Social Security in Spain. Do they leave you to die the road side?

 I have a friend who has been self employed for over 10 years in spain and last year closed his businsess for personal reasons. He has a british passport, is married to a spanish lady and has been declared resident for the 10 years.

He asked a lawyer in Madrid last year about his social security situation in the case he stops being autonomo (as he has a few ailments) and the lawyer told him that if he has the Spanish social security card (which he does) , then basically he has that forever so no need to worry.

So in the case that he stops being autonomo and is essentially not working and not on the "paro", then he can still get prescriptions from the spanish social security due to posessing the social security card.

However, the other day he went to the doctors to get a prescription and the doctor informed him that his social security account is "on hold" as he is no longer paying social security so the doctor was not able to issue the life preserving treatments.

My friend is now baffled as he is given on one hand what seems to be proper advice only for the doctors to say no, and refuse treatments now.

(The doctor did kindly mention though that he and his wife could go to social security and fill in some forms and that he could go onto his wifes social security and that it would be activated again, but my friend is wondering "thats all fine....but  what if my wife was not working either?")

Do the spanish social security just leave you in the lurch to die by the roadside if you do not have social security?

Why was my friend not informed of this via letter?

 Well not exactly but pretty much!! He will always have treatment through the emergency ward of a hospital, but as far as GP's are concerned and continuous treatment it appears that they are blocking social security cards to freelancer who aren't working and have paid for years and years religiously. I wasn't aware this was happening until recently and to be honest I am shocked. It is an absolute disgrace. Not only do freelancers have absolutely no unemployment benefit or any subsidies of any kind they are now cancelling their national health cards. What will this come to? Will one have to pay to use the pavement next? For a freelancer who is not working, it is cheaper to hire private medical insurance than go back on the national health, and pay the minimum social secuirty monthly payment, which is 280 euros! Work that one out !!!! Something is going terribly wrong with this issue!

When we came to Spain 2 years ago I registered as autonomo to teach English, I gave the business up as I was coverered for health care by my husband's autonomo payment  and as I fancied a break from work we could not see much advantage of paying 2 separate autonomo payments for the same single set of benefits (one  partner paying covers the other) and 2 lots of accountant fees.

When I wound up my shortlived business,  my accountant advised me that I would get health cover from my personal social security (autonomo payments) for up to 3 months from the date of my last payment,  which was pro rata for the number of months I had been trading and paying contributions (She advised me of the limits of the the scheme when I became self- employed so this was no surprise)

NHS health care in Spain is contribution not residence based for non Spaniards of working age,  so if you cease trading as freelance/self -employed then you will not get indefinite health care. It may sound callous compared to the UK NHS but that is how it is here, which means that freelance ex pats are constantly going to have some stress around running a  viable/profitable business until pension age.

All the above said when I went to the Dr's today with severe breathing difficulties due to bronchitis and asthma the Dr who was leaving his surgery at the time, rushed me into his room and helped me with no reference to anything - the receptionist however was not so laid back and collared my husband for all the necessary numbers and my health card (which was renewed once the cover from my husbands contributions kicked in and my were expired)

The cost of the kick ass drugs which helped almost instantly were less than a tenner for 3 items.

It isperfectly simple . as from january this year if you are without funds , unemployed & out of benefit , you are entitled to healthcare as long as you are a permanent resident. Just go to the InEm/Sepe , whatever it's called these days & get the form

' Solicitud de Reconocimiento del derecho a la Asistencia Sanitaria de la Seguridad Social' , couple of minutes to fill in , make an appoint lment  at the same time to complete the process when they will add you to your wifes. If she is in the  same boat you can both do it.

Wow that is news to me Guslopez thanks for the info. would you mind telling me where you got this information from and can you also clarify the definition of unemployed? do you mean someone who as paid NI as either self- employed or employed in Spain for a specified period?

I know lots of people who are under retirement age who are working under the radar and paying nothing into the system, and I do hope they can't just pitch up and plead poverty like those who have paid their taxes and NI

cheers

The law effects foreigners and Spanish people. Once you stop receiving dole or subsidio payment you have 3 months use of health services. The law in fact is not new, it has always been this way (added modification April 2012 regarding illegal immigrants and new medication charges)  but due to the crisis and cuts they are applying the law strictly to everyone now.

What the Spanish do is simply sign on to one of their family member's cards so they are then included. (Husband, child, mother, etc) If that is not possible you can ask to have a card "for people without incomes" (Tarjeta Sanitaria para personas sin recursos económicos.) but this card is only given to the Spanish people where as before this card was given to illegal immigrants.

Apologies, I wrote the wrong document title in the last post. This is the exact way.

You are able to apply using the ' Solicitud de Reconocimiento del derecho a la Asistencia Sanitaria de la Seguridad Social '.
Obtainable from the INEM/SEPE office. Once completed & an appointment made, assuming you are entitled ( It would only be too much income which would prevent that) you will receive a ' Documento acreditativo del derecho a asistencia sanitaria ' which you take to the centro salud for renewal / registration.

As from April 24th  everyone who was registered as a permanent resident , or is a Spanosh national, is entitled. You can't do the ' Extranerjo titular sin recursos ' now without the above. The health centres cannot now sign you on without first having the ' Documanto acreditivo' .

Many  Spaniards have no idea that they are all now entitled. Even some office staff are unclear on some aspects.

I have just helped a relative of a spanish neighbour who had been told that after 40 years of paying in soc. sec in France & in receipt of a full French disability pension , albeit  under the age of 65,  that he was not entitled to healthcare !! He was & he is & he now has it!

Anyone who wasn't resident before the 24th April has to prove income to get residencey & show private healthcare.

Just a reply by contrast:

Subject: From The Daily Mail Newspaper iPad App:

We are a fekin joke!! Foreigners must laugh at us.
Why are we such a soft touch all the time.  It makes me mad!!!!!

Open door for health tourists - and it’s down to human rights!

HEALTH tourists must be given free treatment by GPs because it is their
human right, say NHS bosses.

New guidelines tell doctors across England they must register any foreign
patient who asks for care otherwise it would be ‘discriminatory’ .

These include asylum seekers, overseas students or tourists coming for a
short holiday. Once registered, they will be entitled to the same NHS care
as all other patients and can receive free blood tests, jabs and – in some
cases – free prescription drugs.

In fact, the new rules will give overseas patients more rights than those
living in the UK who can be turned away from surgeries if they live a few
yards outside its catchment area. There are also fears the ruling will make
it even harder for local patients to get an appointment.

Already half of patients cannot get an appointment with their doctor within
48 hours, according to the Government’s  own figures. Some family doctors
are furious at the guidelines and describe them as a ‘charter for health
tourism’ .

They say that such patients, once registered at a surgery, will also find it
far easier to be referred to hospital for thousands of pounds of free
treatment.

By law, overseas patients are not entitled to be treated at hospital –
unless it is urgent – but staff rarely check on their backgrounds.

Until now, GP practices were not legally obliged to register foreigners and
many turn away patients if they do not have passports or ‘proof of address’
documents.

But the new guidelines issued to all doctors in England will change this.

One GP, who wished to remain anonymous , said: ‘I am not sure the British
taxpayer should be paying for the world’s health treatment for free.’

And Tory MP Chris Skidmore, who is campaigning for tougher regulation on
health tourism, said: ‘It is alarming that managers are passing these kind
of diktats to doctors, many of whom are rightly worried that GP registration
is effectively buying free treatment on the NHS.

‘This is not just about the money, vital though that is – we cannot have the
NHS, paid for by taxpayers, being abused by people who pay nothing into the
system and who are not eligible for free care.’

Mr Skidmore has obtained figures showing that health tourists currently owe
the NHS £40million in unpaid medical bills.

In the last year nearly 3,600 ‘overseas visitors’ have had hospital
treatment worth at least £1,000 a time.

National guidelines say it would be discriminatory for GPs not to treat
health tourists.

NHS London, one of four strategic health authorities in England, has backed
up this advice with further guidelines explaining they will ‘promote human
rights and public health’ .

Dr Vijayakar Abrol, a GP who practises in Edgbaston, Birmingham, said: ‘The
guidance is not worth the paper it is written on. We do not have endless
resources. Why should we give these patients – be they from India, Canada,
the US or Eastern Europe – free treatment?

‘We cannot go to those countries and get free treatment ourselves.’

Last week an investigation by BBC’s Panorama found that staff working at GP
surgeries were taking bribes of £800 to register health tourists on surgery
lists.

One manager, Asif Butt, who worked at a practice in Sparkhill, Birmingham,
has since been suspended.

Some doctors say it is cost-effective – not to mention humane – to register
overseas patients.

Dr Vivienne Nathanson, head of science and ethics at the British Medical
Association , said it would be far cheaper to give patients insulin for
diabetes, for example, rather than later treating them in A&E after they had
fallen into a coma.

They also believe it could help prevent the spread of certain diseases such
as tuberculosis which is commonly brought in by overseas patients.

 Yes I read this in the Mail and the Express. If this is a EU ruling then surely this must apply to Spain. So when I retire and live in Spain for 6 months does it mean I am able to sign on to a doctors surgery to get my prescription, then carry on with my own doctor when I return to the UK for the other 6 months?

Hope this hasn't gone to far off the original thread.

Regards.

Tech

I cannot see how any country can offer limitless medical care and benefits WITHOUT it being contribution based.   There are far too many differential sets of rules throughout Europe and its countries and it goes without saying that even in the UK the pot is getting smaller simply because more immigrants are encouraged to take out of it even without having a job and contributing.  

It makes no sense to instruct doctors in the UK to treat everyone who drops on their doorsteps and is causing huge resentment amongst the indigineous population purely because people here in the Uk who have contributed all their lives are inevitably being pushed to the back of the queue to treat more serious cases of diseases and medical conditions, many of them expensive, like dialysis and TB,  amongst immigrants just arrived. 

Until all countries in Europe are "singing from the same hymn sheet" I see no future for the UK only to become bankrupt !

Just more EU bureacrats playing monopoly with money they themselves have not earned but are more than happy to distribute to every tom, dick and Mohammed !

 Sorry but this is one thing you can't blame the EU on.  The NHS has always been "airy fairy" about its advice on how to treat foreigners.  The managers, despite guidance given by the DoH, usually turn around and say register them anyway, it saves problems.  The advice to GPs comes from NHS bosses and not the EU (and the ECHR is nothing to do with the EU, either).

Example 1 - 45 year old student from Saudi Arabia turns up to register at GP practice.  Has 2 wives, 5 children and a nanny in tow.  Father, both wives and children and "student visa" stamped in their passports, nanny does not.  Despite refusing to register the nanny (who also has "no recourse to public funds" stamped in her passport) practice manager is over ruled and told to register the nanny as she is part of their household.

Example 2 - SE Asian woman turns up to see a doctor about diabetes.  No record of living in UK, no passport, admits to having arrived 2 days before without any medication.  Doctor issues private prescription but PCT over rules GP and told to issue free prescription as she is over 60.

Example 3 - Guidance issued by government to treat ex-forces personnel as priorities for injuries obtained during service.  PCT tells practices to ignore this as it would be discrimatory.  One week later, PCT tells all practices that "travellers" are to be treated as a priority over regular patiens as they may not be in the area for very long.  This is not considered discriminatory by the PCT.

I could go on (all the above happened to me, by the way) but I think it shows why the NHS eats up more money than any other department (apart from benefits).  No matter how much money is thrown at the NHS, the administrators will find more and more ways to spend it.  

I don't think this mess is down to "administrators" but more down to government policy and their practice of "playing the game like true English gentlemen" that is brought into play.   If only the rest of Europe even knew what the game was all about, ask the average Spaniard if he knows anyone in Spain that has taken "his case of unfair treatment, be it racist, criminalised or otherwise to the ECHR" and he will probably have never heard of it, whereas in the case of the UK it is a feeding frenzy amongst upwardly mobile solicitors who have fleeced the government dry in the process.   Pop into any French city to see the treatment of illegal immigrants for example Romanians and you will find that they have never heard of the ECHR or any other rule which states they have to treat Romanians the same as any other EU resident, instead they will be frogmarched to the nearest port, where no doubt they will embark a vessel bound for the UK and get just the opposite treatment here !

Pop into any other EU country and they will all do things differently even within the same country but in differing regions as does Spain who is one of the worst for doing whatever they feel appropriate at the time.    I watched as the local police in our little Spanish Village stopped a car full of what appeared to be Moroccans and instead of offering help and assistance, immediately ordered them out of the village, again in the UK they would be treated on the NHS if they required treatment and were illegal now and given a house no doubt.

The point is that the UK is slowly going bankrupt and the government will in the end have to discriminate and introduce more rules to ensure people are getting out of the system what they have put in.   In these times of high unemployment and low receipts into the government coffers, the size of the pot prevails I am afraid so watch this space in the future !

My only surprise is that the UK hasn't already gone bankrupt.

 The Department of Health in UK issues guidelines and rules about the treatment of foreigners in UK.  These are quite explicit on who and who can't get treatment.  Howeve, it is up to the local "administrators" in the Primary Care Trusts to actually adminster these rules.  The government in UK says one thing, the PCTs constantly over rule these guideline.  That is why GPs in UK have now been given these guidelines which are contrary to the DoH guideline.  No wonder the average receptionist in UK finds it confusing.

There are as many cases in front of the ECHR (which is separate from the EU although anyone joining the EU must abide by it) from Spain as there are from UK.  Spain (and France) have constantly been found to be in violation of the rules but, unlike UK, appear to ignore the rulings.  JWhite talks about the treatment of Moroccans in Spain.  Spain has issued two amnesties for these people so that they can take up residency which the UK has never done.  This means that many illegal immigrants from this country have been given legal status in Spain.  Although we go on about the amount of illegals coming to UK, Spain has a much bigger problem.  Why should the police, who stopped a car full of what may be illegal immigrants, offer help and assistance?  If only UK would turn people arriving who expect free care, free housing and free benefits when they have paid nothing into the system then we could save a shed load more money.  

It is about time that the UK woke up to the fact that it is being taken for a ride.  

Having read through this thread with interest, what I take away from this discussion, in reference to the original question is:

"We don't really know for sure, but we think they should, because Broken Britain is broken because of immigrants"

Having read through this thread with interest, what I take away from this discussion, in reference to the original question is:

"We don't really know for sure, but we think they should, because Broken Britain is broken because of immigrants"

Nobody is going to be left at the roadside to die either in Spain or the UK of that I'm sure, I have experienced first hand emergency situations in both countries and the dedication, care and proffesionalisam of the medical staff always wins through.

Be assured llegaralasestrellas Britain certainly ain't broken