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About Spanish Healthcare System

While planning your move to Malaga and the Costa del Sol one of the important tasks will be arranging appropriate healthcare for you and your family. Not only it puts your mind at ease but is also an obligatory requirement if you wish to legally reside in Spain. In the article below we summarized the Spanish healthcare system and the requirements of accessing it for expats living in Malaga and the Costa de Sol. 


Firstly, the good news is that according to various studies Spanish healthcare system ranks among the best in the world. In the latest Healthcare Access and Quality Index research, which studied the quality of healthcare in 195 countries, Spain scored 90 points out of maximum 100 placing it eighth in the world rankings. It also ranks highly on accessibility and it guarantees universal coverage and no upfront payments from patients except of a proportion of prescription charges. 


In Spain, there are both public and private healthcare systems running in parallel with each other. 


Public healthcare consists of both state-of-the-art hospitals and medical centres (centros de salud) and more than 90% of Spanish citizens make use of the public system for their medical needs. The system is funded by the social security contributions and is decentralised, meaning that each autonomous region of Spain manages health and social services individually with its corresponding powers and responsibility. Living in Malaga and the Costa del Sol you will be covered by the healthcare services of Andalusia - SAS (Servicio Andaluz de Salud). 


The usual model adopted by the public system allows its users to choose for the primary care doctor (GP), through which they can access the rest of the system. To see the specialist, the patients must first be referred by the primary care doctor. The main disadvantage of the state system is that waiting times to see specialists and for surgical procedures can be quite long unless it is an emergency. Also, important to note that a considerable knowledge of Spanish is required to make use of the free public system. 


As an expat, you are entitled to free public healthcare if you are a legal resident in Spain and meet the following requirements:

- You are employed or self-employed and are paying social security contributions

- You were employed or self-employed, past 2014, paying social security contributions and haven’t interrupted your residency in Spain even if currently you are not contributing into the system

- You receive certain state benefits

- You are EU pensioner entitled to pension benefits

Once registered with the social security, the main policy holder can include the family members such as spouses (even if currently unemployed and not contributing to the system) and children. It also covers divorced, separated and widowed partners. 


If you are not entitled to the public healthcare system by means of above, after a year of legal residency in Spain you can join the Spanish government special pay-in health insurance scheme known as Convenio Especial, which provides access to the state healthcare for a monthly fee which usually compares beneficially to the private health insurance charges. Meanwhile however you need to arrange for the private healthcare.


Spanish private healthcare sector is being used by around 18% of population either as a supplement or an alternative to public. The main advantages of the private healthcare scheme are that policyholders do not usually have to wait as long for treatment and can see the specialists directly. Also, it is quite common for private centres and hospitals to offer medical services in more languages than only Spanish with English being widely present which convinces most expats to subscribe for a private insurance scheme. The largest private insurance companies in the Spanish market are Sanitas, DKW, Adeslas and it is always advisable to request quotes from several providers. 


Whatever your situation is, we at Malaga Expat Consulting can assist you both with registering with the Social security services (TGSS offices) and your local medical centre (centro de salud), or help you to obtain quotes from private health insurance providers. We can even join you for doctor’s appointments if you are not that confident in your knowledge of Spanish. 



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