Medical Assistance

Procedure

General Information


Purpose:	The purpose of medical assistance is to provide the necessary medical and pharmaceutical services to maintain and restore health.
Holders:	They have the right to health protection and medical assistance in accordance with the provisions of article 3.1 of Law 16/2003, of 28 May, on the cohesion and quality of the National Health System: All persons with Spanish nationality and foreigners who have established their residence in Spanish territory. Persons entitled to medical assistance in Spain in application of Community regulations on the co-ordination of Social Security systems or bilateral agreements covering the provision of medical assistance, provided that they reside in Spanish territory or during their temporary movements to Spain, in the form, to the extent and under the conditions established in the Community or bilateral provisions indicated. More information on holders
Beneficiaries / Requirements:	For the purposes of the provisions of the international regulations on the coordination of Social Security systems, and the revised text of the Law on guarantees and rational use of medicines and health products, approved by Royal Legislative Decree 1/2015, of 24 July, the persons listed in the section on holders of the right to medical assistance are considered insured persons. For the same purposes, the spouse or person with a similar relationship of affectivity, who must accredit the corresponding official registration, as well as the descendants and assimilated dependants of the same who are under 26 years of age or who have a disability to a degree equal to or greater than 65% shall have the status of beneficiaries of the previous insured persons, provided that they fulfil all of the following requirements: That they have their legal and habitual residence in Spain, unless this is not required by virtue of the corresponding international regulation, or they are persons who temporarily move to Spain and are in charge of workers transferred by their company outside Spanish territory in a situation assimilated to that of being registered in the corresponding Social Security scheme. That they do not fall under any of the following Social Security schemes: That they are a worker employed by another person or self-employed worker, affiliated and in a situation of registration or assimilated to that of registration. That they are a contributory pensioner under these schemes. Be in receipt of any other periodic benefit from these schemes. For these purposes, the following shall be considered as persons assimilated to descendants: Minors subject to the guardianship or legal foster care of an insured person as policyholder, of their spouse or of their unmarried partner. Sisters and brothers of the person insured as policyholder. More information on beneficiaries
Contents:	The list of National Health System benefits includes benefits for public health, primary care, specialist care, emergency care, pharmaceutical products, orthotics and prosthetics, dietary products and healthcare transport. The benefits are provided through a range of techniques, technologies and procedures that include the portfolio of common services, which is separated into the following types: Basic care services: Including prevention, diagnosis, rehabilitation and emergency health care provided at health and social health centres. These are fully funded by public funds. Supplementary: Including benefits provided to outpatients, such as pharmaceuticals, ortho-prosthetics, health products and non-emergency health transport. These are subject to a contribution by the user. Ancillary services: These are not classed as benefits and are considered as extra support for improving pathologies. These are subject to a contribution and/or reimbursement by the user. More information
Refusal / Expiry:	When the conditions required to be the holder or beneficiary of the right are lost. Due to death.
Forms:	The application form for recognition of the right to medical assistance, both for the holder and for the beneficiaries.
Documentation:	DNI or official document identifying the holders and their beneficiaries. Family record book or Civil Registry certificates proving the family relationship with the holder, when the entitlement is requested for beneficiaries... More information
Where to process it:	You can apply for this procedure through the Social Security E-Office (http://sede.seg-social.gob.es), either with the digital certificate or with permanent Cl@ve. If you do not have a way of identifying yourself electronically, you can submit this application through "Applications and procedures for Social Security benefits"(https://tramites.seg-social.es/). You can also apply at a Social Security Service and Information Centre by calling 901 10 65 70 / 91 541 25 30.
Competent body:	The granting and control of insured or beneficiary status will be the responsibility of the National Social Security Institute (INSS) or, where appropriate, the Social Marine Institute (ISM). The entitlement to medical assistance shall be provided by the competent health authorities; the health centres in the autonomous communities will provide access to health care benefits by issuing individual health cards.
Other important information:	Detailed information Other circumstances and special situations Medical Assistance: consult eligibility and issue of the document that accredits eligibility European health card Provisional replacement certificate (CPS). Programmed medical treatment in another member state Reimbursement of expenses Special Scheme for Seafarers. Frequently asked questions