# Sticky  Does permanent residence = free healthcare?



## xabiaxica

I've moved a lot of current posts on this subject to this thread to avoid duplication. 

They pre-date (by an hour or two) the original thread starter of this one, so reading through might seem a bit odd at first.


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## Paulc66

Thanks for the info Steve. Why would you only need private health insurance for the first five years? I have read this elsewhere as well. I would of thought you would need it all the time. Or is it that it is compulsory for the first few years?


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## SteveG999

Paulc66 said:


> Thanks for the info Steve. Why would you only need private health insurance for the first five years? I have read this elsewhere as well. I would of thought you would need it all the time. Or is it that it is compulsory for the first few years?


Because you can become Spanish resident after 5 years, freeing the way for more conventional medical arrangemnets through their system ( AKA their equivalent of our NHS )
Steve


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## Barriej

SteveG999 said:


> Because you can become Spanish resident after 5 years, freeing the way for more conventional medical arrangemnets through their system ( AKA their equivalent of our NHS )
> Steve


So thats another difference between those who got here before 31st Dec and got residency at WA status then.

As to paying into the Convenio Especial after the 5 years, because the UK wont be issuing any S1 for those who arrive in the EU now, they will have to pay for the rest of their lives at €60 a month until 65 and then €157 a month each after that.

Its just one more cost to have to budget for.


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## kaipa

SteveG999 said:


> Because you can become Spanish resident after 5 years, freeing the way for more conventional medical arrangemnets through their system ( AKA their equivalent of our NHS )
> Steve


Is that correct?. I thought only those who contributed got free healthcare. Do you not just pass to the convenio in your region but still pay?. Maybe I'm wrong. I'm still working so get healthcare on basis of SS payments.


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## CltFlyboy

kaipa said:


> Is that correct?. I thought only those who contributed got free healthcare. Do you not just pass to the convenio in your region but still pay?. Maybe I'm wrong. I'm still working so get healthcare on basis of SS payments.


I _think_ that Steve is correct. Remember, I've been researching this for over a year since we're coming from the US; as I understand it, UK is handled the same way. After 5 years you can apply for resident status, then participate in the national healthcare. 10 years you can apply for citizenship. I think.

Also, as I recall, if you open your own negocio and pay into the system then you automatically get to take advantage of the healthcare as if you were a citizen (since you are paying directly into the system). That could make a lot of sense for someone looking to open a small business while also needing healthcare.


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## xabiaxica

SteveG999 said:


> Because you can become Spanish resident after 5 years, freeing the way for more conventional medical arrangemnets through their system ( AKA their equivalent of our NHS )
> Steve


How do you mean? 

You're resident as soon as you have formalised the TIE, which must be done within a month of arriving. 

Unless you mean 'permanent resident'? Being a permanent resident doesn't confer automatic right to state healthcare.


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## trotter58

Barriej said:


> So thats another difference between those who got here before 31st Dec and got residency at WA status then.
> 
> As to paying into the Convenio Especial after the 5 years, because the UK wont be issuing any S1 for those who arrive in the EU now,* they will have to pay for the rest of their lives at €60 a month until 65 and then €157 a month each after that*.
> 
> Its just one more cost to have to budget for.


Are you sure? ....AFAIK after 5 years legal residency a temporary resident can apply for permanent residency and have the same healthcare as a Spanish resident.
see Healthcare for UK nationals living in Spain.

" *If you are not working*
_If you’ve been a resident in Spain for 5 years or more, you can apply for permanent residency. This will give you access to state healthcare on the same basis as a Spanish citizen.

Once you’re a permanent resident, you need to register for healthcare at your local INSS office.

You’ll need to show a ‘legislation letter’ (‘documento de no exportación’ in Spanish) stating that you are not covered by the UK for healthcare. You can request this by calling NHS Overseas Healthcare Services.

NHS Overseas Healthcare Services
Telephone: +44 (0)191 218 1999
Monday to Friday, 8am to 6pm
Saturday, 9am to 3pm
The INSS will give you a document which you need to take to your local health centre.

If the UK pays for your healthcare, for example through an S1 form, you cannot register for healthcare as a permanent resident._"


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## Paulc66

Trotter, just read your post. That sounds better around healthcare. But why would Spain want to
give me free healthcare if I have never paid into the system ?


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## trotter58

Paulc66 said:


> Trotter, just read your post. That sounds better around healthcare. But why would Spain want to
> give me free healthcare if I have never paid into the system ?


You will have paid Spanish taxes on all your worldwide wealth for at least 5 years until you qualify and these taxes can be considerably higher than UK taxes.
Spanish healthcare is contribution based, which is opposed the the UK's residency based healthcare. This partly explains the lure of the UK to economic migrants. However, both countries are civilised and will take care of your healthcare if you don't have any other cover.


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## kaipa

5 years residency does not give you free healthcare
I work and if I stop paying in my healthcare stops after 3 months. The convenio is not just for expats it is used by Spanish as well.


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## kaipa

Only undocumented illegals get free healthcare under the Universal Healthcare Act it is not open to all migrants


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## xabiaxica

trotter58 said:


> Are you sure? ....AFAIK after 5 years legal residency a temporary resident can apply for permanent residency and have the same healthcare as a Spanish resident.
> see Healthcare for UK nationals living in Spain.
> 
> " *If you are not working*
> _If you’ve been a resident in Spain for 5 years or more, you can apply for permanent residency. This will give you access to state healthcare on the same basis as a Spanish citizen.
> 
> Once you’re a permanent resident, you need to register for healthcare at your local INSS office.
> 
> You’ll need to show a ‘legislation letter’ (‘documento de no exportación’ in Spanish) stating that you are not covered by the UK for healthcare. You can request this by calling NHS Overseas Healthcare Services.
> 
> NHS Overseas Healthcare Services
> Telephone: +44 (0)191 218 1999
> Monday to Friday, 8am to 6pm
> Saturday, 9am to 3pm
> The INSS will give you a document which you need to take to your local health centre.
> 
> If the UK pays for your healthcare, for example through an S1 form, you cannot register for healthcare as a permanent resident._"


Yes, the UK government has been saying that for years. 

Neither I, nor anyone in my extensive network of people who keep tabs on these things, have ever come across anyone who has been successful in an application, simply because they've been resident for 5 years.


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## trotter58

kaipa said:


> 5 years residency does not give you free healthcare
> I work and if I stop paying in my healthcare stops after 3 months. The convenio is not just for expats it is used by Spanish as well.


Are you a permanent resident?...and are you not working? My quote states at the start " *If you are not working* "


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## trotter58

kaipa said:


> Only undocumented illegals get free healthcare under the Universal Healthcare Act it is not open to all migrants


I did take the time to include a link which supports my view. Perhaps you could do the same?


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## stevec2x

Hi
I read somewhere recently that once a person has permanent residence (ie over 5 years), then they will have automatic access to state healthcare, but I can't remember where I read it!

Can anyone confirm this?

Cheers

Steve


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## trotter58

xabiaxica said:


> Yes, the UK government has been saying that for years.
> 
> Neither I, nor anyone in my extensive network of people who keep tabs on these things, have ever come across anyone who has been successful in an application, simply because they've been resident for 5 years.


Interesting. Do you have any documentation of refused applications from your extensive network? 
Has anyone actually challenged a refusal?


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## kaipa

trotter58 said:


> I did take the time to include a link which supports my view. Perhaps you could do the same?



We went through all this a couple of years ago when the law was suggested. Its is not for expats only illegal immigrants. I think actually in the end the law was never ratified. You will only get free healthcare if you have contributed/ been resident before Brexit. All other arrivals have to pay for the whole period of residency.


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## xabiaxica

trotter58 said:


> Interesting. Do you have any documentation of refused applications from your extensive network?
> Has anyone actually challenged a refusal?


Afraid not, but over the past several years we've discussed this on various forums & privately, & although people have come forward to say that they have applied, none have succeeded, except those who were resident before April 2012. April 24th iirc.

When the Spanish govt changed its healthcare rules for nationals in Oct 2012, it was required to include residents. They added a caveat that you had to be registered as resident before April 2012 in order to qualify.

Prior to this date even Spanish nationals didn't have automatic right to healthcare unless they were working. If they stopped work, they lost their right to healthcare.

I'm not sure if it's a coincidence, but the claim seems to have first appeared on the UK govt webpage around the beginning of 2018.


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## trotter58

kaipa said:


> We went through all this a couple of years ago when the law was suggested. Its is not for expats only illegal immigrants. I think actually in the end the law was never ratified. You will only get free healthcare if you have contributed/ been resident before Brexit. All other arrivals have to pay for the whole period of residency.


Sorry I missed it.
However, the link is still there and there's a webinar available on "Brits in Spain" facebook which gives a little insight into Spanish healthcare for residents (the webinar can be viewed at Facebook Live Q and A on Residency)
*******EDIT........
*Further to this subject please see post at*








Does permanent residence = free healthcare?


I've moved a lot of current posts on this subject to this thread to avoid duplication. They pre-date (by an hour or two) the original thread starter of this one, so reading through might seem a bit odd at first.




www.expatforum.com




for informative links regarding healthcare for residents not covered by the withdrawal agreement.


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## incatalunya

It says it on the British Enbassy website I think....but it´s false information.


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## CltFlyboy

More info, this publication is widely respected throughout the world. They state that they worked with experts in immigration to write this article:

Spain Visa and Residency Information 2021 - International Living Countries

From the article:
"
Long Duration (Permanent) Residence Permit
After five years of living in Spain on one of the residence permits described above, you are automatically eligible for permanent residence as long as you have not been out of Spain more than 10 months in the five years. Time spent on student staying permits counts at 50%. Once you have this permit, you only need to be in Spain one day each year to keep it. Permanent residence gives expats the right to work and access to the government healthcare system.
"


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## MataMata

The wording is incomplete and therefore misleading.

It should say "Permanent residence gives expats the right to work and access to the government healthcare system" WHICH ENSUES FROM THAT.

In other words healthcare due to being employed and contributing to the social security system.

5 years residency absolutely does NOT give the right to FREE healthcare!


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## blondebob

MataMata said:


> The wording is incomplete and therefore misleading.
> 
> It should say "Permanent residence gives expats the right to work and access to the government healthcare system" WHICH ENSUES FROM THAT.
> 
> In other words healthcare due to being employed and contributing to the social security system.
> 
> 5 years residency absolutely does NOT give the right to FREE healthcare!



" 1. Holders of the right to health protection and health care are all persons with Spanish nationality and* foreign persons who have established their residence in Spanish territory."*






BOE.es - BOE-A-2018-10752 Real Decreto-ley 7/2018, de 27 de julio, sobre el acceso universal al Sistema Nacional de Salud.







www.boe.es


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## Overandout

blondebob said:


> " 1. Holders of the right to health protection and health care are all persons with Spanish nationality and* foreign persons who have established their residence in Spanish territory."*
> 
> 
> 
> 
> 
> 
> BOE.es - BOE-A-2018-10752 Real Decreto-ley 7/2018, de 27 de julio, sobre el acceso universal al Sistema Nacional de Salud.
> 
> 
> 
> 
> 
> 
> 
> www.boe.es


Brilliant how selective quoting substantiates a false argument!

Please now quote Article 3, paragraph 2 (especially point c).

And stop misleading people.


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## trotter58

Overandout said:


> Brilliant how selective quoting substantiates a false argument!
> 
> Please now quote Article 3, paragraph 2 (especially point c).
> 
> And stop misleading people.


Just for clarity, is this the quote that you're referring to?
"
_«Article 3. Holders of the right to health protection and healthcare.

1. Holders of the right to health protection and health care are all persons with Spanish nationality and foreign persons who have established their residence in Spanish territory.

Notwithstanding the foregoing, people with the right to health care in Spain in application of the community regulations for the coordination of Social Security systems or of the bilateral agreements that include the provision of health care, will have access to it, provided that reside in Spanish territory or during their temporary trips to Spain, in the form, extension and conditions established in the community or bilateral provisions indicated.

2. In order to make the right referred to in section 1 effective, charged to the public funds of the competent administrations, the persons holding the aforementioned rights must be in one of the following cases:

a) Have Spanish nationality and habitual residence in Spanish territory.

b) Have their right to health care recognized in Spain by any other legal title, even if they do not have their habitual residence in Spanish territory, provided that there is no third party obligated to pay for said care._

*c) Being a foreign person with legal and habitual residence in Spanish territory and not having the obligation to prove the compulsory coverage of health care by other means.*"

A foreign person with temporary habitual residence doesn't comply with point C until he has permanent residence. 
During the period of temporary residence the foreign person is obliged to prove healthcare cover by other means. Which is required on the 1st application and then the subsequent 2 year applications, until the foreign person has gained permanent residency and compulsory cover is no longer required.


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## Overandout

Yes, that is the part I am referring to. What it says is that you will get free health care in Spain as a resident (this is the part people like to read and stop at this point, but it continues..) *as long as you are not obliged to prove compulsory health care by other means.* For both EU citizens and visa applicants, the applicable immigration law DOES oblige us to prove ths healthcare by other means, so the right referred to in section 1 does not apply to most of us.


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## MataMata

I was just writing "What's missing from the above is FREE health care as enjoyed by Spanish nationals" when your post popped up.

I rest my case then that 5 years residency absolutely does NOT give the right to FREE healthcare!

Those not entitled to an S1 will therefore have to pay for PHI or convenio especial in perpetuity the only other option being taking up Spainish citizenship which need 10 years residence for starters.


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## kaipa

Why are we discussing this?. It is a simple fact that 5 years residency does not give you free healthcare. Only those resident before 2012 have it. The rest have it because either they work or, in the case of Brits before 31st Dec, the S1 covers them. Anyone from UK arriving in Spain with NLV will need to have healthcare cover for the whole time they have residency. The caveat that you get it if you have no access to any coverage anywhere else is not applicable to Brits, Americans. We went through this a few years ago- with people demanding free healthcare and waving the law at funcinarios and nothing came of it. Let's not start posting Google translations of individual paragraphs of various decretas and just move on.


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## xabiaxica

If anyone can find me one person who became legally resident after April 2012 who has successfully recieved free & full access to the Spanish healthcare system simply because they are permanent residents after 5 years, I'll eat a pickled gherkin.

If you knew me, you'd know how much I hate anything pickled, and that I would be far more likely to eat a hat.


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## Overandout

To complete my post (becasue someone will still not believe this is the case) the laws which oblige the EU and 3rd country immigrants to have health care arranged outside of the state system are :

"art. 54.1 del RD 557/2011, de 20 de abril, por el que se aprueba el Reglamento de la Ley Orgánica 4/2000, sobre derechos y libertades de los extranjeros en España y su integración social[4] _tras su reforma por Ley Orgánica 2/2009_ como el Real Decreto 240/2007, de 16 de febrero, sobre entrada, libre circulación y residencia en España de ciudadanos de los Estados miembros de la Unión Europea y de otros Estados parte en el Acuerdo sobre el Espacio Económico Europeo (art.7[5]) y la Orden PRE/1490/2012"

Source - a legal opinion published in Legal Today (which also reaches the same conclusions as I do, albeit in a much more academic and detailed way). This has also been tested in the Tribunal Supremo (sentence of 13th May 2019).



https://www.legaltoday.com/practica-juridica/derecho-publico/derecho-administrativo/tienen-derecho-todos-los-extranjeros-a-la-sanidad-universal-2019-09-03/


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## Overandout

Maybe we should make this a "sticky"? I do seem to have to post this every year or so to disporove the misinformation around.


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## xabiaxica

Overandout said:


> Maybe we should make this a "sticky"? I do seem to have to post this every year or so to disporove the misinformation around.


It won't stop the question being asked again, but yes, I'll stick it, if only so that it's easy to find your link again!


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## trotter58

Overandout said:


> Yes, that is the part I am referring to. What it says is that you will get free health care in Spain as a resident (this is the part people like to read and stop at this point, but it continues..) *as long as you are not obliged to prove compulsory health care by other means.* For both EU citizens and visa applicants, the applicable immigration law DOES oblige us to prove ths healthcare by other means, so the right referred to in section 1 does not apply to most of us.


I'm sorry but I disagree.
Yes, Visa *applicants *have to prove they have healthcare and this is tested each time they apply. When 3rd country nationals (applicants) have applied 3 times, over the 5 year period, they become permanent residents. As permanent residents they are allowed to apply for the permanent TIE card which lasts for 10 years. When they come to renew the permanent card they no longer need to prove healthcare.


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## Overandout

trotter58 said:


> I'm sorry but I disagree.
> Yes, Visa *applicants *have to prove they have healthcare and this is tested each time they apply. When 3rd country nationals (applicants) have applied 3 times, over the 5 year period, they become permanent residents. As permanent residents they are allowed to apply for the permanent TIE card which lasts for 10 years. When they come to renew the permanent card they no longer need to prove healthcare.


Did you actually read the legal opinion I linked to?

I copy one of the most concise conclusions reached:

"Los extranjeros con permiso de residencia que no trabajan o están cubiertos por la Seguridad Social deberán mantener un seguro privado o público que cubra la asistencia sanitaria durante su residencia y precisamente por esta obligación no tendrán derecho a la asistencia sanitaria."

"Foreigners with permission to reside and who do not work or are not covered by the Social Security must have a private or public insurance which covers the provision of health care during their residency and precisiely due to this obligation are not entited to health care" (referring to the free health care in section 1 of the BOE posted by Blondbob).

You are entitled to disagree, but you are not just disagreeing with me, you are disagreeing with the lawyer Leopoldo J Gomez Zamora (with quite an impressive CV by my standards) and the Tribunal Supremo... good luck continuing your argument!


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## trotter58

Overandout said:


> Did you actually read the legal opinion I linked to?
> 
> I copy one of the most concise conclusions reached:
> 
> "Los extranjeros con permiso de residencia que no trabajan o están cubiertos por la Seguridad Social deberán mantener un seguro privado o público que cubra la asistencia sanitaria durante su residencia y precisamente por esta obligación no tendrán derecho a la asistencia sanitaria."
> 
> "Foreigners with permission to reside and who do not work or are not covered by the Social Security must have a private or public insurance which covers the provision of health care during their residency and precisiely due to this obligation are not entited to health care" (referring to the free health care in section 1 of the BOE posted by Blondbob).
> 
> You are entitled to disagree, but you are not just disagreeing with me, you are disagreeing with the lawyer Leopoldo J Gomez Zamora (with quite an impressive CV by may standards) and the Tribunal Supremo... good luck continuing your argument!


Yes I did read the link. I was in the process of editing my reply when you poste.

From the document that you quote.....
" *The aforementioned STS of the Social Chamber of May 13, 2019 points out that health care charged to public funds, when the applicant is a foreigner with legal residence, is only granted in the event that said benefit is not covered. mandatory by other channels, public or private, and if there is a third party obliged to cover said protection or there is a rule that imposes it or that such provision is being met by virtue of other public insurance, the requirements for that the public system must address what is already covered.* " 

I do see his point but if mandatory health cover is required when you become permanently resident why is it only tested during your 5 year temporary application period? Why not test on renewal of permanent TIE card?


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## Overandout

trotter58 said:


> Yes I did read the link. I was in the process of editing my reply when you poste.
> 
> From the document that you quote.....
> " *The aforementioned STS of the Social Chamber of May 13, 2019 points out that health care charged to public funds, when the applicant is a foreigner with legal residence, is only granted in the event that said benefit is not covered. mandatory by other channels, public or private, and if there is a third party obliged to cover said protection or there is a rule that imposes it or that such provision is being met by virtue of other public insurance, the requirements for that the public system must address what is already covered.* "
> 
> I do see his point but if mandatory health cover is required when you become permanently resident why is it only tested during your 5 year temporary application period? Why not test on renewal of permanent TIE card?


They can test whenever they want. They don't always, but they can.
Think of it like the ITV of your car, many people only fix the brake lights when its time for the inspection, but that doesn't mean that its OK to drive around for 6 months without them working. Same with health cover, you might not get "caught" but the law requires you to have it all the time you are here.


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## trotter58

Overandout said:


> They can test whenever they want. They don't always, but they can.
> Think of it like the ITV of your car, many people only fix the brake lights when its time for the inspection, but that doesn't mean that its OK to drive around for 6 months without them working. Same with health cover, you might not get "caught" but the law requires you to have it all the time you are here.


Fair point and good link. Thanks


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## kaipa

It is important that this information is correct. It appears that some people still believe that after 5 years of residency they will no longer need to pay for healthcare and will simply transfer to the state healthcare which is free. If you are budgeting on only five years healthcare fees you might be surprised to find you will need to pay even if you are on the convenio and for over 65s that is approx 160€ ( at the moment).


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## kaipa

I am intending to leave Spain in a year to return to UK. I will only remain in UK for a couple of years until I reach retirement and my child has finished education there. When I leave I will have been more than 5 years with Spanish residency. I believe I can still return if my absence does not exceed 5 years. Will I receive healthcare on return, especially as I would have made a number of years of contributions?


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## Joppa

kaipa said:


> I am intending to leave Spain in a year to return to UK. I will only remain in UK for a couple of years until I reach retirement and my child has finished education there. When I leave I will have been more than 5 years with Spanish residency. I believe I can still return if my absence does not exceed 5 years. Will I receive healthcare on return, especially as I would have made a number of years of contributions?


That depends on your contribution record in Spain, but I would say yes. And if you are getting UK state pension, then you are eligible for S1 and get free Spanish health care.


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## blondebob

Overandout said:


> Brilliant how selective quoting substantiates a false argument!
> 
> Please now quote Article 3, paragraph 2 (especially point c).
> 
> And stop misleading people.


How am I misleading anybody ? I took the quote that I used at my INSS when going from several years private onto the Spanish system back in 2019 but also posted the link to the FULL BOE assuming people would Read the entire thing so please don't tell me what to quote


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## Barriej

The Brits in Spain Facebook page has listed the next live Q&A and its about hHealthcare.
I have asked the following question.

_Something that seems to be confusing is the information on the .gov website about Spanish healthcare. I arrived here in August 2020, am 59 and don't work and have registered to become resident. I have private healthcare and will continue with this. But on the website it says once I have been a resident for 5 years I can get FREE healthcare from the Spanish system. Does this mean I can stop paying for the Private and just register and receive completely free healthcare just like a Spanish Citizen, even though I will not have paid anything into the system, until the Uk picks up with the S1 for me in 2029?_

Lets see what answer I get.


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## xabiaxica

blondebob said:


> How am I misleading anybody ? I took the quote that I used at my INSS when going from several years private onto the Spanish system back in 2019 but also posted the link to the FULL BOE assuming people would Read the entire thing so please don't tell me what to quote


So are you saying that you now get free & full access to the state healthcare system in Spain, despite having not paid into the system, & having registered as resident after April 2012?

I know that some people in Andalucía managed this when for a few months they were going down the 'free healthcare for all' route, but I also know that they closed that door fairly quickly when they realised that nowhere else in the country was doing it & that it's no longer possible - although those who did manage it have kept it.


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## blondebob

xabiaxica said:


> So are you saying that you now get free & full access to the state healthcare system in Spain, despite having not paid into the system, & having registered as resident after April 2012?
> 
> I know that some people in Andalucía managed this when for a few months they were going down the 'free healthcare for all' route, but I also know that they closed that door fairly quickly when they realised that nowhere else in the country was doing it & that it's no longer possible - although those who did manage it have kept it.


Correct


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## xabiaxica

Barriej said:


> The Brits in Spain Facebook page has listed the next live Q&A and its about hHealthcare.
> I have asked the following question.
> 
> _Something that seems to be confusing is the information on the .gov website about Spanish healthcare. I arrived here in August 2020, am 59 and don't work and have registered to become resident. I have private healthcare and will continue with this. But on the website it says once I have been a resident for 5 years I can get FREE healthcare from the Spanish system. Does this mean I can stop paying for the Private and just register and receive completely free healthcare just like a Spanish Citizen, even though I will not have paid anything into the system, until the Uk picks up with the S1 for me in 2029?_
> 
> Lets see what answer I get.


Thing is, they keep repeating this, even though we know that it simply doesn't work that way, & they have been questioned about it in the past. 

Let us know what they say.


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## xabiaxica

blondebob said:


> Correct


Unless you live in Andalucía, & slipped in while that door was open - you're the first & only case I've come across who has actually achieved this, except as a 'sin recursos' case. 

Or does that apply to you?


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## kaipa

xabiaxica said:


> Thing is, they keep repeating this, even though we know that it simply doesn't work that way, & they have been questioned about it in the past.
> 
> Let us know what they say.


You are right Andalucia had it for a while but it appears to have been closed so some people might have it. The best example of this was Elyes" posts. He is American and has been here more than 5 years. He went through a very thorough process trying to find out if he could get it and eventually determined it was not possible


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## blondebob

xabiaxica said:


> Unless you live in Andalucía, & slipped in while that door was open - *you're the first & only case I've come across who has actually achieved this*, except as a 'sin recursos' case.
> 
> Or does that apply to you?


Thats odd as in post #25 above you wrote and I quote " _I know that some people in Andalucía managed this when for a few months they were going down the 'free healthcare for all' route" _so you seem to be contradicting yourself

Yes I am resident in Andalucía but certainly was not aware that I was slipping in anywhere, just walked in normally with my documents and registered "sin problemo"


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## xabiaxica

blondebob said:


> Thats odd as in post #25 above you wrote and I quote " _I know that some people in Andalucía managed this when for a few months they were going down the 'free healthcare for all' route" _so you seem to be contradicting yourself
> 
> Yes I am resident in Andalucía but certainly was not aware that I was slipping in anywhere, just walked in normally with my documents and registered "sin problemo"


Being resident in Andalucía is what makes the difference. 

As I said, there was a very short window where it was possible to do as you have done. Then that window was firmly closed & were you to try now, you wouldn't be successful. 

So it seems that I still haven't come across anyone who has actually achieved what you have - except during that window of time in Andalucía.


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## kaipa

Yes Andalucia did it but they also had it for people who were registered in 2012. They seem to have stopped it now though.


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## blondebob

xabiaxica said:


> Being resident in Andalucía is what makes the difference.
> 
> As I said, there was a very short window where it was possible to do as you have done. Then that window was firmly closed & were you to try now, you wouldn't be successful.
> 
> *So it seems that I still haven't come across anyone who has actually achieved what you have - except during that window of time in Andalucía.*


I must have been lucky to have stumbled through this "window of time", not intentional I can assure you but I am not alone in achieving this.


----------



## xabiaxica

blondebob said:


> I must have been lucky to have stumbled through this "window of time", not intentional I can assure you but I am not alone in achieving this.


I know you're not alone - I personally (face to face) know someone who managed to 'slip in' at that time too. Just lucky timing. 

But that short window was special, & sadly doesn't mean that it was possible before then, nor that it's possible now.


----------



## MataMata

trotter58 said:


> As permanent residents they are allowed to apply for the permanent TIE card which lasts for 10 years. When they come to renew the permanent card they no longer need to prove healthcare.


That's not the chronology.

You become permanent resident after 5 years and it's then, when you renew your TIE or apply for your first one if you've hung onto the green residencia, that the need to to demonstrate healthcare falls away.

Nobody will be 'testing' after that.


----------



## MataMata

xabiaxica said:


> Thing is, they keep repeating this, even though we know that it simply doesn't work that way, & they have been questioned about it in the past.
> 
> Let us know what they say.


Perhaps they are still (mis)reading this: (reference to 'citizens' and 'citizenship' being a misnomers of course!)

14 February 2019
13:29 CET+01:00
The President of the Valencia region had some reassuring words for those British residents who have made their home in the region in eastern Spain.
"Healthcare is not under threat for the 71,000 Britons issued with a health card," Ximo Puig, the regional president from the Spanish socialist party (PSOE) said, insisting that universal healthcare was a right for every Valencian citizen and would continue to be so, whether a Brexit withdrawal agreement was struck or not.
*READ ALSO: British Embassy ‘reassures’ Brits in Spain over healthcare post-Brexit*
Puig said that around 71,000 Brits were currently registered in the Valencia region and had been issued with health cards and they should not fear that they would become void after March 29th..
"No Briton will lose (Valencian) citizenship in terms of the basic right to healthcare," he said on Tuesday, following an inter-departmental meeting to analyse the effects of Brexit of those living in the Valencia region.


> La posición cambiante del Reino Unido respecto al Brexit nos empuja a desarrollar diferentes respuestas a cada uno de los escenarios posibles. Por ese motivo prestaremos asesoramiento a las empresas afectadas y pondremos en marcha una plataforma online de información para ellas pic.twitter.com/w4c5niMpVI
> — Ximo Puig (@ximopuig) February 12, 2019


Apart from the 71,000 Brits officially registered as resident in Valencia - the majority of whom live along the coast in Alicante province – around 100,000 British visitors to the region receive healthcare while on holiday.
Valencia remains one of the most popular destinations in Spain for British residents and visitors alike. Last year, 37 percent of the 9.2 million visitors to the region came from the UK.
Puig said that in return for treating Brits at its health centres and hospitals, the region of Valencia claims approximately €75 million a year from the UK.
He said that “the Generalitat (Regional government) has the political will to formalize a bilateral agreement" with the United Kingdom, where some 10,000 Valencians live, to continue receiving economic compensation for the aforementioned universal health care”.
“Even in the worst case scenario of a hard Brexit, Brits can continue with their status as Valencians, and that means free healthcare,” he emphasized.


----------



## kaipa

Do Americans with NLVisa get free healthcare after 5 years? If they do then Brits will. If they dont then we won't


----------



## xabiaxica

kaipa said:


> Do Americans with NLVisa get free healthcare after 5 years? If they do then Brits will. If they dont then we won't


As I think was mentioned earlier, an American member here, Eyles, tried every possible avenue to get free access to the healthcare system after 5 years residency -. and failed. He ended up continuing with the _convenio especial._


----------



## timwip

xabiaxica said:


> As I think was mentioned earlier, an American member here, Eyles, tried every possible avenue to get free access to the healthcare system after 5 years residency -. and failed. He ended up continuing with the _convenio especial._


I got free access immediately; however, that is because I am married to a Spanish citizen. Otherwise, I would not have gotten it.


----------



## xabiaxica

timwip said:


> I got free access immediately; however, that is because I am married to a Spanish citizen. Otherwise, I would not have gotten it.


Yes, that makes a HUGE difference!


----------



## blondebob

xabiaxica said:


> I know you're not alone - I personally (face to face) know someone who managed to 'slip in' at that time too. Just lucky timing.
> 
> But that short window was special, & sadly doesn't mean that it was possible before then, nor that it's possible now.


I got mine in February 2019 and a couple in the same situation as I was did similar but that wasn't until Mid November 2019. So that "special" window you mention wasn't so short. No idea about before or now as irrelevant to me.


----------



## stevec2x

Good grief, I never expected so many replies! Thank you everybody. The reason I asked the question is that I (aged 57) have free healthcare because my partner is classed as a pensioner, and therefore has free healthcare via s1, and I am classed as her dependent, so I get healthcare as well. However, in 2019, my partner was literally dying on the floor of a pharmacy with a diabetic hypo. The ambulance got there in the nick of time, heroes! But ever since, there's been that thought at the back of our minds, "if the worst had happened, I would also lose my healthcare".

Then I saw a comment somewhere about permanent residency and healthcare, and just wanted to find out more.

PS we arrived in Spain in May 2012, unaware of the April cutoff.

Thanks to all


----------



## xabiaxica

stevec2x said:


> Good grief, I never expected so many replies! Thank you everybody. The reason I asked the question is that I (aged 57) have free healthcare because my partner is classed as a pensioner, and therefore has free healthcare via s1, and I am classed as her dependent, so I get healthcare as well. However, in 2019, my partner was literally dying on the floor of a pharmacy with a diabetic hypo. The ambulance got there in the nick of time, heroes! But ever since, there's been that thought at the back of our minds, "if the worst had happened, I would also lose my healthcare".
> 
> Then I saw a comment somewhere about permanent residency and healthcare, and just wanted to find out more.
> 
> PS we arrived in Spain in May 2012, unaware of the April cutoff.
> 
> Thanks to all


No-one was aware of that cutoff until it was retroactively announced in the October!


I can imagine you would be concerned, but the good news is that you will eventually still get the S1 when you retire, & should the worst happen, the convenio especial is pretty cheap until you qualify for an S1 in your own right. 

Glad your partner pulled through.


----------



## Overandout

For what its worth, I never knew about the 2012 change either. I arrived first time in 2004 and was admitted to the SS system because I got a job within a few months, I have been contributing non-stop ever since (even when I lived in Asia) so every time I do any formal procedue I just allow them to check my vida laboral or I print it off and take it with me.


----------



## yevlondon

i just saw this in BREXPATS IN SPAIN facebook group as a "clarification from the British Embassy". not sure how to link to a specific post so i am copying it here. BREXPATS IN SPAIN 

not my information, just sharing in case someone wants to give it a go.

========
Rights to healthcare here is a massive concern especially now we are living with the risks of Covid. Many members are wanting to exercise their right to State healthcare after being resident here for 5 years. What are the conditions, who does it apply to and how can they claim it? The healthcare team at the British Embassy wrote this explanation of how to apply for healthcare as a permanent resident:

If you are a permanent resident in Spain you are entitled to apply for Spanish State healthcare on the basis of your permanent residency status. You can now also apply online. Here’s what to do:
Call the Overseas Healthcare Service on (0044) 191 218 1999 and as for a ‘legislation letter’. This tells the Spanish authorities that the UK does not cover your healthcare
Complete the Spanish Seguridad Social healthcare application for (https://bit.ly/3jNEGMe)
Upload both of these documents, along with your passport and your permanent residency certificate to the INSS online application service (https://bit.ly/2EzgCwB) Make sure you select ‘No certificate’ (or ‘Sin certificado’) at the bottom of the page. Please note, the application forms are in Spanish.
Remember that if you already receive your healthcare in Spain because you work and pay into the Social Security system or you claim a Spanish or UK State pension, this option is not available. If you’re a UK State Pensioner, the UK can cover your healthcare in Spain using an S1 form. See https://www.gov.uk/.../healthcare-in-spain-including-the... for more information on healthcare


----------



## xabiaxica

yevlondon said:


> i just saw this in BREXPATS IN SPAIN facebook group as a "clarification from the British Embassy". not sure how to link to a specific post so i am copying it here. BREXPATS IN SPAIN
> 
> not my information, just sharing in case someone wants to give it a go.
> 
> ========
> Rights to healthcare here is a massive concern especially now we are living with the risks of Covid. Many members are wanting to exercise their right to State healthcare after being resident here for 5 years. What are the conditions, who does it apply to and how can they claim it? The healthcare team at the British Embassy wrote this explanation of how to apply for healthcare as a permanent resident:
> 
> If you are a permanent resident in Spain you are entitled to apply for Spanish State healthcare on the basis of your permanent residency status. You can now also apply online. Here’s what to do:
> Call the Overseas Healthcare Service on (0044) 191 218 1999 and as for a ‘legislation letter’. This tells the Spanish authorities that the UK does not cover your healthcare
> Complete the Spanish Seguridad Social healthcare application for (https://bit.ly/3jNEGMe)
> Upload both of these documents, along with your passport and your permanent residency certificate to the INSS online application service (https://bit.ly/2EzgCwB) Make sure you select ‘No certificate’ (or ‘Sin certificado’) at the bottom of the page. Please note, the application forms are in Spanish.
> Remember that if you already receive your healthcare in Spain because you work and pay into the Social Security system or you claim a Spanish or UK State pension, this option is not available. If you’re a UK State Pensioner, the UK can cover your healthcare in Spain using an S1 form. See https://www.gov.uk/.../healthcare-in-spain-including-the... for more information on healthcare


I look forward to hearing of someone actually succeeding


----------



## Andaluz

xabiaxica said:


> If anyone can find me one person who became legally resident after April 2012 who has successfully recieved free & full access to the Spanish healthcare system simply because they are permanent residents after 5 years, I'll eat a pickled gherkin.


I'd never previously heard of, what for me, seems to be an important April 2012 reference.

I'm a UK passport holder, not currently working but have had a permanent residence in Spain, since the mid 90's.

Does this mean I will continue to have ongoing access to state healthcare in Spain, without having to pay a monthly fee ?


----------



## Barriej

Andaluz said:


> I'd never previously heard of, what for me, seems to be an important April 2012 reference.
> 
> I'm a UK passport holder, not currently working but have had a permanent residence in Spain, since the mid 90's.
> 
> Does this mean I will continue to have ongoing access to state healthcare in Spain, without having to pay a monthly fee ?


Can I ask what you are doing about healthcare at the moment?
Do you have private, Convenio or nothing?

I would think that the Spanish Government might have something to say if you just stopped contributing privately or stop the convenio just to try and get something for nothing.


This extra part is included in the healthcare section, but its rarely referenced .

*How to access healthcare services*
Once you’re registered for healthcare, you’ll get a health insurance card. Take it with you whenever you visit a doctor, hospital or pharmacy.

*How much you’ll pay*
*Once registered for healthcare, basic state services are free.
There are some things that you may need to pay a percentage of the cost for, such as orthopaedic services.*

This to me says that you will get Emergency treatment (just like the Uk) but other stuff may (and will be) charged for.

Ive asked the Consulate to clarify the wording and will report back.


----------



## kaipa

Unfortunately, it is all from the UK end. As many of us have pointed out the 5 year rule doesn't appear to apply to Americans who have to pay after 5 years ( Elyses is our American poster). The Spanish official sites seem to interpret the law differently relying on the idea that the applicant has no recourse to healthcare assistance from their country. I guess this is why the UK site says you need a letter to say you dont receive healthcare from UK. Having said that the UK has now said that all UK nationals resident abroad will have access to the NHS when in UK so I wonder how that might effect things. One thing is for sure - this will not be immediately acted on and will just drag on for years so you need to plan for worst hope for best.


----------



## trotter58

kaipa said:


> Unfortunately, it is all from the UK end. As many of us have pointed out the 5 year rule doesn't appear to apply to Americans who have to pay after 5 years ( Elyses is our American poster). The Spanish official sites seem to interpret the law differently relying on the idea that the applicant has no recourse to healthcare assistance from their country. I guess this is why the UK site says you need a letter to say you dont receive healthcare from UK. Having said that the UK has now said that all UK nationals resident abroad will have access to the NHS when in UK so I wonder how that might effect things. One thing is for sure - this will not be immediately acted on and will just drag on for years so you need to plan for worst hope for best.


I can understand why the 5 year rule doesn't apply to Americans as their health cover isn't reciprocated to Spanish immigrants, whereas the UK reciprocate their healthcare.


----------



## kaipa

The problem is ( and I might be wrong) is not all Spanish nationals are entitled to free healthcare hence the convenio which was designed for those Spanish who had no contributions. Now I know that this was the case and it might have changed but the convenio was not invented for solely for immigrants.


----------



## xicoalc

kaipa said:


> I am intending to leave Spain in a year to return to UK. I will only remain in UK for a couple of years until I reach retirement and my child has finished education there. When I leave I will have been more than 5 years with Spanish residency. I believe I can still return if my absence does not exceed 5 years. Will I receive healthcare on return, especially as I would have made a number of years of contributions?


Contributions meaning working and paying social security? I believe that once you have worked you are entitled to healthcare for life. But this may have changed and may vary on comunidades too. When i first came I was autonomo and after a while I stopped working for a couple of months and suddenly my SIP stopped working. It was an error and they changed it and told me that here, when you have contributed you are entitled for life to healthcare. If you have permanent residency then you can leave for up to 5 years so if you already have healthcare I would assume it would continue on return.. but thats my logical thinking and not neceserily how it is!


----------



## Megsmum

I thought since 2012 all Spanish nationals were entitled to healthcare. 

Since my cancer diagnosis I've asked the question as to what happens if I cease to be autónomo and stopped paying. The answer was straightforward...no autónomo payments no healthcare... I'm currently getting sickness benefits and still paying some social security payments per month. I'd love for it to be true that once paying autónomo you get life cover, might be for Spanish citizens not I think for foreign nationals. Like to be wrong.


----------



## xicoalc

Megsmum said:


> I thought since 2012 all Spanish nationals were entitled to healthcare.
> 
> Since my cancer diagnosis I've asked the question as to what happens if I cease to be autónomo and stopped paying. The answer was straightforward...no autónomo payments no healthcare... I'm currently getting sickness benefits and still paying some social security payments per month. I'd love for it to be true that once paying autónomo you get life cover, might be for Spanish citizens not I think for foreign nationals. Like to be wrong.


This, at the time that it applied to me, was dependent on area. Com. Valenciana for example had it. They called it the former worker scheme and as i said, i was struck off the sip card but a visit to the social security and it was all changed over to that and i was told its for life no matter if i work or not. 

Since then ive always worked so never given it any more thought. But keep in mind it was well before 2012 that everyone is talking about (i didnt even know things changed).

My OH is spanish and so my family and friends are all spanish and i know people who don't work, have used all their paro etc and they still get health care. But the actual rules im not clear on.


----------



## kaipa

I was certainly told that once I stop working I have 3 months then SIP is invalid. Never heard of 5 year rule for immigrants .


----------



## Megsmum

Exactly this... important to remember when giving advice individual cases do not always reflect the official line....


----------



## Andaluz

Barriej said:


> Can I ask what you are doing about healthcare at the moment?
> Do you have private, Convenio or nothing?
> 
> I would think that the Spanish Government might have something to say if you just stopped contributing privately or stop the convenio just to try and get something for nothing.
> 
> 
> This extra part is included in the healthcare section, but its rarely referenced .
> 
> *How to access healthcare services*
> Once you’re registered for healthcare, you’ll get a health insurance card. Take it with you whenever you visit a doctor, hospital or pharmacy.
> 
> *How much you’ll pay*
> *Once registered for healthcare, basic state services are free.
> There are some things that you may need to pay a percentage of the cost for, such as orthopaedic services.*
> 
> This to me says that you will get Emergency treatment (just like the Uk) but other stuff may (and will be) charged for.
> 
> Ive asked the Consulate to clarify the wording and will report back.


Sorry for the delay in replying.

I'm receiving state healthcare in 2021 (post Brexit) in the same way as 2020 and before.
No private HC, No convenio pyts, No questions.

As I said, I'm not currently in employment but was an _autonomo,_ a number of years ago.

1. The wording that you have doubts about, seems fairly clear to me "...*basic state services are free"*
From looking at the text you provide, for me, the question that a precise answer would be of use is....What doesn't come under basic classification ?

2. From the HM Govt advice
_If you’ve been a resident in Spain for 5 years or more, you can apply for permanent residency. This will give you access to state healthcare on the same basis as a Spanish citizen.






Healthcare for UK nationals living in Spain


How to get state healthcare if you live, work or study in Spain.




www.gov.uk





3. I'd add the relevant April 2012 date that has been mentioned in the thread and point out I have been resident since the 90's._


----------



## Megsmum

Ate you saying despite no longer being autónomo you continue to get state health care ?

Sorry you were resident before 2012 that's why


----------



## Andaluz

Megsmum said:


> Ate you saying despite no longer being autónomo you continue to get state health care ?
> 
> Sorry you were resident before 2012 that's why


Yes.......... and it would appear to be, yes.


----------



## Overandout

kaipa said:


> I was certainly told that once I stop working I have 3 months then SIP is invalid. Never heard of 5 year rule for immigrants .


The "5 year rule" appears only in foreign texts (the UK source is the one cited most often) but despite searching and asking people who quote it, I have never seen this written in any Spanish document.
It may have existed in the past and the foreign sources not updated maybe? 

If you look at the legal opinion I linked to above, you will see that the author summarizes the rights to state healthcare with reference to the applicable laws and makes no reference to any period of residence which gives a change in those rights.

I would love to find the original source of this "legend" just to read it for myself, if anyone can find it ( I have asked this before but people just link to the UK Gov site).


----------



## kaipa

Overandout said:


> The "5 year rule" appears only in foreign texts (the UK source is the one cited most often) but despite searching and asking people who quote it, I have never seen this written in any Spanish document.
> It may have existed in the past and the foreign sources not updated maybe?
> 
> If you look at the legal opinion I linked to above, you will see that the author summarizes the rights to state healthcare with reference to the applicable laws and makes no reference to any period of residence which gives a change in those rights.
> 
> I would love to find the original source of this "legend" just to read it for myself, if anyone can find it ( I have asked this before but people just link to the UK Gov site).


I agree entirely. I don't know any working people ( who are more savvy about these things) who say this is true that is why everyone gets so paranoid about losing their jobs, the healthcare gets cancelled after a period of 3 months. If people thinks a person can pay 4 years convenio then get it all free compared to someone who has worked 10 years then it would be very unfair. Expats seem to think the convenio ( which exists in lots of forms) is solely for them but it is a system for Spanish too.


----------



## trotter58

Worth watching........https://www.facebook.com/BritsInSpain/videos/1106608309857919

Relevant question at 10mins:30secs.


----------



## Overandout

trotter58 said:


> Worth watching........https://www.facebook.com/BritsInSpain/videos/1106608309857919
> 
> Relevant question at 10mins:30secs.


He sure seems convinced, there must be something in this! But I wish it was a Spanish official giving the advice, not another "Brit".
I have gone to the INSS website to look for the procedure to apply as he describes. I can't find a procedure listed in those offered which matches, but I guess that doesn't mean to say that it doesn't exist.
I searched the INSS portal for the words "residente" and "imigrante" but no results are given. Searching for "extranjero" there is one result, but it is a process of how boat crews can be covered when requiring medical attention in a foreign port.

I have found this though:



Asistencia Sanitaria Pública: comprobación del derecho



A checker to see if you have the right to medical care under the state system. We all know that the official lists of requirements to be an "asegurado" and a "beneficiario" do not include this holy grail of simply having 5 years residence, but I would love to see the result of this checker for a person who has no SS contributions, is below pension age (no S1 or equivalent) and over 5 years of legal presence in Spain as resident.

As it is a personal check I can't manipulate my own data to get the result under those conditions. Any volunteers?


----------



## trotter58

__ https://www.facebook.com/video.php?v=1106608309857919



It was also mentioned that UK citizens applying after 2021 (Non lucrative visa) would have their medical costs picked up by the UK when they became eligible for the S1. This looks like a reciprocal deal between the UK and the EU. This means that UK Spanish residents would not have to pay Conveno Especial in perpetuity as others have claimed.

Non lucrative applications from other 3rd countries (USA/Canada) may still have to fund their own healthcare.


----------



## kaipa

One thing to bear in mind is that up until recently this didn't affect that many Brits as the majority either work or have S1. This means it is not a large number of people wanting this. With the absence of the S1 it becomes a bigger issue. People who work still contribute and autonomos also will contribute. There would need to be an agreement made that the UK would reimburse Spain for healthcare of permanent UK residents for Spain to grant it. I very much doubt the UK will get that agreement as it just makes Brexit as something that the UK gets to cherry pick at


----------



## xabiaxica

I might end up eating a pickle... I've seen on a FB group somone who has apparently been successful.

Is there anyone on this group who could benefit from this, fancies working through the steps & reporting back as to their result? I already have access to state healhcare, so I can't do it.

There are step by step instructions & links here





__ https://www.facebook.com/BritsInSpain/posts/2817677608336622


----------



## kaipa

I hope it does as my paro will finish soon and I was informed that if I dont have a work contract I will be deregister from public healthcare. Weird that the UK says one thing and Spanish another!


----------



## xabiaxica

kaipa said:


> I hope it does as my paro will finish soon and I was informed that if I dont have a work contract I will be deregister from public healthcare. Weird that the UK says one thing and Spanish another!


Let us know how you get on!


----------



## Overandout

As far as I can see, the idea here is that when you are faced with the question in the form "¿Tiene cobertura obligatoria de esta prestación por otra vía (Régimen especial de funcionarios o de otro país)?, the Brits in Spain logic is that because the "Brit" in question will have a letter stating that his/her country will not provide health cover, they can answer "No".

Technically they are correct because the form doesn't ask if the applicant is obliged to arrange an alternative cover via other means, which of course most immigrants are.

I think that if this works, it is simply because the funcionario processing the application will not be aware of the immigration laws applicable to every applicant, and as long as they answer the question "¿Reside en el territorio Español?" with a Yes, the application goes through.

But this then leaves me with a question: why do you have to have "permanent residency"? Surely the UK authority will give you a letter saying that they won't cover you even the day after you leave the UK, and the form doesn't ask if the applicant is a permanent resident....

It sure will be interesting to see how many people can get this approved as it does seem to be a bit of a golden opportunity. I also wonder if the other nationalities know about this and recommend it.


----------



## trotter58

Perhaps other nationalities don't reciprocate their healthcare? 

Although covered under the WA, I too would be interested to hear from anyone, from the UK, who has gained permanent residence with no S1 cover and now has free Spanish healthcare.


----------



## Overandout

trotter58 said:


> Perhaps other nationalities don't reciprocate their healthcare?
> 
> Although covered under the WA, I too would be interested to hear from anyone, from the UK, who has gained permanent residence with no S1 cover and now has free Spanish healthcare.


I don't think this process has anyuthing to do with reciprocation.

I think that the idea here is exactly that once the UK says that that the person is not covered in any way by the NHS funds, Spain will pick up the bill.

So in theory, this would be available to all nationalities.

If we could find a person willing to try this, I would love to see what result they get by running the "test your eligibility" test I posted in post number 82 and then apply as suggested by Brits in Spain.


----------



## kaipa

Why would Brits be eligible and not Americans? We know from the persistence of Eyles that he couldn't get it


----------



## Overandout

kaipa said:


> Why would Brits be eligible and not Americans? We know from the persistence of Eyles that he couldn't get it


Maybe he simply couldn't prove that he had no coverage by other means? I don't know, and until we find where this right is written in Spanish law or procedure, we will just be guessing. But it is interesting!


----------



## kaipa

Yes I agree. The new thing for me is this letter that you send saying that you have no NHS cover . It's weird 1: is the letter in English or Spanish. If its English then this signals some kind misunderstanding.2 Since Brexit all UK nationals have free access to NHS even if not resident.3 Why is it not clearly stated in any Spanish resolutions?


----------



## Lynn R

kaipa said:


> Yes I agree. The new thing for me is this letter that you send saying that you have no NHS cover . It's weird 1: is the letter in English or Spanish. If its English then this signals some kind misunderstanding.2 Since Brexit all UK nationals have free access to NHS even if not resident.3 Why is it not clearly stated in any Spanish resolutions?


I think that is just the same "legislation letter" as it is known, which has been available from the DWP since those who were resident before April 2012 were able to register for public healthcare in Spain if they could prove that they were not eligible for healthcare by any other means. As far as I'm aware, it comes in two versions, Spanish and English - just like S1 forms and the Spain (Individual) Double Taxation forms do.


----------



## kaipa

Lynn R said:


> I think that is just the same "legislation letter" as it is known, which has been available from the DWP since those who were resident before April 2012 were able to register for public healthcare in Spain if they could prove that they were not eligible for healthcare by any other means. As far as I'm aware, it comes in two versions, Spanish and English - just like S1 forms and the Spain (Individual) Double Taxation forms do.



So its nothing new.? This has been around for a while? If that is the case, then it looks like nothing has changed on the ground, so to speak and its basically what we have all said. After 5 years you will not qualify for free healthcare unless you have the C1 under WA.


----------



## Overandout

I don't think that the letter is new, neither is the claim that permanent residents are entitled to free heath care.

I'm not even sure that the right which Brits in Spain / the UK Government think exists even stems from the often misinterpreted law from 2018 which actually only really gives free care to refugees.

I think this was actually my error in the past. The Brits in Spain group doesn't ever seem to have claimed the this right comes from that law, it was just an assumption because it is so often misinterpreted / misquoted.

The problem is they also don't seem to have ever stated where they do think it does come from.

I really find it hard to believe that anyone would think that Spain would single out a particular nation's immigrants to which this right would apply, so it must apply to permanent residents of all nationalities.

But why is it not listed in the INSS's list of conditions to become an "asegurado" or a "beneficiario"? We are still missing something and the best way to find out what would be to study a real case of someone who gets it approved.


----------



## MataMata

Not forgetting of course that success in one autonomous region of Spain does not guarantee success in any other!
We definitely need to see this acted out as suggested!

As to different treatment for different nations for all practical purposes the WA endowed British nationals with the same rights as they enjoyed before Dec 31st, and *in their country of residence*, certainly not greater.

Also reciprocal health care provisions are different for each member state and as a British national you can only ever benefit from another states system *to the same extent as a citizen of that state.*

In France for instance citizens are nominally covered for 70% of the cost of their health care with the balance being paid either privately or more commonly covered by an insurance policy called a 'mutuelle'. There are exceptions but broadly speaking that's the situation. Medicines are mostly FREE.

The so called 'legislation letter' has been a feature of their system for a number of years whereby production permits otherwise non insured individuals to join the 'Protection universelle maladie' scheme or 'PUMA.

Subject to someone finding it in Spanish legislation, or it being evidenced by personal experiences, it would appear that Spain _may_ have adopted a similar approach.

A point not to be overlooked is that membership of the Spanish health system by virtue of a 'legislation letter' does mean that UK NHS care is no longer available to you, you can access primary and emergency care with Spanish EHIC (TSE) but anything further requires payment or private/travel insurance.


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## kaipa

MataMata said:


> Not forgetting of course that success in one autonomous region of Spain does not guarantee success in any other!
> We definitely need to see this acted out as suggested!
> 
> As to different treatment for different nations for all practical purposes the WA endowed British nationals with the same rights as they enjoyed before Dec 31st, and *in their country of residence*, certainly not greater.
> 
> Also reciprocal health care provisions are different for each member state and as a British national you can only ever benefit from another states system *to the same extent as a citizen of that state.*
> 
> In France for instance citizens are nominally covered for 70% of the cost of their health care with the balance being paid either privately or more commonly covered by an insurance policy called a 'mutuelle'. There are exceptions but broadly speaking that's the situation. Medicines are mostly FREE.
> 
> The so called 'legislation letter' has been a feature of their system for a number of years whereby production permits otherwise non insured individuals to join the 'Protection universelle maladie' scheme or 'PUMA.
> 
> Subject to someone finding it in Spanish legislation, or it being evidenced by personal experiences, it would appear that Spain _may_ have adopted a similar approach.
> 
> A point not to be overlooked is that membership of the Spanish health system by virtue of a 'legislation letter' does mean that UK NHS care is no longer available to you, you can access primary and emergency care with Spanish EHIC (TSE) but anything further requires payment or private/travel insurance.


I think it has recently changed and every UK national irrespective of place of residence will receive free NHS healthcare.


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## Overandout

Are you saying that the 5 year residence = free health care is a Brexit thing? (or rather a benefit of the W.A.?)


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## Glynb

Had a look at the UK Government link. It states:
All residents in Spain need to register to access healthcare.
_Once registered for healthcare, basic state services are free, but there are some things that patients need to pay for. For example, you usually have to pay something towards prescriptions – either a reduced price or the full price.
UK nationals usually access the Spanish national health system in one of these ways:_

_through entitlement to healthcare if they’re employed or self-employed in Spain_
_paying directly into the public health insurance scheme (Convenio Especial)_
_registering a UK-issued S1 form with the social security office_
_using a European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC) for temporary stays_
_through entitlement to healthcare as a permanent resident if they’ve lived in Spain for 5 years_
As we're not pensioners (S1) and not employed, our only option for us was the Convenio Especial. Unfortunately it doesn't cover any prescriptions or prosthesis, so if you needed some very expensive medicines you might end up in difficulty. We're praying we stay relatively fit for the next few years until we can get hold of the S1 and security!

The final bullet point "_through entitlement to healthcare as a permanent resident if they’ve lived in Spain for 5 years" _is a new one on me. Is it as clear and simple as it sounds?


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## xabiaxica

kaipa said:


> I think it has recently changed and every UK national irrespective of place of residence will receive free NHS healthcare.


Only if covered by the S1 if they live outside the UK.


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## Glynb

xabiaxica said:


> Only if covered by the S1 if they live outside the UK.


Yes, this is my understanding. 
Holidaymakers are covered by EHIC still. UK State Pensioners are covered via S1. 
Employees and self-employed in Spain are covered by their work contributions. 
So if you don't fall into any of those categories, you either pay for private health care, pay for the Convenio Especial (which doesn't cover medication costs) or, if you're still registered, pop back to the UK and use the NHS (presumably keeping schtum about your Spanish Residency!).


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## Do28

I am in the don't work in Spain category and so pay for private health insurance. As a dual domicile person still employed in the UK I can also access the NHS legitimately. I can't even pay the Convenio until I have been resident for a year although my private health cover is way better so I will just keep that. Its no different from when we were in the US apart from being a LOT cheaper!!!


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## kaipa

flybe said:


> I am in the don't work in Spain category and so pay for private health insurance. As a dual domicile person still employed in the UK I can also access the NHS legitimately. I can't even pay the Convenio until I have been resident for a year although my private health cover is way better so I will just keep that. Its no different from when we were in the US apart from being a LOT cheaper!!!


I still dont understand how you can legally have access to the NHS if you are a resident of Spain? ( and not a S1) I still pay tax in UK and make voluntary SS payments but I certainly dont have access to the NHS. A couple of years ago whilst visiting the UK I got a eye infection and the optician said that I would need to pay for the treatment as I wasn't living in UK
You seem to keep insisting that you have this dual residency giving you access to both countries based on the belief that you contribute to both but that would mean I have dual residency


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## Do28

kaipa said:


> I still dont understand how you can legally have access to the NHS if you are a resident of Spain? ( and not a S1) I still pay tax in UK and make voluntary SS payments but I certainly dont have access to the NHS. A couple of years ago whilst visiting the UK I got a eye infection and the optician said that I would need to pay for the treatment as I wasn't living in UK
> You seem to keep insisting that you have this dual residency giving you access to both countries based on the belief that you contribute to both but that would mean I have dual residency


I am not sure why you are confused. I assume you are trying to equate my circumstances to your own and struggling to understand that someone can live in multiple places during a year?

I am a UK tax payer, I pay UK tax and NI and as a result am entitled to access to the UK NHS. I am also a Spanish resident but as I am not employed in Spain and do not contribute to the Spanish social system I am not entitled to access it so I have private health care even though I am ultimately liable to pay tax here under the double taxation agreements.

I guess you have just "gone native" and have no outside of Spain property or financial interests so probably a bit difficult to understand the global aspects of someone with a lifestyle like mine.

My year is split evenly between the UK and Spain, I pay all the contributions required of me. I have a UK address and a Spanish address, my wife, my dog, my house are all UK, in fact my wife does not have any Spanish residency and comes here under 90/180 rules which keeps me very much as having an "anchor" in the UK.


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## kaipa

UK nationals who no longer live in the UK

Because the NHS is a residency-based system, under NHS rules UK nationals who move abroad on a permanent basis lose their entitlement to free NHS healthcare.

UK nationals living and working in EU countries, Norway, Iceland, Liechtenstein or Switzerland on or before 31 December 2020 and their family members may be eligible to use NHS services without charge. They are advised to check with the relevant authority in the member state where they live for further information before travelling to the UK.

UK nationals who moved to the EU on or after 1 January 2021 should not expect to use NHS services for free when visiting the UK unless they have an EHIC, PRC or S2 to show that their healthcare costs are funded by the EU country where they reside, or another exemption applies.

Any treatment that may have to be paid for will be charged at 150% of the national NHS rate.

The UK government always advises visitors to the UK to take out travel or health insurance that has the necessary healthcare coverage for their needs. This is particularly important for those with pre-existing health conditions. Appropriate insurance means visitors may be able to recoup any treatment costs from their insurer


I still dont understand you. The NHS is resident based and you are not a UK resident you are Spanish. Just because you recieve your income from UK doesn't give you residence there. You seem to insist that you have legal residency in both countries and as far as I know this is not possible ( unless you interpret it more semantically). Now I might be wrong but this has been discussed numerous times here on the forum and each time people ( more knowledgeable than me) have said that such a situation is not possible. I am not trying to pick a fight as if you are right then this means that it would be advantageous for me as I intend to return to UK next year and the fact that I could keep my Spanish residency as well as having UK residency would be great


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## manuka

Glynb said:


> Yes, this is my understanding.
> Holidaymakers are covered by EHIC still. UK State Pensioners are covered via S1.
> Employees and self-employed in Spain are covered by their work contributions.
> So if you don't fall into any of those categories, you either pay for private health care, pay for the Convenio Especial (which doesn't cover medication costs) or, if you're still registered, pop back to the UK and use the NHS (presumably keeping schtum about your Spanish Residency!).



Using this thread as hope it is the best option rather than start a new one!

I am British, have my S1 and receive UK a state pension. Been in Spain since Feb 2022, with my EU spouse and we have gone through all the hoops with lawyer, which included getting private health insurance. Have a temporary document to show residency now, and waiting for appointment in Benidorm with Police to get the final residency doc.
I have been using private health care as we had to have that when we first came to Spain. 

I have been paying for my prescriptions at the chemist. My question is: if I show my S1 at the farmacia do I get that medication free?


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## xabiaxica

manuka said:


> Using this thread as hope it is the best option rather than start a new one!
> 
> I am British, have my S1 and receive UK a state pension. Been in Spain since Feb 2022, with my EU spouse and we have gone through all the hoops with lawyer, which included getting private health insurance. Have a temporary document to show residency now, and waiting for appointment in Benidorm with Police to get the final residency doc.
> I have been using private health care as we had to have that when we first came to Spain.
> 
> I have been paying for my prescriptions at the chemist. My question is: if I show my S1 at the farmacia do I get that medication free?


No. You need to register the S1 at the INSS first & then apply for a _tarjeta sanitaria_ at the local _centro de salud._

In most areas (most) pensioners pay 10% of prescription costs. If you live in the Comunidad Valenciana prescriptions are free for most pensioners. It's income-linked.


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## Dario Gray

Andaluz said:


> I'd never previously heard of, what for me, seems to be an important April 2012 reference.
> 
> I'm a UK passport holder, not currently working but have had a permanent residence in Spain, since the mid 90's.
> 
> Does this mean I will continue to have ongoing access to state healthcare in Spain, without having to pay a monthly fee ?


I have the A4 green Residency certificate dated MAY 2011 so I was issued my residency before the same said important cut-off date of 24th APRIL 2012 . Going to get in touch with the NHS overseas Health Services to issue me with a ' legislation Letter' [ documento de no exportacion'] in Spanish stating that the NHS does not cover my health care expenses whilst in Spain and to take to the INSS office then they should give me a document to take to my local health centre. Have been a full time living in house carer for my mother hear in Spain and receive a UK carers allowance I've never paid into the Spanish system . Any comments on my situation would be appreciated


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## Overandout

Dario Gray said:


> I have the A4 green Residency certificate dated MAY 2011 so I was issued my residency before the same said important cut-off date of 24th APRIL 2012 . Going to get in touch with the NHS overseas Health Services to issue me with a ' legislation Letter' [ documento de no exportacion'] in Spanish stating that the NHS does not cover my health care expenses whilst in Spain and to take to the INSS office then they should give me a document to take to my local health centre. Have been a full time living in house carer for my mother hear in Spain and receive a UK carers allowance I've never paid into the Spanish system . Any comments on my situation would be appreciated


I assume that the carer's allowance is a transferable benefit which you are entitled to while being a resident in Spain?
If so, I can't see any problem in getting the letter declaring that you have no rights to NHS services.

It will be very intersting to see if you are granted asegurado ststus on the basis of being here since before private healthcare was a requirement. Perhaps this is where the confusion has come from all along, it's not being a permanent resident, its being a resident since pre 2012.

Please let us know how you get on.


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## Dario Gray

xabiaxica said:


> Afraid not, but over the past several years we've discussed this on various forums & privately, & although people have come forward to say that they have applied, none have succeeded, except those who were resident before April 2012. April 24th iirc.
> 
> When the Spanish govt changed its healthcare rules for nationals in Oct 2012, it was required to include residents. They added a caveat that you had to be registered as resident before April 2012 in order to qualify.
> 
> Prior to this date even Spanish nationals didn't have automatic right to healthcare unless they were working. If they stopped work, they lost their right to healthcare.
> 
> I'm not sure if it's a coincidence, but the claim seems to have first appeared on the UK govt webpage around the beginning of 2018.


I have the A4 green Residency certificate dated MAY 2011 so I was issued my residency before the same said important cut-off date of 24th APRIL 2012 . Going to get in touch with the NHS overseas Health Services to issue me with a ' legislation Letter' [ documento de no exportacion'] in Spanish stating that the NHS does not cover my health care expenses whilst in Spain and to take to the INSS office then they should give me a document to take to my local health centre. Have been a full time living in house carer for my mother hear in Spain and receive a UK carers allowance I've never paid into the Spanish system . Any comments on my situation would be appreciated


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## Dario Gray

Overandout said:


> I assume that the carer's allowance is a transferable benefit which you are entitled to while being a resident in Spain?
> If so, I can't see any problem in getting the letter declaring that you have no rights to NHS services.
> 
> It will be very intersting to see if you are granted asegurado ststus on the basis of being here since before private healthcare was a requirement. Perhaps this is where the confusion has come from all along, it's not being a permanent resident, its being a resident since pre 2012.
> 
> Please let us know how you get on.


I will let you know how I get on


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