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As I've been back here (ie on this forum) to make another post I thought I may as well add this. I've been meaning to for some time...
I had presumed that, as an immigrant, I would be entitled to the same emergency heathcare as the Spanish. Maybe in theory, but not in practice. Though resident here, I do not have a Spanish medical card (another story) but after suffering an allergic reaction to wasp stings my arm decided to swell to the size of my thigh. My skin was so tight and shiny it looked as though it was covered in cling-film. (Or that's how I imagined it to be - I'm not into cling film.) I went to the farmacia for help and was told to go immediately to the Medical Centre as I needed an anti-inflammatory jab. Luckily, it was Thursday. Let me explain. The Medical Centre is open only to emergencies on Thursdays - the rest of the week it's on an appointment basis. So where I live, you're only allowed to have a medical emergency on Thursday. So, as I said, luckily it was Thursday. I lugged the great red lump of shiny flesh that had my arm inside it to said centre, where a single nurse was on duty. She asked who I was, seemingly less concerned about my arm. I could have drawn eyes and hair on it and said it was my son sitting next to me, as it happens. She asked for my medical card, and I told her I didn't have one. She asked for my NIF, so I told her I don't have one, I have an NIE instead. She asked me for my Social Security number, so I told her I don' have one of those either. She asked if I had medical insurance, which I don't, and I told her. She explained that under these circumstances she could not do anything to help me.
I left without her even looking at my son. Sorry, my arm. I returned to the farmacia for Ibuprofen, antihistamine and I would have had a steroid-based cream but he didn't have any. He did give me some nice soothy stuff, though. The pharmacist told me that I needed urgent medical help and that I should go to the regional hopital. However, being unable to bend my son - sorry, arm - I couldn't drive.
God forbid that I should have a car accident. They'll have to going through all my documents before they decide whether or not they can treat me, and when they don't find anything, what will they do?
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No healthcard? No private insurance? Ever paid into the Spanish social security system? How about even an EHIC? None of those? Then you will get emergency treatment exactly the same as a Spaniard who hasn't any of those things. Attendance at an Urgencia (A&E) at you local hospital, not clinic. Either that or, like the Spaniards have to, pay at a private clinic for treatment.
As a non-resident, I had to go to A&E (taxi as I also did my arm in) and was treated on the EHIC. As a resident, I have a healthcard and can be seen at any health centre although they still tell you to go to A&E for emergency treatment, just like UK as most GP surgeries won't stock the injection you needed.
You must have got your right to residency before the new rules came in. Nowadays you have to show provision for healthcare, either with an S1, private insurance or paying into the regional healthcare system before you are allowed to get the green card.
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No, I don't have an EHIC. I haven't been back to the UK for seven years, so I'm not entitled to one. I have an S1, as does my wife, we also have documentary proof of pension payments from the UK Pension Service. However the INSS refuses to honour them, stating our papers "no sirve por nada" (They're no good). We've been resident since 2007, with the appropriate certificates, but we haven't paid into the Spanish system as we haven't ever worked here.
Regarding your comment, "Then you will get emergency treatment exactly the same as a Spaniard who hasn't any of those things" I thought that the Spanish were entitled to their medical cards by virtue of their nationality. It seems I am wrong.
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Yes, you are wrong. The Spanish, like other nationalities, have to have paid into the system to get any treatment.
If you have the S1 on age (over retirement age) reasons you are entitled to a healthcard and full access to the health system here. Perhaps call the International Pensions Centre in Newcastle to get the S1 updated. Some official saying they're no good doesn't wash. Once the healthcard is issued you will also be allocated a doctor in your local health centre.
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Scooby. in April 2007 the Residencia was abolished for EU Citizens. You mention being here for 7 years. If that was before April 2007 then you should have had a Residencia, which would have been renewed after 5 years, when you should have (like anyone coming after April) registered on the EU Citizens Register. (green paper)
I seem to get the impression that you are not registered. If that is so then it would explain why you cannot get medical cover, even wth an S1 (or an E121 as previously).
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Hi johnzx
Thanks for your input. Yes, we do each have the green "Certificado de Registro de Ciudadano de la Unión." The INSS said that it was the S1 was meaningless and that I would have to pay into the Spanish system to be entitled to any medical assistance. I have been to the office three times, and, while my Spanish has been good enough for me to buy our house, two Spanish cars to date and sort out all the other usual problems, the last time I felt it necessary to employ a gestor.
According to www.gov.co.uk, "If you registered as a resident in Spain before 24 April 2012, have an annual income of less than €100,000 and are not covered for healthcare though any other means, speak to your local INSS office to register for healthcare in Spain as a resident." That applies. Additionally, regarding the S1 forms, www.gov.co.uk says "Once issued, register the S1 form with your local INSS office, before you register with your local GP surgery." This also applies. So in my opinion, there are two counts on which we are entitled to the same medical care as a native Spaniard. But when my gestor presented a copy of that UK web page to the clerk he said "No es en Español, no es válido." The S1 is in Spanish as well as English, but the clerk said it does not give us any entitlement under the new Spanish rules. (This was in March 2014.)
The gestor was very apologetic and has not charged me anything. She said that she did not know about the new rules to which the clerk referred and as the INSS office we attended is in the provincial capital we can't go anywhere higher.
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The clerk is talking rot. Are you over retirement age or registered disabled? In either case, the S1is valid so ask for an hoja de reclamacion. The complaint form. However, if you are under retirement age ( I assume you're not as you mentioned getting pensions unless they are private ones) then they won't be valid as they are based on the amount of NI you paid in the last 2 years which would be nothing. That's the only reason I can think of. The only thing that has changed recently is NI based S1 has been stopped by the UK but that doesn't come in to effect until July. Pensioners and registered disabled are entitled to free healthcare and nothing has changed. The only other thing is, is your padron up to date? To get our healthcards we had to show the S1, residence cards (which you have) and an up to date padron dated in the last 3 months. We were given temporary cards there and then and the permanent cards came about 2 months later.
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We thought the clerk was talking rubbish too, as did our gestor. Yes, we are over retirement age, receiving UK state pension but we are not registered disabled. We took letters from the International Pension Centre in Tyne & Wear detailing entitlement but the clerk wasn't interested as they are in English. He didn't give them more than a cursory glance. We subsequently rang the UK Pension Centre and asked for them in Spanish but they don't provide them in any other language. They advised us to get them professionally translated but until our gestor comes back to us witht details of the new laws here in Spain I think that it would be a waste of money.
I took all our certificates of empradonamiento. We had one in 2007 when we first moved here, one for each of the cars we bought (2008, 2012) and the latest is dated February this year. The clerk didn't look at them. He insisted that as we have not paid into the Spanish system, we are not entitled.
Thanks for the tip about the Hoja de Reclamación. I thought it was just for purchases of goods or services which are sold. Our gestor suggested we make a denuncia but suggested we wait until she had checked the law. I'll mention that to her (I'm about to email her to see if she has any news).
I was also under the impression that the Spanish government receives a concession for every foreigner on their health system from the government of the native country of the immigrant, i.e. the UK government pays the Spanish for each expat who has emigrated here and registered on the health system. By making it impossible to register, the Spanish government is missing out (if this is true).
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The UK pays somewhere around 3,000 pounds or euros p.a. for each person registered regardless whether they subsequently never use the service or get a major operation each week.
When I tried to register my wife (she is much younger than me, and from Philippines) we had the paperwork from DWP, and although the local office accepted she would covered, Malaga office insisted that she had to have her Resistencia first. When she got that they registered her.
You can complete and download the form from the web or get them at place where you wish to complain. They must be available everywhere, including police, town hall, government offices etc, everywhere.
The form consists of three copies. Marked down the left long side shows which copy is for you, which for the place complained about and the copy for the consumer’s office at the town hall. You keep two copies. If you are not satisfied after 2 weeks, take the consumers office copy to that office and they will pursue the complaint. Usually, the matter gets resolved before you need to go to the consumer’s officer. Completing the form does not mean you need to take the complaint further, so always do so, never be put off with promises that they will put things right. If they do then tear up the forms, if they don’t you are on track with the process.
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Hi johnzx
Thank you very much for this information - it's invaluable. Thanks for the info about the form, too - all useful stuff.
I have emailed my gestor and mentioned the Hoja de Reclamación. I await her response.
As an aside, your mention of your wife being a Filipina brought fond memories of the place and the lovely people I met in Cebu about 30 years ago...
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Hi Scooby. I don't where in Spain you are but this might be of help.
http://www.juntadeandalucia.es/salud/export/sites/csalud/galerias/documentos/c_8_consumo/formulario_quejas_reclamaciones.pdf
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Hi johnzx
Brilliant! Thank you. And I can complete it and save it on my PC if I want. And I live in Andalucía.
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UPDATE.
I returned to the INSS office with a different gestor and the mountain of paperwork we have amassed and met with a representative who was expecting us. We were told that the S1 forms are no longer valid but, as pensioners, we do have the right to intial medical treatment and consultation with the medico at our local Medical Centre. We were not given temporary medical cards, which our (English) paperwork said we should get, despite our asking. We were instead given a single sheet stating that we are intitled to initial consultations. We were told to register at our local Medical Centre with this letter. At last, I thought! We're as good as there! However, not so. The receptionist at the Medical Centre has told us the paperworkwork we have "No sirve" (is useless). When I asked what we should do he just shrugged his shoulders.
This was just 20 minutes ago. I'm back to contacting the gestor again! There seems to be three sets of rules - the ones that the UK tells you, the ones that the Spanish authorities tell you and the ones that are actually applied!
This message was last edited by Scooby2 on 13/06/2014.
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Latest Update
We returned to the medical centre yesterday, this time to meet with a rep from the INSS (who is here once a month to sort out admin issues). She was really helpful, explaining everything and speaking slowly so that we could understand. She has given each of us a copies of the form "Solicitud de Tarjeta Sanitaria" (Application for a Health Card) which serves as a temporary card. Note: the Junta de Andalucia DOES NOT ISSUE TEMPORARY HEALTH CARDS, contrary to what the British Embassy states! It may be different in other regions. We were advised that our Health Cards will be sent by post.
I hope this helps anyone else who applies for their Health Cards in Andalucia. However, it does seem to help if you find people who who work in the places where you need help, e.g. the INSS office!
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