The card is valid in Spain and in other EU countries as is usually issued for up to 5 years.

The E111 card should not be seen as a replacement for Travel Insurance and is best regarded as a card that can help you in an emergency. If you produce the card, you may still be expected to pay for certain treatments, in these cases, you should obtain full details of the centre that has treated you and obtain a receipt for your payment. If you want to make sure that you have full cover whilst in Spain, you should consider taking out a Travel Insurance policy. If you have a holiday home in Spain and travel on a regular basis, you may consider taking out annual travel insurance. This type of policy is now available from any number of sources and is quite cheap to purchase. When considering which policy to buy, take note of the maximum trip duration stipulation, some of the cheap policies, will only allow you to be abroad for a maximum of 30 days in any one trip. The real advantage of Travel Insurance is that in a medical emergency, you will be able to make one call to the Emergency Assistance number on the policy and their call centre, used to dealing with problems and armed with all the contact details will be able to co-ordinate all of the arrangements for you. Spanish Doctors can speak English to a certain degree but you will find that your insurers help line, will have a person that can communicate in Spanish and you may find this a real help.

E112 – If you are going to Spain and take regular medication that will need renewing whilst abroad, you will need to obtain a form E112 again from the usual sources. You will need to take with you the generic name of the drug to enable the local chemist to identify it correctly. If you are on medication, it is a good idea to carry with you at least a copy of your prescriptions, in some circumstances you may to asked by authorities to prove why you are in possession of certain medication.

Permanent Residence – If you are going to live in Spain on a permanent basis, the EU card is not an adequate solution and you will find that you are only afforded temporary cover. The Spanish health service is easily on a par with what you would expect to receive in the United Kingdom, and in an medical emergency, you can expect to receive good treatment, remember though that as in The United Kingdom, rural or remote areas many not have the same concentration of cover or facilities. They have a national health service( Instituto Nacional de la Salud) & also offer private medical facilities. If you are working Spain and paying local taxes, part of this will be going to INSALUD and you will be covered anyway, if this is not the case, you will need to obtain a Tarajeta de Sanitaria ( A Health Card). The process is quite simple:-

You will need to complete form E121 from the United Kingdom

You will need your Residencia and Spanish NIE number

With this information, you can visit your local social security office (in Spain), tell them your nominated medical centre, and a doctor will be appointed for you. You will not to able to specify a doctor of your choice and whilst they are all highly trained, you may be allocated one that does not speak English. Spain also has many excellent private medical facilities which of course you can pay for and there is a greater concentration in the cities and on the Costa Del Sol. If you decide to pay for your own medical care, you will of course find a wider range of doctors and many will be fluent in English.

Private Medical Insurance – The more appropriate option though is to consider Private Medical Insurance, with this you will have access to both the state run facilities and many private clinics If you are worried about health matters that you should seriously consider, private medical insurance, there are a large variety of policies on offer and quite simply if you living abroad permanently, as at home, you may become ill from time to time, private medical insurance, can give you peace of mind.

Expatriate Medical Insurance – As ties between different European countries strengthen many Britain’s are moving to Spain, Portugal, Malta or any one of the new member states. However many are unaware that they need healthcare cover or indeed how complex the system can be. This is one area that Assetsure through it’s associates can help. Expatriate medical insurance is a complex involved field and although, you may find expatriate medical insurance online, it pays to talk to an advisor. Another area that Assetsure can help with is providing cover for Britons who have decided to retire abroad. International Health Insurance can provide valuable cover at any time and we at Assetsure can offer a full range of products from many of the leading providers. Understanding the sometimes complex nature of local healthcare systems can be a challenge and as well as providing your holiday home insurance or retirement property insurance, we would like to assist you with your medical covers.

Continental Cover – The European Health Insurance Card (EHIC) has been designed to assist with reciprocal healthcare provision arrangements. But what exactly is and what is not covered by the EHIC and other’E” forms?

THE EHIC – The EHIC replaced the E111 in 2005 and it gives access to healthcare within the European Economic Area and Switzerland. The EHIC covers treatment needed during a trip due to either illness or accident. This includes treatment for pre-existing conditions, chronic conditions and routine maternity care. The card gives access to free or low-cost emergency medical treatment, which will be delivered under state health system in the country that is being visited. The card is available to residents of EEA countries and Switzerland. The EEA is made up of the European Union plus Iceland, Liechstien and Norway. You are entitled to a UK issued EHIC if you are’ordinarily resident” in the UK.This is defined as’lawfully living in the UK for a settled purpose as part of the regular order of his or her life for the time being”. While the EHIC provides access to emergency healthcare when on holiday there are a number of other forms that give UK residents access to healthcare within Europe. E112: This is designed to help alleviate waiting times on the NHS,by offering patients the option to have NHS funded treatment abroad. Patients are selected by their local NHS trust or primary care trust based on their suitability to travel and respond to treatment. All treatment, travel and accommodation costs will be covered by the NHS. E121: This covers healthcare costs of UK state pensioners living in Spain when they access the Spanish sickness insurance system. This form issued by the UK Department of Work and Pensions. E106: This covers medical costs for those who are ordinarily resident in the UK and who are moving to Spain, either to take early retirement or to look for work. The form gives temporary cover for two years. After this time an E121 can be applied for if allegeable, or you must pay into the state healthcare insurance scheme or alternatively take out an international private medical insurance.

THE DISADVANTAGES OF EHIC

  • The card is not normally available if you are living in another country. However if you are normally resident in the UK and move to another EEA country or Switzerland but still pay compulsory UK national insurance you are entitled to a UK issued card. If you are not paying NI contributions you will not.Because state healthcare systems carry across Europe, the healthcare may not be of the same standard as offered the NHS and the patient may have to pay for some of their treatment.
  • The card will at no time pay for emergency evacuation or repatriation back to the home country, this also includes the costs of flying back a body if someone dies abroad.
  • The card is only valid within EEA countries and Switzerland so what about the rest of Europe.
  • The E112 does not give a choice of providers treatment is provides by state hospitals and there still can be long waiting times. The E121 has a very complex application process and there can be long delays in the issue of the E121while a residence permit issued. In addition pensioners who live in the UK but spend over three months of the year in Spain are not eligible for an E121 but under current legislation are also not eligible for free of charge NHS treatment.
  • The E106 form gives cover for only two years and in Spain only. After that time or outside of Spain treatment must be paid for or alternative cover sought.

THE ADVANTAGES OF PRIVATE MEDICAL INSURANCE – The department of Health advises all UK residents to take out comprehensive private insurance for treatment not covered by the EHIC or any other E form. International private medical insurance have a number of advantages over these European public health provisions:-

  • One plan will give the same cover wherever it is used, for the cover duration
  • Most providers will give a choice of area of cover which means that one plan can be used in a number of countries. Also plan holders wishing to travel to a different country purely for the purpose of receiving medical treatment, the costs of the treatment will be covered.
  • Plan Holders can be treated at whatever public or private hospital or clinic they choose provided the insurer does not have any restricted hospital lists
  • Most providers will offer a choice in the level of cover, usually ranging from inpatient and emergency only, through to cover for most medical eventualities.
  • Most providers will pay for plan holder to be evacuated by air ambulance if there is no adequate medical treatment available in their location. Most providers will pay for a plan holders body to be flown back to their home country if they die abroad
  • Financial Servcices Authority regulation means that UK based providers must comply with stringent regulations, designed to protect the customer.
  • Dental treatment, optical treatment and wellness tests are covered by most providers and the cover provided is potentially much greater than the free cover given by state health care schemes.
  • Some plans will cover things like the costs of a flight to visit critically ill relative, legal expenses or travel insurance.

SUMMARY OF Expatriate Medical Insurance –

  • Emergency assistance 24 hours a day by multilingual support staff
  • Private Room and board
  • Surgery, Anaestesia and Nursing
  • Operation and Recovery room equipment
  • Medicine while in hospital and prescribed as an outpatient
  • Diagnostic and lab tests, X rays and MRI etc
  • Chemotherapy and Radiotherapy
  • Care at home following hospital discharge
  • Outpatient Surgery
  • Acute dental treatment following an accident
  • Transportation by ambulance
  • Medical practitioner’s fees, including specialists
  • Physiotherepy, Chiropractor, Homeopathic and Acupuncture treatments
  • Home nursing
  • Psychiatric treatment
  • Optional Coverage
  • Maternity
  • Emergency Evacuation
  • Dental

If you decide to buy a property in Spain and require holiday home insurance, including insurance for holiday letting, contact Assetsure for a quote.

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