Medical assistance for returned Spaniards and for Spanish workers and pensioners resident abroad and temporarily in Spain, and for relatives of the above living with or accompanying them.
Returned Spaniards and pensioners, employees and self-employed workers, as well as their relatives, not living in the EU/EEA/Switzerland, who are temporarily in Spain, shall be entitled to medical assistance paid by public funds through the National Health System when, according to the provisions of Spanish Social Security, the provisions of the home state or international Social Security regulations and agreements set for this purpose, do not provide this coverage.
Relatives entitled to medical assistance:
-
The spouse of the persons indicated or whoever lives with them in a similar relationship, as a common law couple.
-
Descendants of the persons indicated, and those of the spouse or common law partner, who are under their responsibility and under 26, or older with a recognised disability equal to or greater than 65 per cent.
The recognition of entitlement to medical assistance lies with the INSS in any case, which shall issue a document accrediting the right. This right shall be maintained until the beneficiary meets the requirements established to obtain such right according to the provisions of Spanish Social Security, the provisions of the home state or international Social Security regulations and agreements.
Returned Spaniards shall justify this status by presenting their withdrawal from the consulate of the country of residence and the census certificate of the town where they have established their residence in Spain.
Law 40/2006, of 14 December, the Statute of Spanish citizenship abroad and RD 8/2008, of 11 January, which regulates the benefit due to need in favour of Spanish residents abroad and returned citizens, amended by Law 26/2015, of 28 July, on the second opportunity mechanism, reducing the financial burden and other social measures.
Medical assistance in application of EU regulations and international agreements:
-
Individuals entitled to medical assistance under EU regulations on the coordination of Social Security systems or bilateral agreements that cover the provision of medical assistance, shall have access to such assistance, provided that they reside in Spanish territory or when travelling temporarily to Spain, in the manner, to the extent and under the conditions laid down in the aforesaid EU or bilateral regulations.
-
In no case shall citizens of member States of the European Union, the European Economic Area or Switzerland staying for less than three months be considered non-resident or unauthorised foreign citizens in Spain for the purposes set forth in article 3 ter of
Law 16/2003, of 28 May, and as regulated in article 6 of R.D. 240/2007, of 16 February, on entry into, free movement within and residency in Spain for citizens of member States of the European Union and other States that are part of the Agreement on the European Economic Area.
Medical assistance for people with disabilities:
In relation to medical assistance for people with disabilities, the sole transitional provision of the Consolidated Text of the General Act on the rights of people with disabilities and their social inclusion, approved by Royal Legislative Decree 1/2013, of 29 November (BOE 3/12), shall apply.
The power to recognise the right to medical assistance lies with the |AR/IMSERSO.
Special schemes for civil servants:
-
Individuals who are members or beneficiaries of the special Social Security schemes managed by the Mutual Society for Spanish Civil Servants, the Armed Forces Social Institute and the Mutual Society for Spanish Court employees keep the scheme of obligatory cover for health care provision, in accordance with the special regulations governing each Mutual Society, which, likewise, determines their respective protected group, including civil servants who have joined any public administration after 1 January 2011 in bodies to which the mutual scheme applies. These civil servants will remain members of the mutual scheme when they become pensioners.
-
Recognition and control of their status as members or beneficiaries of a mutual scheme is the responsibility of each mutual society, in accordance with its specific regulations and its respective organisational structure.
-
The mutual societies and the National Social Security Institute or, where appropriate, the Social Marine Institute, shall establish the necessary collaboration and coordination mechanisms to avoid the duplication of inherent and derived rights, where they are incompatible, and to ensure access to the public health care system for those members of the mutual scheme who have opted for that form of medical assistance.
Foreigners not registered or authorised as residents in Spain:
Foreign citizens who are not registered or authorised as residents in Spain shall receive the following types of health care:
-
Emergency medical assistance in the event of serious illnesses or accident, irrespective of the cause, until medical discharge.
-
From 01-09-2013, foreign minors under 18 resident in Spain referred to in article 3 ter of
Law 16/2003, of 28 May, shall be entitled to public medical assistance from the NHS with the same period as persons with insured status, with the user's contribution rate for those services of the NHS portfolio that require it the same as for those who are actively insured.
-
From 01-09-2013, pregnant foreign women as referred to in article 3b of Law 16/2003, of 28 May, shall be entitled to NHS care for pregnancy, birth and the postpartum period, to the same extent as individuals with insured status, with the user's contribution rate for those services of the NHS portfolio that require it being the same as for those who are actively insured.
The AR/Public Health Services are responsible for recognising the entitlement to medical assistance.
Provision of medical assistance to applicants for international protection:
-
Individuals applying for international protection whose stay in Spain has been authorised on those grounds shall, while they remain in that situation, receive medical assistance to the extent provided for in the basic common portfolio of NHS health care services regulated by article 8a of Law 16/2003, of 28 May.
-
The necessary assistance, medical or otherwise, shall also be given to applicants for international protection with special needs.
-
The AR/Public Health Services are responsible for recognising the entitlement to medical assistance.
Provision of medical assistance to victims of human trafficking in a period of recovery and reflection:
-
Victims of human trafficking whose temporary stay in Spain has been authorised during the period of recovery and reflection shall, while they remain in that situation, receive medical assistance to the extent provided for in the basic common portfolio of NHS health care services regulated by article 8a of Law 16/2003, of 28 May.
-
The necessary assistance, medical or otherwise, shall also be given to victims of human trafficking with special needs.
-
The AR/Public Health Services are responsible for recognising the entitlement to medical assistance.
Special agreement on the provision of medical assistance to individuals who do not have insured or NHS beneficiary status:
For the purposes of the provisions of article 3.5 of Law 16/2003, of 28 May, those individuals who, not having insured or beneficiary status, do not have access to a system of public health care protection on any other grounds, may receive medical assistance by making the relevant payment or paying the relevant fee arising from the signing of a special agreement.
This means of access to medical assistance, regulated by R.D. 576/2013, of 26 July and developed by Order SSI/1475/2014, establishing the basic requirements of the special agreement on the provision of medical assistance to individuals who do not have insured or NHS beneficiary status, in force since 01-09-2013, allows individuals covered by it, by making a payment, to access the basic common portfolio of NHS health care services, regulated by Article 8 bis of Law 16/2003, of 28 May, with the same guarantees with regard to extent, continuity of care and cover as are enjoyed by individuals with insured or NHS beneficiary status, in the area of public administration with which the agreement was entered into and without prejudice to the content of additional provision one of this royal decree.
The National Health Management Institute is responsible for recognising entitlement to medical assistance through the special Agreement