Information for Spanish citizens

• One-stop shop for Brexit of the Spanish Embassy in London

Information for the citizens of the United Kingdom

Access to the Spanish public health system for people entitled to health care by the UK’s National Health Service (NHS) following the withdrawal of the United Kingdom from the European Union is guaranteed until 31 December 2020 by the Withdrawal Agreement agreed last November between the European Union and the United Kingdom, still pending the ratification process in the British Parliament.

The guarantees offered by the Withdrawal Agreement are as broad as possible, maintaining the right of UK citizens to continue to receive health care in all EU Member States on the same terms as if they continued to be EU citizens and vice versa.

However, in the event that the agreement is not ratified, the Spanish Government has approved Royal Decree-Law 5/2019, of 1 March, which adopts contingency measures for the withdrawal of the United Kingdom of Great Britain and Northern Ireland from the European Union without having reached the agreement provided for in Article 50 of the Treaty on European Union.

In relation to access to health care, article 13 of the Royal Decree-Law establishes that Spain will continue to provide nationals of the United Kingdom with health care in Spain on the same terms and under the same conditions established prior to the UK's withdrawal from the European Union, provided that the UK:

• Guarantees these same conditions to those who are entitled to receive health care in the United Kingdom at Spain's expense, reciprocity that will be subject to verification 2 months after the entry into force of the Royal Decree-Law.
• Guarantee the reimbursement of expenses for health care provided in Spain by health services on the same terms as at present.

Finally, it is important to remember that the right to health care by British entities will take priority over any possible right to health care arising from residence or stay in Spain.

1. 1. National tourists from the United Kingdom in Spain

   I am a citizen of the United Kingdom and want to travel as a tourist to Spain at a later date than the date of the United Kingdom's withdrawal. Will I be entitled to health care in Spain? What document will I have to provide?

   • With Withdrawal Agreement:

     Yes, your situation will not change, the European Health Insurance Card will be the document that allows you to receive health care during your travels, as the Community Regulations will continue to apply.

   • Without Withdrawal Agreement:

     Yes, the contingency measures adopted by the Government of Spain guarantee your health care during temporary stays, provided that the competent British authorities grant reciprocal treatment to Spanish citizens.

     You will be treated in the health centres of the National Health System by presenting the document accrediting the health coverage provided by the corresponding British entities (NHS).

2. British students in Spain

   I am a citizen of the United Kingdom and I am studying a phD / masters / ERASMUS scholarship in Spain. Will I have the right to healthcare?

   • With the Withdrawal Agreement: Yes, you have the right to receive healthcare if you are the holder of the European Health Insurance Card (EHIC) or, if your university or research centre sends you temporarily to Spain, is still covered by the British health system, so you must request an S1 form in the United Kingdom before leaving.
   • Without the Withdrawal Agreement:

     Yes, the contingency measures adopted by the Government of Spain guarantee health care for students entitled to healthcare in the United Kingdom during their stay in Spain, provided that the British authorities grant a reciprocal treatment to Spaniards.

     You will be treated at the healthcare facilities integrated in the Spanish National Health System by presenting the document accrediting health coverage by the corresponding British institution (NHS).

3. UK national workers resident in Spain

   • 3.1. I am a citizen of the United Kingdom and work permanently in Spain. Am I entitled to free health care? How can I prove this if I am asked to do so?
     • With Withdrawal Agreement:

       Yes, Spanish legislation guarantees health care to all workers registered with the Spanish Social Security. In this case the recognition of the right is automatic, you will not have to carry out any procedure.

       You will be treated in the health centres of the National Health System by presenting the health card issued to you by the Autonomous Communities of your place of residence.

       Health cards issued prior to the date of withdrawal will remain valid and will be fully effective for receiving health care in Spain.

   • 3.2. I work in Spain; is my family entitled to health care?
     • With Withdrawal Agreement:

       Yes, a relative of a national of the United Kingdom who works legally in Spain, as long as he or she is authorised to reside and actually resides in Spain, is entitled to health care.

       It applies to the worker’s descendants who are under 26 years of age or disabled if they are dependent on and live with the worker, as well as to their spouse or unmarried partner.

     • Without Withdrawal Agreement:

       Yes, Spanish legislation guarantees health care to the descendants of the worker who are under 26 years of age or disabled, provided that they are dependent on and live with the worker, as well as their spouse or unmarried partner. Family members must be authorised to reside in Spain and effectively reside there.

       Your family members will be cared for in the health centres of the National Health System, presenting the health card issued to them.

   • 3.3. Which services of the Spanish National Health System are free?
     • With and without a Withdrawal Agreement:

       Persons who hold a Spanish health card or who can prove that they are entitled to health care in the United Kingdom or Gibraltar do not have to pay for care in the Spanish public health system, as the cost of their care will be borne by Spain or the United Kingdom, which will reimburse the costs to the Spanish State.

   • 3.4. If I am not considered a habitual resident in Spain, can I be asked to pay for health care?
     • With Withdrawal Agreement:

       Foreign visitors who do not have a health card from the Spanish National Health System or do not provide a document accrediting the health coverage provided by British entities may be charged by the Spanish National Health System for the services provided.

     • Without Withdrawal Agreement:

       Foreign visitors who do not have a health card from the Spanish National Health System or do not provide a document accrediting the health coverage provided by British entities may be charged by the Spanish National Health System for the services provided.

   • 3.5. How will planned treatments be affected by the departure of the United Kingdom from the EU?
     • With Withdrawal Agreement:

       They will not be affected.

     • Without Withdrawal Agreement:

       The contingency measures adopted by the Government of Spain ensure that persons entitled to health care in the United Kingdom or Gibraltar continue to benefit from scheduled treatments after the United Kingdom's departure from the European Union, provided that the competent British authorities grant reciprocal treatment to Spanish citizens.

4.  UK national workers posted by their employers to work in Spain

   I am a national of the United Kingdom, my company is based in the UK but it is going to temporarily post me to Spain. Am I entitled to health care?
   • With Withdrawal Agreement:

     Yes, the Withdrawal Agreement ensures that Community Regulations continue to apply. A company can send a worker to another country while maintaining contributions in the country of origin. As a posted worker, you can work temporarily in an EU country and remain registered with the UK social security system for a period of two years during which your social security rights, including health benefit, remain unchanged

   • Without Withdrawal Agreement:

     Yes, the contingency measures adopted by the Government of Spain provide for posted workers, subject to British law who reside and work legally in Spain, to be able to maintain their status until the date of withdrawal of the United Kingdom from the European Union.

     This provision will apply in the same cases, provided that the competent British authorities grant reciprocal treatment to workers subject to Spanish law who reside and work in the United Kingdom or Gibraltar.

5.  United Kingdom national cross-border workers residing in Gibraltar

   I am a national of the United Kingdom and I travel daily to work in Spain. Will I be entitled to health care?
   • With Withdrawal Agreement:

     Yes, you will maintain the right.

   • Without Withdrawal Agreement:

     Yes, the contingency measures adopted by the Government of Spain guarantee the documentation of cross-border workers and health care in Spain to nationals of the United Kingdom who on the date of the withdrawal travel to work legally in Spain, provided that the competent UK authorities grant reciprocal treatment to Spanish citizens.

6. UK pensioners covered by British Social Security resident in Spain

   In the case of UK pensioners resident in Spain, will their access to health care in their place of residence be affected after Brexit?
   • With Withdrawal Agreement:

     Their right to health care will not be affected, Community Regulations will continue to apply.

   • Without Withdrawal Agreement:

     No, pensioners covered by the British National Health System (NHS) will continue to receive health care in Spain provided that the United Kingdom guarantees the same right to pensioners under the Spanish health system resident in the United Kingdom or Gibraltar and reimburses Spain for the cost of health care provided to persons covered by the British health system during their residence or stay in Spain.

     The Spanish health cards issued to them will remain valid and will be fully effective for receiving health care in the services of the Spanish National Health System.

     When the pensioner covered by the British health system (NHS) residing in Spain does not have a health card, he or she must present to the National Social Security Institute (INSS) the document accrediting the right to health care at the expense of British entities.