US citizen getting Health Insurance and Healthcare in Spain

Payment section                     (Home / Travel / Moving to Spain / Healthcare in Spain)
Care section
Health-care directive section
Miscellaneous section

Ways to pay: national system, or private insurance, or cash.
Get care at: state providers, or private providers.



Health-care directive

Called Documento de Voluntades Anticipadas (DVA), or (maybe in Andalucia only) La Declaracion de Voluntad Vital Anticipada.

Local health center in Andalucia doesn't have any info or forms about this. Have to go to central administration ?

Your document might have to be notarized, and registered with the govt ? Not sure if this is done on a provincial, regional or national basis.

Notaria F. Javier Ramos's "Guia Practica Documento de Voluntades Anticipadas" (PDF)
Alzheimer Europe's "Advance directives" (PDF) 5/2005
AECC's "Voluntades Anticipadas"
Andalucia's "A Guide to Making an Advance Health Care Directive" (PDF) 2013
Andalucia's "Registro de Voluntades Vitales Anticipadas"
Vall d'Hebron Hospital's "Patient's Anticipated Will"


justlanded!BCN's "Healthcare in Spain"
Spanish Visa's "Get Private Medical Insurance in Spain"
Jose Marc Castro's "Retiring to Spain"
Expats in Spain's "Health Care in Spain" (PDF)
NIE Barcelona's "Health Insurance"
Maria Cecilia Tacchi's "Ultimate Guide to Getting Into and Thriving in the Healthcare System"
Seguridad Social's "Medical Assistance"

From Practical Spain's "Health Care, Hospital, Emergencies, Prescriptions":
It is sensible to have a resume of your medical history translated into Spanish, in particular detailing any specific illnesses, drugs required, or allergies. It is most sensible to have the basic bilingual details in writing always carried with you.

Practical Spain's "Bilingual SOS Form"


When going to see a doctor, take a medical phrase-book with you or write out the paragraph that describes your problem before you see your doctor.
My suggestions:
Write everything down ahead of time, run it through Google Translate, print it out, maybe show it to some Spanish friends to make sure it's right. Symptoms, questions, your medical history, allergies, medications, etc. Print English next to Spanish for each sentence. Print it all out and take it with you.

If at the end of the appointment they're giving you some instructions you don't understand, get them to write it down in Spanish, so you can take that home and translate it there.

Tell the Doctor booklet (€6.50)

Expats in Spain's "Emergencies,Crisis Lines and Medical Help" (PDF) (emergency numbers and a few medical terms)
"Spain Emergency Phone Numbers" image

There are translators and interpreters who specialize in medical documents and hospital visits. Probably expensive.

Spanish pharmacies will not accept a prescription from another country.

There are price and service differences among pharmacies; shop around.

Site that shows which medicines are allowed under the NHS: Bot Plus (log in as "INVITADO")

Surprisingly, the NHS here is not really "national", in that each autonomous community has a separate computer system, and they don't connect to each other. So if you move from one community to another, request a copy of your medical records and take them with you.

In Andalucia at least, if you don't keep your padron "renewed" (every 2 years ?), the health service may "annul" your health card, and you'd have to go update the padron and then get the health card reinstated.

Surgery service:

Hearing aids:
Hear-it's "Information about hearing loss and hearing aids in Spain"
t-oigo (for children only ?)
Otoclinic Foundation

Medicare, with a few exceptions, does not cover expenses outside the USA. And if you stop paying for Medicare part B while outside USA, and later go back to USA and resume Medicare part B, your premiums will be higher because of the gap.

From someone on "Expats in Spain" Facebook group:
I am a contract analyst for the largest medical insurance company in the US. What I might suggest is at the very least getting a Medicare Advantage plan rather than straight Medicare when you retire. Medicare does not cover out of the country, but many of the Advantage plans will cover for any kind of emergency while you are out of the US. You do not want to give up or waive your Medicare benefits (even though they cost you) because if you come back to the US there are large penalties and a waiting period to get Medicare started for you. The penalties get bigger and bigger every year for Medicare.

... I have noticed that when retirees get a lot older and need added care, they move back to the US, and then Medicare gives them a ton of trouble trying to get their benefits back.

I'm told USA medicare online system will not let you log in from an IP address outside of the USA; use a VPN.

Elder Law's "Getting Medicare While Traveling or Living Overseas"

Surviving Yucatan's "ACA - Obamacare's Effects on American Expats Living Abroad"
Go Curry Cracker's "Obamacare, Expats, and Limitations on Visits Home"

Americans of a certain age may want to get a measles vaccination before coming to Europe:
Meredith Wadman's "Traveling Abroad? Born Before 1989? You May Need a New Measles Vaccination."
In Spain, even though I'm in the NHS, the local Centro Salud refused to do it for me, saying they do it only for babies. So I went to the regional Vaccination Center for International Travelers, and they prescribed it. But then my local health center wouldn't supply ANY vaccinations for me, even a tetanus booster. They WILL inject a vaccine you buy at a pharmacy, but the nearest pharmacy had almost none of the vaccines I wanted, not even a tetanus booster. Eventually found the "Medical Prevention" department at a regional govt hospital that was willing to vaccinate me for free.

From Dave Barry's "Only Travel Guide You'll Ever Need":
Medical care in Europe is excellent, and you may rest assured that if God forbid anything were to happen to you, the hospital personnel will use only the highest-quality stainless-steel drill to bore a hole in your skull to let out the Evil Spirits.

Ha ha ! We are just joshing, of course. There is really nothing at all primitive about European medical care except that in some countries they practice it in foreign languages, meaning you run the risk of entering the hospital complaining of an inflamed appendix and coming out as a member of a completely different gender. That is why many smart travelers take the precaution of having the international symbol for "No Sex-Change Operation, Thank You" tattooed on or near their private parts. ...

This page updated: August 2017.

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