Healthcare clarification as a resident

Sorry if this has been asked many times but we are still a little confused.

After we apply for residency it states we will be entitled to use the Spanish healthcare system, exactly what will we be entitled to? Are we able to get prescriptions for regular medication etc. Is it similar to NHS or do we have to have private health insurance. Also do we then loose the right to use NHS ?

Thanks in advance

Kevin

" it states we will be entitled"

What exactly is "it"? Assuming youare UK citizens - technically, you don't "apply" for residency, but you register as a foreign resident. You will need to prove you have adequate funds to suport yourself, and that you have medical cover. Are you UK pensioners? If so, you will need to obtain an S1 certificate from the Dept. of Health (Newcastle) which you will use to register with the Spanish social security, and will then be able to use the Spanish equivalent of the NHS. You can register with a GP, and get prescription meds at a maximum of 10% of the retail price. Your EHIC will still be issued by the UK. As from fairly recently, as a British pensioner, you can still access the NHS when visiting the UK. If I've made any slight errors in the above, someone will correct me soon, I'm sure!

If you are NOT pensioners, forget all the above, you will not be automatically entitled to free healthcare just by being residents.

No we are not pensioners, I meant register if that is the correct terminology as supposed to apply.

If you are not pensioners or registered disabled then you will not be able to register for the Spanish NHS. You will need to apply for the residence card and show you have private medical insurance before this will be issued. Depending on where you live, you can enter the state NHS scheme after being a full time resident and registered on the padron. This comes with a payment (€65 per month per person in Valencia). If, however, you are taking up work then you will join the state NHS by paying income taxes and social security. You pay for prescriptions depending on your income (40% of the cost generally).

Mariedav   You pay for prescriptions depending on your income (40% of the cost generally).

That may vary depending on the Region.

In Andalucia really poor people I believe pay nothing; the average pensioner pays 10%  up to a maximum of 10 euros p.m. and it then increases based on one's level of income.

I did say "generally". If you were one of the "really poor" people, as you put it, you wouldn't get the residence bit, anyway, as you have to prove sufficient income therefore, if you're earning that much, then the 40% would generally be what you pay.

Kevinuk1 already stated they are not pensioners.

Well, I guess someone who is already resident could become poor and qualify for cheaper prescriptions? As they say, if you come to Spain seeking to make a fortune, the best way is to start with two fortunes. 

Maridav:   If you were one of the "really poor" people, as you put it, you wouldn't get the residence bit, anyway, as you have to prove sufficient income therefore, if you're earning that much, then the 40% would generally be what you pay.

The income required to obtain EU Registration is:- 

 1 person. 5,136.60 euros p.a.     2 people (couple). 8,732.22 euros p.a.

Thus well under the 18,000 euros p.a. which would take them over the 10%

Why are you mentioning the 10%? That is for pensioners and the OP has already said they are not pensioners. Under pensionable age and earning under €18,000 per year you pay 40% of the charges.

This is from the expatica site on healthcare charges:

Prescription charges in Spain
You have to pay a percentage of the cost of prescription medicines, and the cost is non-refundable. How much you pay depends on your income and whether you are of working age or a state pensioner. For example, if you are of working age and your annual income is less than EUR 18,000 you have to pay 40 percent of the cost of the medication. If your income is between EUR 18,000 and 100,000 you pay 50 percent, and if it’s over EUR 100,000 then you pay 60 percent. State pensioners pay 10 percent unless their income is over EUR 100,000, in which case they also pay 60 percent. You can find out more about this co-payment system, in Spanish, here.

The actual Spanish bit is on the blue here link. There is a total difference between those under and those over pensionable age. I say again, earning over €18,000  a year you pay 10% if you are a pensioner.

Kevin:   After we apply for residency it states we will be entitled to use the Spanish healthcare system, exactly what will we be entitled to? Are we able to get prescriptions for regular medication etc. Is it similar to NHS or do we have to have private health insurance. Also do we then loose the right to use NHS ?

Hi, Maridav.   Yes you are right I was thinking of my situation as a pensioner and registered on the Social Seguridad.

Thinking about this I realised that a person who comes to Spain, before retirement age, and not being in receipt of a UK benefit which would entitle them to an S1 (medical cover as a result of an annual  payment by the NHS)  who does not take employment, to get EU Citizen Registration would have to take out full medical insurance, thus use private medical faculties.  They would then get private prescriptions and have to pay the full cost of any medications. 

As residents they of course would not be able to use an EHIC .

If one takes up work, then they are covered for medical under  Social Seguridad system as a worker and entitled to the beneficial rates as Maridav showed.

If I register as self employed, and all my income goes through the Spanish tax system, including a private pension payment of around £9k pa, as a married couple, around 60 years old, registered in Alicante padron, from the UK.

though I may not get any employment would the tax paid, entitle us both to the Spanish health system!

as early retirees a S1 is no longer available, till my 66th year, the need for assets in cash, I believe is around 10k euros each is possible.

Anyone know the rules?

If you register as self employed (autonomo) and pay the social security flat rate of around €250 a month then yes, you will be covered. Expensive way to do it, though. (Your tax payments have nothing to do with it).

You're confusing taxation and social security. If you are fiscally resident (basically, but not definitively, living in Spain more than 183 days a year) then all your worldwide income "goes through the Spanish tax system" whether you like it or not. Chances are you'll be paying more tax than you were as a UK resident, but that's another issue - if you're living full time in Spain, it's not a choice. However, simply paying tax here does not entitle you to free healthcare. Registering as autonomo may, as Mariedav says, be a costly option, and I think it would involve registering an economic entity as well - you cannot simply claim to be self-employed but without any actual business activity. 

Thanks, I'm looking into the "after Brexit" living full time in Spain, the only issue I have is medical, as I have a existing illness that private insurance refuse the cover so, I probibly will have to pay the 60-65e medical cover to the Valencia health system for each of us, though the cost at 65 does go up massively for a year, and I will have to find out if my wife, who is two years younger, will when I get to 66 retirement and have UK pension, also get free health care?

You need to be resident in Spain for 12 months before you can apply for the convenio especial at 65 euro a month. Be aware you will need private cover for the first year at least.

Once you reach UK retirement age then you wife will be covered as a beneficiary on the basis of your cover. (If we still have an S1 system by then, of course).

‘Jontym  I'm looking into the "after Brexit" living full time in Spain, the only issue I have is medical, as I have an existing illne

What the rules / conditions will be after UK leave (if they do) no one knows, so whether you and  Brits in general will be able to live in Spain is not clear ! !

Not wanting to know details, but if your 'medical issue' means you cannot work and are in receipt of Incapacity Benefit, I believe you can get an S1 and be covered for ‘free medical’ by the payment which DWP would make to Spain.

Just a thought

Thanks all, I will look into the DWP about the S1 form now