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Social security system in Spain
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The spanish healthcare system
The Spanish healthcare system is characterized by being one of those that offers a greater variety of services and by covering numerous eventualities free of charge.
Every person born in Spain or who has obtained Spanish nationality by marriage, residence, or by any other means has the right to healthcare coverage whether they are working, studying, retired, or unemployed. Likewise, the foreigners who reside, work, or visit for tourism have the right to different levels of coverage.
Social security and citizens of the European Union
Here can be found different cases. For example, citizens of the European Union, through a simple procedure, can solicit a European Health Insurance Card in their country of origin. This card provides them coverage in all countries of the European Union as long as their income is less than 100,000 euros per year.
European healthcare greatly facilitates procedures within the Union as well as the mobility of its citizens for work, family reasons, or leisure. It usually covers 100% of what is covered in the country of origin
Social security and non-european citizens
Non-EU citizens should be informed before they travel and should know what the situation would be for their country's citizens. There are sometimes bilateral agreements that guarantee a series of reciprocal rights to the citizens of both countries during their travels.
Even though emergencies are covered, it is always advisable to know what your situation is.
Not all travelers should follow the same steps. Those tourists who come for a few months can access basic coverage and emergency coverage during their stay.
Tourists can go to any health center and receive care in the case of minor or serious emergencies. Chronic diseases or long-term treatments are not included in this. This so-called ‘medical tourism’ is being persecuted to avoid fraud in the healthcare system.
Signing up for social security
In the case of travelling to Spain for work, your employer will take care of your registration in the social security system. As a worker that is listed in the healthcare system, a small part of your salary - paid in part by your employer and in part by you - will be allocated to the healthcare system to cover any sick leave or accidents.
This will give you complete access to all of the services that a Spanish citizen has. This coverage will be extended to all members of your immediate family.
If it is your intention to reside in Spain permanently, you should register in the category to which you belong to obtain your social security number and the corresponding card.
Foreigners that are not registered will only receive healthcare in the case of serious illness or accident, although pregnant women and minors are entitled to medical attention in any case.
If you work as a freelancer, you will be responsible for your own registration as well as turning in all of the necessary documentation.
Characteristics of the social security system in Spain
The healthcare system is structured into different levels, normally related to the severity and urgency of the cases to be treated. Primary care offers more localized care for lesser problems.
It is concentrated in health centers and based on doctor-patient consultations with the exchange of basic information such as symptoms, symptom duration, etc. If a solution to the problem is not found or if further testing is required, the case should be assessed by a specialist. Specialists focus on specific areas of healthcare and have access to equipment that can perform more precise tests and diagnoses.
Normally, you must wait to get an appointment with a specialist. Treatment will involve medium to long-term follow-up periods with significant emphasis placed on prevention and healthy habits that will be beneficial for your general wellbeing.
Emergency departments are concentrated in the big hospitals and treat serious cases that cannot wait.
Admission to public hospitals always occurs through one of three channels - primary care, specialists, or emergencies - and may involve long-term treatment, surgery, and medications that are not covered by the public system, in the case that the patient does not possess a healthcare card.
Medical services not included under social security:
Some medical services are not covered under Spanish social security such as:
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Ophthalmology
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Dental Medicine
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Aesthetic Medicine
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Plastic Surgery
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Assisted Reproduction (Not always)
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Podiatry
Therefore, all Spanish nationals as well as foreigners must pay for these services within the private sector.
Advantages and disadvantages of the public social security system
The biggest advantage of the public system is the wide network made up of renowned, prestigious specialists with extensive experience, as well as hospitals that, in general, have all of the necessary equipment available.
The public system is closely linked to the universities. Therefore, it is in permanent contact with new research and renewed by generations of doctors who promote and improve patient care.
The main drawback is that the number of patients can overwhelm the system at times, especially if the government has implemented budget cuts, if not enough staff has been hired, or if they have to work in conditions that are not the best.
This leads to waiting lists for both operations and consultations that are not of extreme emergency as well as austerity measures for the means destined for hospital admissions, leading in turn to room shortages and a lack of resources.
Private medical insurance
Contracting private health insurance is a good option if you have the economic resources to do so and does not necessarily imply completely relinquishing the public system.
The private system offers quicker service for immediate attention and great professionals, the majority of which combine their work in the public system with that performed in private clinics.
While the comfort is always greater, with individual rooms, more nurses, and no need to wait, there tend to be less hospital resources, since very often these are medium-sized clinics and not large hospitals.
They eventually work hand-in-hand with operating rooms and equipment in the public hospitals. The great disadvantage, of course, is that the cost can be quite high depending on the case.