Pensioners prescriptions

[curatokid]

I read in the paper that a charge of ten percent of the cost is to be made on prescriptions for pensioners, how will this work for UK citizens living in Spain...

[frank]

Same as the Spanish, Brits have always wanted to be treated equally, some times it's a case of be careful what you wish for. Ana Mato said a "casi todos los ciudadanos a pagar más por los medicamentos y tratamientos" Almost all citizens will pay more for medicines and treatment. There are a few exceptions, but to the best of my knowledge, being a Brit isn't one of them. They're also talking about doing away with ambulances etc that transport patients around, paying for collars, wheel chairs, crutches, treatments etc. They will be clamping down on immigrants, you need to be living in Spain, on the padron, according to them there is a lot of "health tourism" going on. Interesting times, university fees going up 50%, and they haven't really started yet, I fear there is a lot more in the pipeline.

[Julie]

Looks like it will be means tested, so the more money you have the more % you will pay, my friend told me yesterday that it will be 8 euro per item now when you go to the chemist, I haven't seen that, but shes spanish, so will know more than I do !

[El Cid]

That €8 comment is not quite correct. For pensioners the charge will be 10% of the cost of the drugs. Certain exceptions will be made for chronic sufferers who need constant medication. The amount that you pay will be capped at €8 a month if your income is less than €18000/pa. Above that it will be capped at €18.

Non pensioners currently pay 40%. This will remain at 40% for people earning less than €18k but will go up to 50% for those in the 18K to 100k bracket and 60% for earners above 100k.

Of course this is all talk at the moment and they have yet to decide how it will work. I can foresee a whole raft of problems with administering it. Do you pay the 10% and then claim any excess over the €8/€18 back? How will they determine your income? Will it be based on your tax declaration? What if you don't bother to submit a declaration? etc. etc. etc.

It seems like a fair system but I think it will be a while before it actually happens.

Sid

[frank]

Looks like it will be means tested, so the more money you have the more % you will pay, my friend told me yesterday that it will be 8 euro per item now when you go to the chemist, I haven't seen that, but shes spanish, so will know more than I do !

You're correct, it will be means tested, a sliding scale of charges, ranges from 40-60%. Re the 8 euros, for pensioners at least, it says,

Pensionistas. Las personas con pensiones más bajas, que tienen una renta por debajo de los 18.000 euros anuales, pagarán un 10% del precio de los medicamentos, con un máximo de ocho euros mensuales; los que cobren por encima de esa cantidad, pagarán un máximo de 18 euros.

In other words pensioners with income less than €18,000 a year, will pay 10% of the cost of the medicines with a maximum of €8 per month. Those with a higher income will pay a max of €18. This article reckons Spain's use of medicines is excessive, it's the second highest consumer of medicines in the world.
http://www.20minutos.es/noticia/1379122 ... to/repago/

Edit. Just seen Sid has beaten me to it.

[Lavanda]

I think it's fair enough — even though my OH will have to pay — it seems reasonable to pay something to stay alive. It's interesting that Spain wants to clamp down on 'health tourism'. I've just been in conversation with an English GP on holiday here who asked what the rules were on a situation with a patient of hers, living in Spain, but 'popping back' to the UK twice a year to 'stock up' on tablets. She went white when I outlined the rules ...

[El Cid]

One part of the new system is that EU foreigners coming to Spain in future will not be allowed residency unless they have private medical insurance or are covered by a reciprocal arrangement under the E121/S1 scheme and can prove sufficient income not to be a potential burden on the state. Also health cards will only be issued to "fiscal" residents - that means that if they are not making a tax declaration in Spain their existing health care could be removed.

At last it seems that the government have accepted that the only form of residence that can be allowed in Spain is fiscal residence. That should give the tax dodgers a problem!

Sid

[Lavanda]

Well, Sid, I feel rather pleased with myself right now as this year we will be filing our fourth tax return in Spain. I knew there was some good reason to take your advice all those years go when I PMed you for help. Well done and thank-you!

[Laslomas]

Why is it that as soon as I reach the correct age to qualify for something it all changes???!!

[El Cid]

Why is it that as soon as I reach the correct age to qualify for something it all changes???!!

El Sod's Law.

Sid

[Abyss_Rover]

I've heard that this will be linked with the medical card and that the computers that know what medication you should be getting, will also know your income bracket. So I guess that if anyone doesn't bother to complete their tax declarations, they will not qualify for the reductions based on their tax declarations.

[Lavanda]

If 'third world' Spain can get a computer system like this (health card linked to farmacy, GPs office, nurse's room, hospital, etc.) up and running why not other countries? It seems there's lots of countries just heamorraging money out to people who do not qualify for healthcare in said country. If Spain sold this computer system world-wide their financial problems would be on the way to being over.

[gus-lopez]

If 'third world' Spain can get a computer system like this (health card linked to farmacy, GPs office, nurse's room, hospital, etc.) up and running why not other countries? It seems there's lots of countries just heamorraging money out to people who do not qualify for healthcare in said country. If Spain sold this computer system world-wide their financial problems would be on the way to being over.

It would be if it existed everywhere but it doesn't! Here we have only recently got computers in the consultorios, we certainly haven't got chips in the medical cards & the farmácias are not linked to anything !
So it looks like we are all going to have to make a tax declaration now even if we haven't got anything to declare & got told too p*** off last time we attempted to make a zero declaration !

P.S. the consultorios aren't linked to the local centro de salud or the hospital as if you are referred you have to take the relevant form to the centro or hospital & queue to make an appointment!

[El Cid]

That may be the case in Murcia but in Andalucia all the cards are chipped and prescriptions are encoded on them. Also we can make appointments online.

It is even possible to change your doctor online.

Sid

[katy]

I think it would be naive to think that the authorities have everything in place to link prescriptions with earnings. Rajoy is like a headless chicken right now with different stuff coming out every day, they cannot possibly have all the mechanisms in place to undertake this, sounds like a recipe for chaos.

[gus-lopez]

That may be the case in Murcia but in Andalucia all the cards are chipped and prescriptions are encoded on them. Also we can make appointments online.

It is even possible to change your doctor online.

Sid

Here you have to go in with your escritura/Rental contract to be able to change doctor ! My Spanish neighbour did it a while back after falling out with the doctor. What a performance.

[Free at Last]

If 'third world' Spain can get a computer system like this (health card linked to farmacy, GPs office, nurse's room, hospital, etc.) up and running why not other countries? It seems there's lots of countries just heamorraging money out to people who do not qualify for healthcare in said country. If Spain sold this computer system world-wide their financial problems would be on the way to being over.

It would be if it existed everywhere but it doesn't! Here we have only recently got computers in the consultorios, we certainly haven't got chips in the medical cards & the farmácias are not linked to anything !
So it looks like we are all going to have to make a tax declaration now even if we haven't got anything to declare & got told too p*** off last time we attempted to make a zero declaration !

P.S. the consultorios aren't linked to the local centro de salud or the hospital as if you are referred you have to take the relevant form to the centro or hospital & queue to make an appointment!

I was also knocked back by Hacienda when I attempted to make a zero tax return - I made an appointment to have them complete the declaration, went along with all my bank statements and they told me they didn't require a declaration until I start receiving my pension. I won't be in the position of having to apply for a tarjeta sanitaria for another 11 years yet, hopefully the rules will have changed yet again by then.

[El Cid]

So it looks like we are all going to have to make a tax declaration now even if we haven't got anything to declare & got told too p*** off last time we attempted to make a zero declaration !
!

This is a common problem and there is a simple explanation.

Every Spaniard living in Spain is tax resident by definition and certainly won't complete an unecessary tax declaration. The guys in the tax office cannot see why we would want to submit a zero declaration and certainly don't want to do any more work than they need to do!

What they fail to understand is that us Ex-pats may need to prove that we are tax resident to get the benefits that come with tax residency. These include better deals on IHT and CGT and it now looks like it might also have some bearing on healthcare entitlement etc.

If you don't feel confident to do it yourself using the PADRE program then a way round the problem is to place a small amount of money in an interest bearing account. The tax on the interest will be deducted automatically by the bank but if you are in the position where you will not have to pay any tax, then they are obliged to give you back the tax that was deducted by the bank.

The only way they can do that is to allow you to make a tax declaration which generates a rebate.

Sid

[Free at Last]

Another question has occurred to me regarding the fact that expats will need to have fiscal residency to be able to access public healthcare in future. How will this affect recent arrivals who won't have had time to establish fiscal residency?

For example, if a British pensioner moves to Spain on 1st January 2013, they will not be able to submit their first tax return until June 2014, although they should be able to qualify for free healthcare with an S1 from day one. Would they not be able to get a tarjeta sanitaria for 18 months under the proposed new rules, and if so, wouldn't that be against European law?

[Lavanda]

Looks like Extremadura's not so backward after all - we are completely integrated with our health cards etc. AND can make a zero tax return. It must be all the EU money be still get.