Healthcare System


The Spanish healthcare system combines both private and public contribution by various provincial governing bodies. These pages tell you how to get yourself into the system and what’s involved when dealing with the insurance scheme.

Here’s also where you find out what to do if you fall ill – who to call and what to say – with a comprehensive list of local emergency numbers. As well as what to expect from the Spanish system if your family is growing.

Healthcare System Healthcare Benefits & Cards Doctors & Emergencies European Agreements European Health Insurance  Healthcare for non-EU citizens Health Insurance Healthcare Abroad

Healthcare System

The Spanish healthcare system is funded by social security contributions and combines public and private healthcare. Citizens who pay social security automatically have the right to use the Spanish healthcare system. The government sets the overall budget for the country, but each region takes individual responsibility.

To benefit from the Spanish National Healthcare system and medical assistance, residents must enrol with the General Social Security Fund (Dirección General de la Tesorería General de la Seguridad Social - TGSS). This gives access to free or low cost healthcare. Provincial social security offices are located throughout the country.

Private medical insurance, as well as the Special Agreement (Convenio Especial), which allows people to access the state-run healthcare service by paying a monthly fee, is also available to those not covered by the security and healthcare system.

The Healthcare System

Any person legally resident in Spain can benefit from the Spanish social security and healthcare system provided they fall into one of the following categories:

  • Employed workers
  • Self-employed workers
  • Students
  • Workers affiliated with a work co-operative
  • Civil servants or military personnel

Contributions

Spain's social security system has two levels:

  1. Contributory: The contributory scheme consists of one general and five special schemes, which includes the majority of the working population. Students are covered by a special protection plan.
  2. Non-contributory: The non-contributory level is for people with no or with a very low income. The benefits include medical assistance.

Social Security Number

Any resident, either salaried or self-employed, is issued with a social security number. This entitles a person to healthcare, sickness, unemployment benefits, as well as government pensions. Once a number is obtained, it is valid for life.

Employers request a social security number for an employee if they don't already have one. Self-employed workers may make the application themselves or hire a gestor to complete the process for them.

The application form and required documentation should be presented to a local office (local to the applicant's workplace or home) of the TGSS. Once the application has been submitted, the worker receives a certificate of registration (documento de afiliación) and a registration number.

The following documents must be presented:

  • A form of national identification with one photocopy; a Número Identificatión de Extranjero (NIE) is sufficient
  • Residency certificate or passport with one photocopy
  • Form TA1 (PDF)

If a person loses their job or ceases to work, they must notify the Tesorería General de la Seguridad Social immediately. The worker is liable for contributions until the agency is notified.

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Healthcare Benefits & Cards

Qualifying for Healthcare in Spain

Qualifying for healthcare through the social security system

Any person who is not affiliated with the Spanish social security system may choose to take out private health insurance or pay the full amount of any medical costs.

In April 2012, Spain introduced a healthcare reform law that affects who is entitled to free treatment under the social security system. Restrictions apply to both residents and non-residents.

The following residents are entitled to free healthcare under the Spanish system:

  • State pensioners resident in Spain, including state pensioners from a country that has a mutual agreement with Spain. This includes all countries in the European Economic Area (EEA)
  • Employees and self-employed workers registered with social security and paying Social Insurance
  • Residents in receipt of certain social security benefits in Spain, or in countries that have a mutual agreement with Spain
  • Those who had registered for social security payments, but whose entitlement has now expired
  • Those recently divorced or separated from a partner who is registered with social security and paying into the Social Insurance fund

Non-registered foreigners from the EU and countries that have reciprocal agreements with Spain are eligible for treatment, provided they meet one of the above conditions. The spouses and children of people in the above categories are also eligible for free medical treatment, even if the partners are divorced or separated. Their children will only be eligible if they are under the age of 26.

Residents who do not belong to the above categories remain eligible for free healthcare services in Spain as long as their pre-tax income from all sources does not exceed €100,000 per year. There are exceptions, including early retirees whose social security contributions to an EU country have met certain levels defined by regional authorities. For more details, residents unsure of their status should contact their embassy.

The following non-residents are also eligible for free healthcare:

  • Students under the age of 26 studying abroad in Spain
  • EEA citizens temporarily visiting Spain with a European Health Insurance Card (EHIC). This entitles the bearer to free emergency medical treatment for three months. The hospital or clinic treating the visitor will decide whether the treatment qualifies as an emergency

Emergency care remains free regardless of an individual's status, as does pregnancy care. This includes prenatal and postnatal care, as well as giving birth.

Applications should be made at a local social security office (INSS) and the following documents must be presented:

  • Valid passport or national identity card
  • Residency certificate
  • Padron certificate
  • A signed declaration stating that the applicant is not covered by health care by any other means
  • Copies of all of the above documents

Claiming healthcare through the social security system

Once registered with social security, a certificate entitling medical assistance is issued. This document can be used to apply for a health card (Tarjeta Sanitaria Individual - TSI) at the local health centre. Once registered at the local medical centre a SIP card will be allocated. A SIP card (Sistema de Informacion Poblacional) is issued to each person registered with the Spanish state health system and should be presented whenever attending a clinic, hospital or collecting prescribed medication from the chemist.

Social security pays a percentage of the cost of treatment and hospitalisation; the patient pays the remaining amount or takes out supplementary health insurance. Spain uses a co-payment system for prescriptions, meaning residents must pay a certain percentage towards prescription charges.For workers with an annual income of less than €18,000, prescribed medicines are covered up to 40 percent by social security and 10 percent for pensioners with a cap of €8 per month. Those with an annual income of €18,000-€100,000 are covered for 50 percent of the cost and pensioners 10 percent with a cap of €18 per month. Workers and pensioners with an income of over €100,000 must contribute 60 percent to the cost of prescribed medicines, with a cap of €60 per month for pensioners.

  • A guide to co-payments for UK pensioners and those of working age can be found on GOV.UK

Official prescriptions are green, when part of the cost must be paid by the patient; pensioners prescriptions are red.

Cards are individual - children and adults each have their own - and are valid for four years. The SIP card carries the following information: full name of card holder, social security number, NIE number (DNI for Spanish citizens), type of user (such as worker or pensioner) and the expiry date.

To get a SIP card, apply at the local health centre taking the social security certificate, passport and NIE/DNI certificate. The health centre issues a receipt, which has the same function as the card itself and can be used immediately; the SIP card is sent to the applicant and their beneficiaries by post. Beneficiaries are family members who are dependent on the worker or pensioner.

Qualifying for healthcare outside of the social security system

People who are not entitled to access free healthcare in Spain must take out comprehensive private medical insurance or join the Special Agreement (Convenio Especial). The Convenio Especial is a health insurance scheme run by the Spanish Government which allows people to access the state-run healthcare service by paying a monthly fee, not including prescription costs. Applicants need to be registered residents for one year before they can qualify for the scheme. The scheme costs 60 Euros for under 65s and 157 Euros for those aged over 65 and above. It is not yet available in all regions. More information about the Special Agreement can be obtained from a local social security office.

There are many international companies providing health insurance to foreign residents. International health insurances offer basic policies, as well as comprehensive policies, normally with a 24-hour help line in English.

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Doctors & Emergencies

The Spanish Health Service offers an extensive network of hospitals and health centres throughout the country, Health centres offer primary health care services and hospitals more specialised attention. To receive medical treatment, those enrolled in the Spanish social security programme should visit a public health centre (centro de salud) in their area of residence (normally located within 15 minutes of any place of residence), or their general practitioner (médico de cabecera). They will be referred to a specialist if necessary, however, there can be waiting lists to see specialists and for non-urgent operations. In rural areas health centres are only open on certain days.

Lists of English-speaking health professionals can be found at many tourist offices and through Embassies or Consulates.

All doctor’s offices must provide the leaflet Carta de Derechos y Deberes (Charter of Rights and Obligations), outlining the services patients are entitled to.

Medical Emergencies

In case of an emergency go directly to a hospital, where emergency services are generally available. Casualty or A&E departments are called 'Urgencias'.

A social security card, a European Health Insurance Card (EHIC) or proof of private insurance should be presented at the hospital. The EHIC card gives the right to free emergency treatment for residents of EU/EEA countries in state hospitals or clinics only. Treatments not qualifying as an emergency are not free.

Bilateral agreements exist with some countries such as Peru, Paraguay, Ecuador, Chile, Brazil and Andorra. Citizens from these countries may benefit from free medical treatment in cases of medical emergencies or accidents. Citizens of other countries should have private medical insurance when travelling to Spain.

  • For emergency services, Tel: 112

Pharmacies

Pharmacies (farmacias) are widely available and can be identified by a large green cross signage. In order to exercise their various professional activities, pharmacists must register with the appropriate provincial Pharmaceutical Association. All of the Pharmaceutical Associations form part of a national body, the Consejo General de Colegios Oficiales de Farmacéuticos (General Spanish Council of Pharmacists). Registered pharmacists are able to provide first line care and consultation.The association's website provides useful information in English, including health advice and a vaccination calendar.

Pharmacies are generally open from Monday to Friday from 09:30 to 14:00 and 17:00 to 21:30, and Saturday 09:30 to 14:00. Information about pharmacies open 24 hours a day (Farmacia de guardia) can normally be found on the window or doors of any pharmacy.

Dental Procedures

Dental treatment is not covered by social security. Private health insurance can cover dental treatments if this has been opted for in the policy.

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European Agreements

Agreements between European countries and Spain affecting health cover...

The European Health Insurance Card (EHIC) is not valid for healthcare in Spain if the holder is a resident of Spain.

European Conventions and Form S1 (former E121 and E106)

A person who has paid regular social security contributions in another EU country for two full years before coming to Spain can benefit from public health cover for a limited period, from the date of their last social security contribution made in the other EU country.

To do this, it is necessary to obtain Form S1 (former E106) and present it to the local Social Security office in Spain. Pensioners and those in receipt of invalidity benefits must obtain the Form S1 (formerly E121) from their home country's social security administration.

Retired EU Citizens living in Spain

EU nationals who have reached the retirement age as established in their home country, and are residents in Spain qualify for free health care provided they have a Form S1 (former E121), obtained from the former country of residence.

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European Health Insurance 

The EHIC or "Health Card" enables holders to access medical resources when travelling outside of their EU country of residence...

European citizens and residents travelling within the European Economic Area, (i.e. the European Union, Norway, Iceland and Liechtenstein) and Switzerland, for private or professional reasons are entitled to a European Health Insurance Card (EHIC), which simplifies the procedure when receiving medical assistance during their stay in a member state.

The EHIC entitles the holder to the same treatment at the same cost as a national of that country. For example, if medical care is provided free of charge in the member state where treatment is required, the claimant will be entitled to free medical care on presentation of the card or an equivalent document. However if a fee is normally applicable, this may need to be paid at the time of treatment.

Note: Rule changes in 2014 now means that it is generally not possible to apply for reimbursement of medical fees normally paid by a resident or citizen of the treating country, even if a patient would normally pay nothing in their home country. However, the implementation of this change varies from country to country so it is advisable to confirm this with your health insurer upon returning home.

The card is only valid for state provided services and not private hospitals or treatments.

It is also not an alternative to travel insurance as it only covers medically necessary services.

Note: Third-country nationals (from outside the EU/EEA) resident in the EU and holding an EHIC cannot use their EHIC in Norway, Liechtenstein or Switzerland. In Iceland, non EU/EEA nationals are only covered for emergency treatment. Holders of an EHIC in Denmark will only be eligible for free treatment in a public hospital in the event of:

  • A sudden illness
  • An unexpected aggravation of a chronic condition
  • An emergency
  • Childbirth

The Card

Cards are issued by the institution that provides health insurance in the country of residence. The only personal information on the EHIC is the card holder's surname and first name, personal identification number and date of birth. The card does not contain medical data. It contains the same information in all countries where it is issued.

The card validity period varies from country to country.

Applying for a card

Many EU countries issue the EHIC by printing the distinctive EU symbol and other relevant information on the reverse side of the standard-issue national health card or its equivalent. For those countries that require a separate application, the Europa website publishes the application process applicable to each EEC member state and Switzerland.

EHIC Smartphone Application

The European Commission (Directorate General Employment, Social Affairs and Inclusion) has developed a useful multi-language smartphone application which gives details of how to use the EHIC in different countries within the EU. It summarises the treatments, costs, procedure for reimbursement and emergency numbers.

The EHIC in Spain

The EHIC is called a Tarjeta Sanitaria Europea (TSE) in Spain. It allows legal residents of Spain to benefit from emergency medical treatment and care when temporarily in a member country.

Anyone covered by the Spanish social security system or a system is entitled to a TSE.

Residents of Spain can apply to the local Social Security Service and Information Centre (CAISS) for the card. No online application is available.

Note: The TSE cannot be used in Spain to make medical claims. The EHIC (TSE) is for use when visiting a member state other than the country of residence where the card has been issued. That means a resident of Spain with a TSE may use it while travelling in other EU/EEA countries.

Foreign nationals permanently resident of Spain paying into the Spanish social security system must obtain their EHIC (TSE) in Spain; the card will not be issued by the applicant's country of origin.

Non-residents Claiming in Spain

Doctors and Dentists: Present the EHIC card immediately and ensure that the doctor is not a private physician; there is no refund system for private treatment unless there is a private insurance policy in effect. Dentistry is not usually covered by the health service and as such fees will not be refunded.

Prescriptions: State (EEA) pensioners (with proof of status) are eligible for free prescriptions, all other cases must pay up to 40 percent of the total cost.

Hospital Treatment: Confirm that the treating hospital is not private; otherwise the patient is liable for the entire treatment cost. Present the EHIC upon arrival.

Further Information

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Healthcare for non-EU citizens

Find out when you are entitled to Spanish public healthcare, when you are covered by bilateral treaties between your home country and Spain, and when you will need to buy private health insurance…

Non-EU citizens who are legal residents of Spain are generally able to access the public health system like any other Spanish citizen. See the Healthcare in Spain page for a list of those who qualify.

Anyone under 18, regardless of nationality, is also able to access the public healthcare system and be treated in the same manner as a Spanish citizen. This right is extended to pregnant women (regardless of age or nationality) during their pregnancies, the birth, and post-natal care in Spain.

Bilateral agreements with non-EU countries

Nationals of countries with which Spain has bilateral healthcare agreements will be given free emergency treatment upon presentation of their Certificate of Right to Medical Care. This certificate is issued by the patient’s home country before leaving for Spain and confirms that the bearer has contributed to their local social security system. It is also possible for nationals of these countries to register for Spanish healthcare online in some regions. See the Asturias online portal for an example.

Spain currently has bilateral healthcare agreements with:

  • Andorra
  • Brazil
  • Chile
  • Ecuador
  • Paraguay
  • Peru
  • Morocco (only those working in Spain)
  • Tunisia (only those working in Spain)

This entitles visiting nationals from these countries access to free emergency treatment in state hospitals in the event of an accident or illness. Valid certificates must be presented.

Temporary stays

For temporary visits, non-EU citizens who need a visa to visit Spain will usually be asked to provide proof of medical insurance as part of their visa application. This applies to holidaymakers and some students. Medical coverage may or not be included in a travel insurance package.

Non-EU citizens who can visit Spain without a visa are strongly encouraged to take out travel insurance that will cover any medical expenses incurred. Insured or not, these visitors will need to pay their medical expenses on the day. For those with insurance, reimbursement must be negotiated with their insurance company, not with the medical provider. Occasionally payment may be deferred if the patient signs a Declaration of Ability to Pay but this depends on the individual facility and is exceedingly rare for a visit to a General Practitioner.

Private Insurance

As many public health facilities in Spain also offer private facilities, some Spanish citizens and residents as well as non-EU citizens buy private health insurance, especially as the public health system does not cover dental care.

Private health insurance may also cover the gap between the subsidised portion of prescriptions and hospitalisation and the portion paid by the patient.

There are many English-speaking companies that sell Expat Health Insurance. For those already living in Spain, comparison engines like Rastreator (in Spanish) are an easy way to see available policies.

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Health Insurance

Information on the Spanish national health care system, with details on who benefits, where and how to register with the authorities and what contributions and benefits to expect.

It is compulsory for all workers resident in Spain to be enrolled with the General Social Security Fund (Tesorería General de la Seguridad Social - TGSS). Provincial social security offices are located throughout the country. The Social Security website has some information available in English.

The National Institute of Social Security (Instituto Nacional de la Seguridad Social - INSS) provides information regarding social security benefits (excluding unemployment benefits), including eligibility. Provincial National Social Security Institute offices are located throughout the country.

Qualifying for Social Security

Any person legally resident in Spain can benefit from the Spanish social security system if they fall into one of the following categories:

  • Employed workers
  • Self-employed workers
  • Students
  • Workers affiliated with a work co-operatives
  • Civil servants or military personnel

There are two different schemes for Social Security:

  1. Contributory
  2. Non-contributory

The contributory scheme is for some civil servants, employed persons who are not eligible for a special scheme and special schemes for the self-employed , mariners and coal miners. All contributory workers will fall into one of six labour categories (régimen), with contribution rates differing from category to category. It is not possible for a person to be registered in more than one scheme for the same occupation.

For employees, a set percentage of earnings is payable and contributions to the social security system will begin as soon as employment begins. Both the employee and employer pay a percentage of the contribution, with the employer paying a larger percentage than the worker. Payments are made towards social security coverage for:

  • Illness
  • Non work-related injuries
  • Retirement
  • Maternity and paternity leave
  • Work-related-injuries and occupational illness
  • Overtime
  • Unemployment
  • Wage Guarantee Fund
  • Occupational Training

Employers make contributions for social security coverage for work-related injuries and industrial accidents.

Self-employed workers receive the same types of social security coverage as employees except they are not covered for unemployment or industrial accidents. Those who are self-employed may choose between a minimum (at least approximately 29 percent of earnings) and maximum contribution amount, and they are responsible for payment of the full amount.

Obtaining a Social Security Affiliation Number

Registration with the social security service is compulsory for everyone working in Spain. Any resident, either salaried or self-employed, is entitled to a social security number. Once a number is obtained, it is valid for life. Periods of employment are referred to as "altas" and periods of unemployment are called "bajos".

Employers need to request a social security number for the person they are going to employ if that person does not already have one.

Self-employed workers may make the application themselves or hire a gestor to complete the process for them.

The application form and required documentation should be presented to a local office (local to the applicant's workplace or home) of the Tesorería General de la Seguridad Social. Once the application has been submitted, the worker will receive a certificate of registration (documento de afiliación) and a registration number.

The following documents must be presented:

  • A form of national identification with photocopy; a Número Identificatión de Extranjero (NIE) is sufficient
  • Residency certificate or passport
  • Modelo TA1 (Social Security application form)

In the event a worker is made redundant or otherwise stops working, the Tesorería General de la Seguridad Social must be notified immediately. The worker is liable for contributions until the agency is notified.

Health Care Benefits

Once a person is registered with the Social Security administration they will be issued with a certificate giving them the right to obtain medical assistance. With this document they can apply for a health card (tarjeta de seguridad social) at their local health centre.

Once registered a SIP card will be allocated. A SIP card (Sistema de Informacion Poblacional) is issued to each person registered with the Spanish state health system and is should be presented whenever attending a clinic, hospital or collecting prescribed medication from the chemist.

People not qualified or affiliated

Any person who is not affiliated to the Spanish social security system may choose to to take out private health insurance or pay the full amount of any medical costs.

EU Country Benefits

European Conventions and Form S1 (former E121 and E106)

A person who has paid regular social security contributions in another EU country for two full years before coming to Spain can benefit from public health cover for a limited period from the date of their last social security contribution made in the other EU country. To do this, it is necessary to obtain Form S1 (former E106) and present it to the local Social Security office in Spain. Pensioners and those in receipt of invalidity benefits must obtain form S1 (former E121) from their home country's social security administration.

Retired EU Citizens

EU nationals resident in Spain qualify for retirement when they reach the retirement age as established in their home country (not at the retirement age set in Spain). Retired people receive benefits and pay nothing provided they have a Form S1 (former E121). This form entitles them to the same benefits as a Spanish national. S1 should be obtained from the former country of residence.

It certifies that:

  • appropriate social security taxes have been paid in that country
  • the holder has reached the official retirement age
  • the holder is receiving a State pension.

Note: The European Health Insurance Card  (EHIC) is not valid for healthcare in Spain if the holder is resident in Spain.

Spanish Doctors and Hospitals

To receive medical treatment, those enrolled in the Spanish social security program should visit a public health centre in their area of residence. They will be referred to a specialist if necessary, however there can be waiting lists to see specialists and for non-urgent operations. In case of an emergency go directly to a hospital. A social security card or proof of private insurance should be presented at the hospital.

Retirement and Pension Benefits

The general retirement age in Spain is 65 years old; however, new reforms will see the retirement age increase to 67 years. The change will be implemented gradually from 2013 to 2027. The retirement age will increase by one month per year until 2018, and then by two months per year from 2019 to 2027. Certain professions have younger retirement ages. Residents who have reached retirement age and paid at least the minimum Social Security contribution for at least 15 years, including two years out of the last 15, qualify for a retirement pension (pensión de jubilación) There will also be an increase from 15 to 25 years of Social Security contributions required to determine the regulatory base of the pension. The retirement benefit paid is based on contributions made over the worker's lifetime. From 2013 to 2027 the calculation will be gradually extended to the contributions made in the last 25 years.

Early retirement

Under new reforms the legal age of early retirement will rise from 61 to 63 years. For early retirement to be possible a minimum of 33 years of social security contributions are required.It may also be possible to retire at age 61 if social security contributions were made for at least 30 years and if registered as unemployed for at least six months prior to the application.

Disabled people and persons registered as unemployed for at least six months prior to the application may be entitled to retire at an earlier age.

How to apply for retirement benefit

A retirement pension application form must be completed and presented along with supporting documents (indicated on the application form) to a provincial National Institute of Social Security (Instituto Nacional de la Seguridad Social - INSS) office (mariners must submit their application to a provincial office of the Social Marine Institute (Instituto Social de la Marina- IMS). Required documents vary from case to case and it is suggested to inquire with the INSS.

The retirement application may be submitted during the three months prior to or following the date employment ends and payment will be effective from the day after retirement. If the application is submitted more than three months after the activity is terminated payment of the pension will begin with a maximum backdating of three months. The pension is paid monthly with two extra payments made with the June and November payments.

The retirement pension is terminated on the death of the pensioner.

Education Benefits

School insurance provides coverage for students for school-related injuries, illness and family crises (such as family bankruptcy or the death of the head of the household). Student under the age of 28, from the third year of compulsory education (ESO) to the third cycle (post-graduate) at university, are covered. The insurance pays for medical services (including pharmaceuticals) and provides financial support for disability and funeral expenses.

In order to be entitled to school insurance applicants must:

  • Be a Spanish citizens or foreigner residing legally in Spain
  • Be under the age of 28
  • Be registered for the studies covered by the insurance, and with the insurance fully paid up
  • Have been covered for at least one year (this does not apply to benefits related to school injury, family crisis and obstetrics or for students who have studied abroad or in the previous year been enrolled in the second year of ESO or special education)

Applicants must submit the school insurance application form and the personal documentation for each benefit as indicated on the application form. Necessary documents include:

  • National ID card or NIE for foreigners
  • Certificate from the education centre for non-university students
  • Proof of registration for university students
  • Specific documentation for each benefit
  • School insurance application form (PDF)

The application form and documentation may be presented at any of the Social Security Information and Support Centres (Centros de Atención e Información del INSS). Amounts vary depending on the benefit.

Recognition of the right to and payment of the benefits is decided by the Provincial Office of the National Social Security Institute (INSS) where the application was submitted. In the case of healthcare benefits, it is the responsibility of the Provincial Office of the INSS for the province in which the medical assistance was given.

Medical benefits must be requested prior to receiving health care except in the case of school-related injury and medical emergencies.

Maternity, Maternity Risk and Nursing Mother Benefit

Paid maternity leave (Permiso de la Maternidad) is available to most categories of employed as well as some self-employed women. Agricultural workers may be able to take temporary disability instead of maternity leave.

Maternity benefits begin from the day of giving birth or the date of the court decision on adoption or the administrative or court decision on fostering. The benefits can begin before giving birth, if it becomes necessary to begin maternity leave before the birth. The daily benefit amount is 100 percent of the average daily wage earned in the month prior to taking the maternity leave.

Eligibility for maternity benefit

To be entitled to maternity benefits it is necessary to have made social security contributions for a required period prior to the birth of the child or the taking of the leave. The minimum contributory periods are as follow:

  • Women under 21 years of age: no minimum period of contribution
  • Women 21-26 year of age: at least 90 days of contributions in the previous 7 years, or 180 days of contributions over their lifetime
  • Women over 26 years of age: at least 180 days within the previous 7 years, or for 360 days in their lifetime

In the case of part-time workers, only the contributions made on the basis of the number of hours worked shall be computed.

If a mother does not qualify for maternity benefit but the father does, the woman may take his available paternity leave as maternity leave. If both parents are employed, the maternity benefit can be shared by both and can be taken part-time.

How to apply for maternity benefit

The Maternity benefit application form is known in Spanish as the Solicitud de prestación de maternidad por nacimiento, adopción o acogimiento del Régimen Especial del Mar. Applications and supporting documents must be submitted to a provincial National Institute of Social Security (Instituto Nacional de la Seguridad Social - INSS) office.

Required documentation varies depending on whether it is a natural birth, adoption or fostering.

The doctor at the Public Health Care service will give the corresponding maternity report to the mother who will give the original copy to her employer. If the mother is treated by a private doctor, they must issue a report to be submitted to the Public Health Care specialist who is the only one with the authority to issue the necessary maternity report. This report will be filled in and returned to the mother. Along with the personal documentation, the application for maternity benefits and maternity report are sent to the Management Centre of the National Social Security Institute (INSS) or the Provincial Office of the Social Marine Institute (ISM).

Duration of maternity benefit

Duration of the benefit is 16 continuous weeks, except in the event of a premature birth or if the newborn must remain hospitalised after birth. In the case of multiple births, the period is extended by two weeks for each child. There is also an additional two weeks if the baby is born with a disability. If time is taken off work whilst pregnant for medical reasons, sixteen weeks of maternity leave after the child is born can still be taken. Maternity leave can be extended for up to thirteen weeks if a baby is born premature of has had to stay in hospital for more than seven days following the birth,

Maternity risk and nursing benefits

A subsidy is also available from the Spanish government for nursing mothers for 9 months after the baby's birth. This subsidy takes the form of two paid half-hour breaks daily to nurse or pump breast milk.

A subsidy is also available for pregnant women who must leave work when the job poses a risk to the pregnancy. The daily benefit amount is 75 percent of the average daily wage earned in the month prior to taking the maternity leave and is payable from the day the woman leaves work.

Paternity Benefit

A paternity subsidy is available to most categories of employed as well as some self-employed men when they take time off from work after the birth of their child or in the event they adopt or foster a child. The daily benefit amount is 100 percent of the average daily wage earned in the month prior to taking the paternity leave.

The benefit amount is calculated based on the wages and days worked in the previous month.

Eligibility for paternity benefit

Fathers must have contributed to social security for at least 180 days in the 7 years prior to taking the leave, or have made contributions for at least 360 days in their lifetime.

If both parents are employed, the maternity benefit can be shared by both and can be taken part-time. In the event of adoption or fostering, only one parent may take leave.

How to apply for paternity benefit

Applications and supporting documents must be submitted to a local Social Security Information and Support Centres (Centros de Atención e Información del INSS).

Required documentation varies depending on whether it is a natural birth, adoption or fostering.

Duration of paternity benefit

The paternity subsidy is paid for 13 days after the compulsory 2 days (4 days if travel was necessary for the birth) paid by the employer, though can be paid up to 20 days if the baby is being born into a large family (or the birth qualifies the family as being large), in the event of adoption, fostering or if there is a disabled member of the family. For multiple births, adoption or foster care, two additional days are added if a child is disabled or for each child after the second. In 2015 paternity benefit will increase to 30 days.

The paid leave can be taken as entire work days or at least half of a work day, with the approval of the employer. It begins from the end of any paid leave taken for the birth, adoption or fostering of a child until the mother's maternity leave ends, or from the legal adoption/fostering until the end of the mother's maternity leave.

Further Information

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Healthcare Abroad

Information on social security coordination between EU member states for obtaining medical coverage and planned health care...

European Union social security coordination enhances cooperation between member countries, and reduces the number of documents needed.

Note: This page discusses the forms needed by state pensioners relocating to another EU member state, family members of a person working abroad or when a person of any age lives in one EU country but is insured in another (e.g. cross-border workers). It is also for anyone planning a trip to a member state for the express purpose of medical treatment. This page is not aimed at EU residents who unexpectedly fall ill while travelling temporarily within the European Union. In this situation medical care can be accessed by holders of the European Health Insurance Card (EHIC).

Types of forms

Form S2 is for planned medical treatment, form S1 is used to register for health care.

Form S1: Registration for Health Care Cover

A person living in one EU country, insured in another, can register for health care cover with the S1 form. This applies to pensioners retiring abroad, as well as families of a person working abroad. An S1 form is available from your current health coverage provider.

Form S2: Planned Medical Treatment

EU-residents are entitled to planned medical treatment in another member country. In order to benefit from European health insurance agreements, the document S2 (ex-form E112), must be obtained from the health insurance institution of the country of residence. Coverage may vary depending on the type of treatment sought and the country in which it is to be received. Health authorities can clarify which costs will be covered. However in principle, costs are only covered for treatments recognised in the country of residence.

Hospital treatment

Hospital treatment in another EU country requires prior-authorisation from the health authorities of the country of residence. The cost of the treatment is covered under the terms of the country of treatment. In some countries, this means that some of the treatment has to be paid upfront by the patient, a cost that is reimbursed later (except in Switzerland).

Without prior authorisation, there is no guarantee that the cost for hospital care will be met.

Non-hospital treatment

Non-hospital treatment is possible with or without authorisation.

  • Treatment without authorisation: The patient meets the costs themselves and may obtain reimbursement later, on the basis of the rules in the country where they are covered for health care. If the treatment costs more in the country of treatment than in the country of residence, it is up to the patient to pay the difference
  • Treatment with authorisation: The costs of the treatment are met, with additional reimbursement if applicable. In the case of Switzerland this option is not available

Further Information

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