Healthcare for retired expats in Spain: A guide

Zorica Lončar
08.06.21
4 minute read

When planning a permanent move overseas, there’s a lot to think about. We know you’ll want to make it as stress-free as possible, so you can concentrate on looking forward to your sunny, well-earned retirement.

One thing you’ll need to make sure you can get is affordable and reliable healthcare whenever you need it. In our guide, we’ll explain how the Spanish healthcare system works, in what circumstances it’s free and how to access it.

As you’re moving abroad, we’d also like to help your savings go a little bit further, so we’ll show you how to save money on your relocation costs. Open a Wise multi-currency account and you can send money to Spain for small fees, avoiding high bank charges, and the real, mid-market exchange rate.

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We’ll cover this in more detail later, but first, here’s what you need to know about healthcare in Spain.

How the Spanish healthcare system works

Spain has a high quality healthcare system ranked among the best in the world, at number 19 according to the 2018 Euro Consumer Health Index¹.

It consists of both public healthcare under the ‘National Health System’ and private healthcare, with many hospitals and practices offering both. The National Health System is organised regionally and is designed to give residents access to basic healthcare free of charge. However, patients do often pay at least a certain amount towards prescriptions, as well as orthopaedic services.

For most UK expats who aren’t permanent residents, health insurance will usually need to be in place in order to access healthcare for stays longer than 3 months.

Is healthcare free in Spain?

Most basic healthcare services are free through the National Health System to Spanish citizens and residents. While the services can be accessed by UK expats through social security contributions from employment, this likely won’t be applicable to your circumstances as a retiree.

However, there are a number of ways that public healthcare can be accessible to you for free or at reduced costs:

  1. S1 form. If you’re in receipt of a UK state pension, or certain UK benefits, you may be eligible to have your healthcare in Spain paid for by the UK. To apply for this, you’ll need to obtain a certificate of entitlement, which is otherwise known as an S1 form. To request a form, phone the NHS Overseas Healthcare Services, +44 (0)191 218 1999².

  2. Public health insurance scheme. Once you’ve lived in Spain and been registered on the padrón at your town hall for at least 1 year, there’s also the option of applying for the ‘Convenio Especial’². You’ll pay a basic monthly fee - €60 if under 65 or €157 if aged 65 and above - to join this scheme, which gives you access to the national health system³.

  3. Long-term residency. When you’ve been resident in Spain for 5 years or more, you may wish to apply for permanent residency. Doing this will give you the same access to public healthcare as a Spanish citizen.

Otherwise, you’ll need to take out private health insurance (and you may have to do this to meet visa requirements). This comes with the added benefits of avoiding wait times in the state system and being able to choose your package to include travel cover.

How to register for Spanish healthcare services

To get access to the National Health System’s services, you’ll need to register.

  • If you’ve applied for an S1 form, then you’ll need to register it with the INSS via your local office or the online portal. You can find more information about how to do this here. Once the form is registered you’ll be sent a Spanish social security number. You should take this with you to your local healthcare centre to register.

  • If you’re going to be paying into the ‘Convenio Especial’ scheme, once your application is accepted, register at your local healthcare centre with your social security number. Get this from your local TGSS office.

  • If you’ve got permanent residency status, you’ll need to prove the UK does not pay for your healthcare with a legislation letter, which you can get from the NHS Overseas Healthcare Services. Take this to your local INSS office to begin registration. You’ll then take the document they give you to your local healthcare centre to register.

Once registered you’ll be given a health insurance card, which you’ll need to take with you whenever you visit a healthcare centre, hospital or pharmacy.

Save on your overseas retirement costs with Wise

Retiring overseas can be costly, and involves managing money between two locations as you prepare to make the big move. So, we know it can really help to save whenever possible.

Open a Wise multi-currency account, and you’ll be able to send money between the UK and Spain quickly and conveniently, for only a small, transparent fee. Crucially, you’ll not be hit with any extortionate bank charges and you’ll always get the real, mid-market exchange rate.

What's more, Wise’s secure online system, with 2-factor authentication and a dedicated round-the-clock fraud team, means you can be assured that your money is in safe hands.

Get the Wise debit card with your account and you’ll see further benefits once you actually arrive in Spain. This card lets you pay in the local currency, for only a small conversion fee, and zero transaction fees. So you can spend with confidence straight away - which is really handy if you need to buy items, like prescriptions, on arrival.

Join Wise and start saving today


In Spain, you can look forward to comprehensive, reliable health care throughout retirement. Just make sure you check your eligibility for public healthcare, as it may be necessary to arrange your own health insurance. It’s also sensible to budget and/or arrange cover for the costs of any additional services.

Hopefully this guide has given you all the information you need to start planning your healthcare in readiness for enjoying retired expat life in Spain.


Sources used for this article:

  1. Expatica - healthcare in Spain
  2. Gov.uk - healthcare in Spain for UK nationals
  3. Citizens Advice - convenio especial

Sources checked on 28-May-2021.


This publication is provided for general information purposes only and is not intended to cover every aspect of the topics with which it deals. It is not intended to amount to advice on which you should rely. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of the content in this publication. The information in this publication does not constitute legal, tax or other professional advice from TransferWise Limited or its affiliates. Prior results do not guarantee a similar outcome. We make no representations, warranties or guarantees, whether express or implied, that the content in the publication is accurate, complete or up to date.

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