# Insulin Pump & Convenio Especial



## mikea2 (Jun 25, 2017)

Spouse is a type 1 diabetic using an insulin pump. We are considering retirement to Spain where we eventually would be eligible for the Convenio Especial. If I understand correctly we would have to pay for our medications. A couple of questions...

1. Does this mean a pump replacement would be at our expense? Anyone know what they cost in Spain?
2. It appears that there are discounts for prescriptions (40% I believe). Would we be eligible for these even though we have to purchase our own drugs?
3. Can anyone comment on prescription costs. I did find some info the seems to indicate insulin (Novolog) is around 30 Euros per vial, vs $285 here in the states.

Thanks for your help.

Mike


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## xabiaxica (Jun 23, 2009)

mikea2 said:


> Spouse is a type 1 diabetic using an insulin pump. We are considering retirement to Spain where we eventually would be eligible for the Convenio Especial. If I understand correctly we would have to pay for our medications. A couple of questions...
> 
> 1. Does this mean a pump replacement would be at our expense? Anyone know what they cost in Spain?
> 2. It appears that there are discounts for prescriptions (40% I believe). Would we be eligible for these even though we have to purchase our own drugs?
> ...


:welcome:

With the convenio especial, you pay the full costs for all medication. There are no discounted prescriptions under this scheme. 

I can't comment on insulin pumps, although I used to know someone who had full access to the state health system, including discounted prescriptions, who bought their own testing strips.


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## mikea2 (Jun 25, 2017)

Thank you. I think my misunderstanding was the places I saw that prescriptions were available at 40% or 10% for chronic conditions. If I understand correctly that's the case if prescription coverage is provided, we would call it a copay in the US. Since there is no coverage, there is no copay we end up at full price.

This would mean we could be out $5K to $10k for a new insulin pump if something happened to the current one.

Thanks again.


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## xabiaxica (Jun 23, 2009)

mikea2 said:


> Thank you. I think my misunderstanding was the places I saw that prescriptions were available at 40% or 10% for chronic conditions. If I understand correctly that's the case if prescription coverage is provided, we would call it a copay in the US. Since there is no coverage, there is no copay we end up at full price.
> 
> This would mean we could be out $5K to $10k for a new insulin pump if something happened to the current one.
> 
> Thanks again.


If you have full access to the health service as an employed person, or pensioner, you pay a percentage of the actual price of the medication. The percentage paid depends upon your personal circumstances.


As a working person, I pay 50% of medication costs. Pensioners with a state pension from Spain or a country with a reciprocal agreement - mostly EU countries, & an annual income below 18,000€ pay 10% with a sliding scale upwards for higher incomes. In my region, all pensioners get free medication. 
There are caps on the costs of some medications for chronic conditions.

None of these discounts apply to private healthcare, nor to the convenio especial. 

Though some private healthcare companies might offer a way of claiming back medication costs from them, the discounts won't be at source - that's to say, you'll still pay the full amount at the farmacia.


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## mikea2 (Jun 25, 2017)

*What about becoming an autonomo?*

A friend suggested I might become an autonomo. I'm a Certified Public Accountant in the US. If I were to do contract work for my current employer could that enable me to pay into the Spanish system?

If that's possible is there a minimum amount I would have to make?

I'm 62 now, what would happen if I decided to retire in 3 years? could I still pay into the system and maintain coverage?

In addition to the 260 Euro per month into the spanish system are there other costs for health insurance?

I'm aware there are other costs in being an autonomo but if I only worked with US clientele I think I avoid the VAT. 

Maybe I'm making this too convoluted but would like to make sure I understand all my options..

Thank you.


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## xabiaxica (Jun 23, 2009)

mikea2 said:


> A friend suggested I might become an autonomo. I'm a Certified Public Accountant in the US. If I were to do contract work for my current employer could that enable me to pay into the Spanish system?
> 
> If that's possible is there a minimum amount I would have to make?
> 
> ...


You'd need to get a work visa to be able to do that.


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## mikea2 (Jun 25, 2017)

*Difficulty of getting a work visa?*

Thanks for your help. I appreciate your time to discuss this with me.

Is it difficult to get a work visa? I understand I would need a business plan, maybe a contract from my client, etc. Would it just be rejected because I'm not doing business with people in Spain?

If I did get the visa what happens if I retire in 2 or 3 years? Would I lose access to healthcare? What if I don't make a profit but earn just enough to cover the social security costs?

The one thing I keep reading is that people find being an autonomo expensive because they have to pay each month regardless of income. For us it would seem to be a matter of paying 300 € this way or (upon turning 65) paying 300 € and paying full price for prescriptions. The other hassle would be the various tax forms that we would have to file regularly. I don't want to break any laws in doing this. I would actually be working for a firm here in the US that would allow me to work from there as a courtesy to me.

Thanks again for your input.


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## xabiaxica (Jun 23, 2009)

mikea2 said:


> Thanks for your help. I appreciate your time to discuss this with me.
> 
> Is it difficult to get a work visa? I understand I would need a business plan, maybe a contract from my client, etc. Would it just be rejected because I'm not doing business with people in Spain?
> 
> ...


My monthly autónomo payments aren't much less than 300€ a month, & I pay income tax on top of that & I submit quarterly tax returns. It's possible to do those yourself, but I use a gestor & pay about 60€ a month - but they do everything for me.

I'm not sure you'd actually be better off.

Yes work visas are hard to come by. Usually you need a contract with a company in Spain, & they have to prove that no EU citizen is available to fill the position.

What you are suggesting might secure you a non-lucrative visa. That depends on the consulate. Some issue them to those who work remotely, some don't.

That wouldn't change the healthcare issue for you though. 


Have a read of this from the Chicago consulate. It mentions self-employment, but doesn't say how much the 'required capital' is. http://www.exteriores.gob.es/Consul...cago/Documents/documentosvisados/autonomo.pdf


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## mikea2 (Jun 25, 2017)

*Thank you...*

I think that brings us back to where it began. I do appreciate you help and willingness to share your knowledge.


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