How to access the Spanish public healthcare system as a beneficiary

Has your husband or wife been granted S1 entitlement to public healthcare in Spain? Have you got a few more years to retirement? Or maybe you aren’t working but your spouse has a job or is self-employed …
Good news is that you can ‘piggy-back’ access to the state healthcare system as a beneficiary. 

Using S1 form
If your spouse has been granted an S1 but you’re not of retirement age, then you can ride off the back of their S1. You’ll need to request an S1 from the Pensions Authorities (NHS) in the UK, and this useful article explains how to do this. 

Once you receive the S1 with dependant as beneficiary confirmation, take this along with your passport, marriage certificate, residency document and Padron certificate to the INSS (Spanish Social Security) – don’t forget to book an appointment first.
You can also submit your application online – this link to the UK government website goes through this process step-by-step.. 

Spouse is working, or self employed (autonomo)
If your spouse is working or self-employed (autonomo) in Spain, then you can also gain access to the public healthcare system in Spain. If you’re a British citizen, you’ll need to provide several documents, as follows:

• Certificate of Non-entitlement from the NHS in the UK (shows that the UK won’t cover you for healthcare),  translated (contact NHS Overseas to get this)
• Marriage Certificate – translated and legalised with an apostille stamp – this article tells you how to get this.
• Passport (in date)
• Residency document
• Padron certificate (dated within the last 90 days, with both names on (padron convivencia)
• Valid email address and Spanish mobile phone number (not got a Spanish number? Get a Lobster SIM from Upsticks today!)
• To give your application the best chance of success, make sure your documents are up to scratch  – this article tells you how

When you have your documents prepared, make an appointment at the INSS either online via this link or by sending an email to [email protected]
You can also submit the application online using a Digital Certificate and some gestores can arrange the whole process for you for a small fee.

What happens after you’ve submitted your application?
In the case of an S1 registration, you’ll need to wait for a letter to confirm your access to healthcare – this can take several months to come through. If you haven’t received the letter within 90 days of the application, it’s best to book another appointment or send a follow-up email to check progress with the INSS office.

In the case of a spouse who has access due to work or self-employment, access is usually granted straight away, and if you visited INSS in person, you walk away with the ‘access to healthcare’ letter. If you apply online, then you should receive the letter by email fairly promptly.

You need to register the “access to healthcare” letter with your local Centro de Salud (Healthcare Centre), where they will order your Health Card (Tarjeta Sanitaria) and assign you a doctor. The Health Card should be delivered to our home address within a few weeks – in the meantime, the Access letter is sufficient to confirm your eligibility for treatment.