The Affordable Care Act & Health Insurance Marketplace

The Affordable Care Act & Health Insurance Marketplace in spain. The healthcare system in Spain is regarded as one of the greatest in the world. Because social security payments fund the system, most residents do not need private health insurance.

Spain is ranked seventh out of 89 nations in terms of total healthcare, trailing only Austria and Denmark in Europe, according to the 2019 Health Care Index.

While the Spanish public health system is excellent, some ex-pats prefer to supplement their coverage with private insurance, reducing wait times and making it easier to consult an English-speaking doctor.

In Spain, who needs health insurance?

If you live and work in Spain, you are likely to pay Spanish income tax and social security, which contribute to state healthcare provision.

If you don’t qualify for health insurance, you can either pay for your care or purchase a private health insurance plan.

In Spain, public health insurance is available.

In Spain, who is covered by public health insurance?

• Employees: In Spain, employees and self-employed people must contribute to social security. This entitles them to health insurance in Spain.
• Self-employed freelancers and business owners: In Spain, freelancers are responsible for their social security contributions to public healthcare. You can get a social security number by going to your local Social Security Office. Spouses and children: Workers’ spouses and children are also eligible to state healthcare as long as they live in Spain.
• The Affordable Care Act & Health Insurance Marketplace in spain
• They must get an S1 form from their country of residence to qualify. Preparing this form will make the registration process go more smoothly. Residents of the EU, EEA, and Switzerland visiting Spain temporarily can use their European Health Insurance Card, which enables them medical care at the exact cost of a Spanish person.
• Non-EU/EEA nationals: Before obtaining a Spanish visa, non-EU/EEA nationals may be required to show proof of private health insurance. Some non-EU countries, on the other hand, have an agreement with Spain. Knowing what you’re entitled to be crucial, so check with your home country’s consulate or embassy before leaving.
• Students: EU citizens studying in Spain are covered by their EHIC for the duration of their studies. Non-EU students, on the other hand, may need to purchase a private health insurance coverage before arriving. More information is available from your university.

What is covered by Spanish health insurance?

The TSI health card covers hospital and doctor visits. It also includes home treatment, which is especially beneficial to the elderly and disabled.

When you present a TSI card to a hospital or a doctor in Spain, you will not be charged any costs. However, you must pay the prescription cost at the time of purchase at pharmacies.

Depending on your income, TSI may pay 40–60% of the cost of prescription medications (90 percent for pensioners). Prescription medications in Spain are inexpensive, even though people are responsible for the remaining costs.

Dentist rates are reasonably priced, and the overall quality of care is excellent. On the other hand, private health insurance can cut expenditures in half, with dental insurance costing as little as €10–20 per month.

What is the procedure for applying for public health insurance?

If you live in Spain, you must register your address on the Padron at the town hall where you live.

You will receive an empadronamiento once you have completed this (certificate of registration). To apply for a healthcare card, you’ll need this. You’ll also need to ensure your social security number, which your company will provide. If you haven’t gotten one, contact your local social security office, the Tesoreria General de la Seguridad Social (TGSS). More information can be found in our guide to Spanish doctors.

On the government’s website, you can look up your local Social Security Office (Oficina del Instituto Nacional de Seguridad Social).

Once you have your TSI card, you can register with an individual doctor or at your local health center. Within your local healthcare district, you can choose doctors and pediatricians. However, it would be best if your primary care physician recommended you see any additional specialists.

Your TSI health card verifies that you are covered by Spanish health insurance. It must be presented if you seek medical help or acquire a prescription from a pharmacy.

In Spain, private health insurance is available.

Private health insurance is an option if you require additional healthcare services. Private health insurance firms in Spain offer a variety of solutions tailored to your unique needs.

Before committing to a specific plan, it’s critical to properly explore your health insurance options and seek as much information as possible. Foreigners should check to see if their package offers the same protection level in Spain as in their home country.

Because the EHIC card only covers travel within the EU, EU citizens who regularly travel outside the EU may consider purchasing private health insurance.

The benefits of purchasing private health insurance in Spain

While public healthcare is of good quality, some citizens choose private coverage. This allows patients to bypass the state system’s long daily wait times.

This is a crucial issue to consider when assessing the benefits of private care, especially if you will need treatment frequently.

A private health insurance plan allows you to choose a doctor who is fluent in English. Tourist bureaus and embassies can also provide lists of English-speaking doctors.

How to Pick a Health Insurance Company

You can compare private health insurance carriers in Spain and request free quotations. You can also use the following tools: Acierto.com (in Spanish) and Rastreator.com (in English) (in Spanish).

The following are some of Spain’s largest private health insurance companies:

• Allianz Care is a service provided by Allianz.
• Cigna International is a global health insurance company.
• Health Across the Globe

Contributions and refunds from health insurance

Spain’s General Social Security Fund (Tesorera General de la Seguridad Social) contributes to the country’s healthcare system. Anyone working in Spain is given a social security number and must contribute monthly.

In Spain, your health insurance contributions are based on the government’s annual minimum and maximum contribution rates.

In 2019, the current payment rates were established. General employees pay 4.7 percent of their annual earnings into the social security system. Employers contribute 23.6 percent of a worker’s salary (a total contribution of 28.3 percent ). Self-employed employees pay between 18.75 percent and 26.5 percent, depending on their earnings.

Unemployed or low-income people can get health insurance.

The Convenio Especial is a pay-in scheme offered by the Spanish government (special agreement). This is for those who may have difficulty accessing the system’s benefits, such as those who become unemployed or have low income.

It’s simply a low-cost insurance plan that gives you coverage in exchange for a small monthly price. You can pay a minimum, average, or maximum contribution. During average employment, the convenio, especial, is suspended because your salary covers your contributions.

Beneficial resources

• In Spain, low-income people have access to healthcare.
• The UK government’s guidance on healthcare in Spain