When you're a British expat in Spain, returning to the UK is a time to catch up with friends and family, sort out business and family affairs, and revisit old haunts. Usually, you're returning to the UK for a holiday, so hopefully, you won't have to see a doctor or access any NHS services during your visit.
However, the way you access the NHS has changed recently, so it is wise to be prepared, especially if you're a pensioner.
NOTE: If you currently have a Health Plan Spain private insurance policy, you are automatically covered with international health insurance coverage of up to 12,000 Euros per person, per claim when travelling abroad. You will also have a free 24-hour English-speaking helpline at your fingertips if you need any urgent assistance or advice. Learn more about our travel assistance.
State Pensioner Access to NHS
If you're a State Pensioner with a UK-issued S1 form - or you are included in the category of Posted workers from UK to Spain (and therefore you may have an S1 form issued by HMRC or you are using a UK-issued EHIC/GHIC in Spain):
Officially you have the right to free secondary care and you will be able to access healthcare on the same basis that a UK resident would, where secondary care is defined as access to A&E and hospital treatments. Primary care – GP clinics, Walk-Ins, some dentist and ophthalmology services - is free at the point of use, too. It will be entirely up to the GP surgery in question, whether they will accept patients from abroad.
What this means in practice is that if you find a local surgery that will accept you, you will be able to see a GP. If you require a specialist, you will have to be referred by a GP. You will only be charged for treatment in cases where UK residents would be charged for the same treatment.
Prescriptions will also need to be paid for on the same basis as a UK resident. If exemptions apply for UK residents (for pregnant women etc.), they will also apply to you. Expat State pensioners therefore will not need to pay for prescriptions while visiting the UK.
To access services at the GP surgery or hospital, State Pensioners will need to remember to ask reception or the billing department to call the Overseas Healthcare Team on 0191 218 1999 to verify that you are indeed registered as S1 in Spain. You should have your national insurance number at hand.
Posted Workers
Posted workers will need to provide their NHS number OR ask the reception or the billing department to call the Overseas Healthcare Team on 0191 218 1999 to verify that they do have a registered S1 in Spain. You will also need to have your national insurance number at hand.
Workers
If you are a worker in Spain contributing to Spanish social security, if you are in receipt of a Spanish state pension or benefit, or you were registered based on residency prior to the 24th of April 2012 (and therefore might not have contributed to the Spanish system):
You will be able to access NHS services as you are covered by the Spanish-issued European Health Insurance Card (EHIC) aka Tarjeta Sanitaria Europea. This takes care of any medical necessities that cannot wait until your planned return to Spain. You will also be expected to pay for prescriptions on the same basis as a UK resident. Again, if UK residents would be exempt, you will be too. You should present your Spain-issued EHIC at the point of access for medical services.
Limite de Rentas
If you are "limite de rentas", you will be covered by a Spanish-issued Certificado Provisional Sustitorio (CPS), which is a kind of temporary EHIC that you apply for whenever you travel within EEA countries. This will cover you for all state-provided care, as long as you cannot wait until you return to Spain. You will also pay prescriptions as a UK resident would, and will be entitled to the same exemptions. You should issue your CPS at the point of access to the NHS.
Early Retiree
If you are an Early Retiree and do not have private healthcare insurance such as one of our Sanitas policies, you will need to take out private travel insurance to access NHS services. Alternatively, you can choose to pay for any NHS services you use as you use them. You will be required to pay the whole prescription fee unless your insurance covers that. You should show your insurance policy at the point of access to the NHS or pay upfront.
If you have a residual S1, you will not be affected as it will remain valid until its original expiry date.
Some exceptions to who can receive free NHS treatment
Due to the residency-based nature of the National Health Service (NHS), UK nationals who permanently relocate abroad may forfeit their eligibility for free NHS healthcare in accordance with NHS regulations.
UK nationals residing in the European Union (EU) should be aware that, upon visiting the UK, they may not be entitled to free NHS services unless they can present an EHIC, PRC (Provisional Replacement Certificate), or S2, demonstrating that their healthcare expenses are covered by their current EU country of residence or another applicable exemption.
Certain categories of former UK residents are exempt from paying for NHS treatment when visiting England. These include:
Free Travel Assistance with Health Plan Spain Policies
If you currently have a Health Plan Spain private insurance policy, you are automatically covered with international health insurance coverage of up to 12,000 Euros per person, per claim when travelling abroad.
Cover includes visits to see a doctor, hospitalisation, emergency dental care, and prescription payments.
You also have a free 24-hour English-speaking helpline at your fingertips if you need any urgent assistance or advice.
Please visit our travel assistance page for further details.