Spanish healthcare for tax-paying expats

[RikJarney]

Hello all. A few questions about getting Spanish healthcare...

My wife (Dutch) and I (UK) bought a place, moved to Spain and registered as Spanish residents after the cut-off date 24 April 2012. We have NIE numbers and the new green ID cards. We currently have private health insurance with Sanitas, but would like to get Spanish health cards if possible. Perhaps we can reduce our expenditure and cancel the private health insurance.

I managed to obtain an S1 form from the UK, she couldn't get anything from the Netherlands, not having lived there for years. I handed in a copy of my S1 to our local health centre about 8 months ago but did not hear back. I read recently that the UK will no longer cover its citizens abroad and they are advised to get private health care. So I didn't bother chasing up the health centre.

However, on completing our book-keeping/tax matters with a gestor, we were told that as resident, tax-payers with an income of under 100k we would qualify for Spanish healthcare. (Note: we are NOT employed/selfemployed, nor pensioners; we receive royalties from art works which we pay tax on.)
We were told that we would need to get a letter from the UK/NL stating that we are not entitled to health care in our home countries and along with the tax payment form, passports, padron, NIE, we could apply for health cards at the local Tesoreria General de la Seguridad General, which is in Granada for us.

What information we could find suggested otherwise: it stated that unless we were employed/self-employed we would only be entitled if: (i) we had been residents from before 24 April 2012, (ii) earned less than 100k, and (iii) presented a letter stating that we are not receiving healthcare in the UK/NL.

We would fail on the first point here if those conditions all needed to be met.

Questions:

1. Is this the case? Or might we still qualify for a health card, as our gestor seemed to suggest?
2. If yes, what is the 'letter' stating we are not receiving healthcare in the UK/NL called and where does one get it from in the UK/NL?
3. Anything else we need to know?

Thank you.

[CapnBilly]

I'm afraid your gestor is wrong, and you are correct. The key piece if information is being registered by the 24th April 2012.

However, your S1 is still valued until the expiry date, so you should chase that. The changes are in respect of people who retire, and leave the UK after 1st July 2014.

There is also a scheme where you can subscribe to the Spanish Health service by paying €60 a month (per person) if you are under 65. Over 65 it goes upto about €160, but by this time you may ( or may not, depending on your age) qualify for an S1 through a state pension. This may be about the same cost as your private care,but it covers you for pre existing, which can be important.

It's been in place for about 9 months, and is a national scheme, but being implemented regionally. Some regions have been slow, and I think Andalucua may be one if them. It was introduced in Valencia about 7 months ago. The only criteria (besides paying ) is that you can only join once you have been registered (Registro de Cuidadnos etc- the green certificate) for a year. The scheme is called "Convenio Especiale"

This is a link to some information.
http://www.seg-social.es/Internet_6/Tra ... 6/177501_6

It's under this heading towards the bottom

Special agreement on the provision of medical assistance to individuals who do not have insured or SNS beneficiary status:

[RikJarney]

However, your S1 is still valued until the expiry date, so you should chase that. The changes are in respect of people who retire, and leave the UK after 1st July 2014.
...

This is a link to some information.
http://www.seg-social.es/Internet_6/Tra ... 6/177501_6
:

Thanks for the comprehensive reply! Hm, as I thought. I think my S1 has already expired I think, will have to check once I find it. If it hasn't expired, presumably I'm only covered until it does expire, correct? In which case it won't be a long term solution.

Please repost the link, as it doesn't work for me.
Thanks again.

[CapnBilly]

http://www.seg-social.es/Internet_6/Tra ... 6/177501_6

[RikJarney]

http://www.seg-social.es/Internet_6/Tra ... 6/177501_6

Thank you for the link. Very informative, but a bit vague, unless I'm being somewhat slow. The document states - excuse me while I quote almost in full with annotations:

Health care in Spain ... provides cover for the people who have insured status.

• Insured status is granted to people in any of the following circumstances:
a. Being employed by a third party or self-employed ...
b. Being a pensioner in the Social Security system.
c. Being in receipt of any other periodic Social Security provision ...
d. Having exhausted unemployment benefits and others of a similar nature, being unemployed, not having insured status on any other grounds and residing in Spain. This case shall not apply to ... foreigners not registered or authorised as residents in Spain).

• Individuals who are not included in the above point or in article 3 of R.D. 1192/2012, of 3 August, who, not having an income, calculated annually, of more than one hundred thousand (100,000) euros or obligatory cover for the provision of health care by some other route, find themselves in any of the following circumstances:

> Having Spanish nationality and residing in Spanish territory.
> Being nationals of a member State of the European Union, the European Economic Area or Switzerland and being registered on the Central Register of Foreign Citizens.
> Being nationals of a country other than those mentioned in the preceding sections, or stateless, and having authorisation to reside in Spanish terrritory, for as long as that authorisation is valid in accordance with the terms provided for in its specific regulations.
...

• Minors ...

There seem to be three categories to qualify for health care.

Category 1: I am not a pensioner, not employed/self-employed and don't qualify for this category.
Category 3: I am not a minor
Category 2: Do I qualify for this? I am a registered foreigner with residential status (ID, padron) who pays taxes on an income of royalties <100k?

The only thing is that I do currently have Sanitas cover. What if this expires? Would I then be eligible?
Or is this document only for people who were resident before April 2012?

Thanks for any thoughts.

[CapnBilly]

Yes, that's the free scheme for people who registered before 24th April 2012. If you read my original post I referred you to the section at the bottom that page which gives brief details of the scheme I outlined, and a link to the law which introduced it.

This is the heading at the bottom of the page

"Special agreement on the provision of medical assistance to individuals who do not have insured or SNS beneficiary status"

[RikJarney]

Thank you for the reply, it is much appreciated. Not easy interpreting governmental documents (of any country), never mind bureaucratic Spain!

I think private health insurance with Sanitas at €50pm pp is preferable to Spanish health ins at €60.

Thanks again.

[CapnBilly]

Yes, it only makes a real difference if you have pre-existing conditions, then it can be quite cheap.

[Unicorn]

And prescription charges. On state health I get 40% (or is it 60%) discount and cancer and other specific illness drugs are free. Can make a massive difference.