State, NHS or insurance: Who covers expat eye care in Spain?

Most eye care treatments in Spain are covered under the Spanish State healthcare system. Retired British citizens who receive an exportable UK pension are entitled to Spanish state healthcare cover under the UK pension scheme if they hold an S1 form. If you’re a UK pensioner and current resident in Spain, you can take this form along with your passport, NIE/TIE (residency certificate or card), padrón (certificate from your local town hall), proof of pension and birth certificate to your closest social security office (Seguridad Social) to apply for a Spanish healthcare card.

It’s important to note that early retirees are no longer eligible to apply for a residual S1. Instead, they have the option to pay a monthly fee (€60 for under 65s, €157 for over 65s) to access the Spanish healthcare system — this scheme is called the Convenio Especial. You will need to have been a Spanish resident for at least one year to benefit from this, so for the first year of your residency, you may need to find private health insurance.

Currently, it remains unclear if these schemes will be impacted by Brexit, so it’s a good idea to keep an eye on the official NHS guidance and also subscribe to the UK government’s weekly updates for expats living in Spain.

Around 25% of the Spanish population is covered by private health insurance. While private healthcare is not always a necessity, waiting times are shorter than in the public healthcare system and you’ll have the added benefit of choosing English-speaking specialists. Also, generally speaking, it tends to be more affordable than equivalent cover in the UK. However, having to pay both a monthly subsidy as well as additional prescription costs can become expensive, so this is something to consider.

When selecting your provider, you may come across the terms con copagos (with co-payment) and sin copagos (without co-payment). Con copagos insurance will have a cheaper monthly cost, however, you will need to pay a small amount on each visit. On the other hand, sin copagos policies set a monthly price with no additional fees, which may be more suitable for those who need to visit an eye care specialist on a regular basis.

Spain’s public healthcare is generally regarded as one of the better systems in Europe. As mentioned, most eye care in Spain is covered within the Spanish State healthcare system, although you will still need to pay an additional cost for prescriptions.

Expats who work in Spain are eligible to apply for the SIP Card, which gives them access to local healthcare. You’ll need to bring your passport, NIE/TIE (residency certificate or card), padrón (certificate from your local town hall) and work contract to the local Seguridad Social office to get yours.

You may also be eligible for state healthcare even if you live in Spain, but are unemployed, do not receive a state pension or are under 26 years of age. In this case, you may be entitled to a SIP Card as a beneficiary of a spouse or parents who receive a pension or work in Spain. You’ll be required to bring your passport, green residency certificate or card (TIE), padrón, birth certificate and marriage certificate (if your beneficiary is your spouse) to the same Seguridad Social office.

For more information on arranging cover, take a look at our guide on what expats should know about eye care in Spain.