The basic Spanish Social Security healthcare network is organised based on consultants, ambulances and hospitals. Spain has a reciprocal healthcare agreement with a series of countries (including all the countries of the European Union). Citizens of those countries need to obtain form E-111 from their doctor to gain access to public medical services in Spain. 

Once the process of transfers to the Autonomous Communities is completed, the Instituto Nacional de Gestión Sanitaria (Institute of Health Management) is responsible for managing the rights and duties of INSALUD and health provision in the cities of Ceuta and Melilla, and performing any other activities necessary for its services to function correctly in accordance with the General Health Act in force. 

All employed and self-employed persons must join the social security system and pay monthly social security contributions through their employer. They are given a social security card which entitles them to free hospital and medical treatment. Private insurance can also be taken out but treatment costs are only reimbursed in certain emergency cases. In Spain, 40% of medical treatment is private. 

Treatment is free if you go to a doctor who works in the social security system. If special treatment is required, the doctor refers the patient to hospital and specialist services by means of an official report. Medicines are always prescribed by the doctor on an official prescription form. Some medicines are not covered by social security. 

Under the social security system, hospital treatment is provided free. Patients are also entitled to any necessary prostheses, orthopaedic parts, transfusions etc. 

Private medical coverage can be obtained from one of the many private healthcare companies in Spain, which can be found in the Yellow Pages under 'Healthcare Companies'. 

Departments of Health and Regional Health Services attached to the Autonomous Communities have taken on the corresponding competences, functions and financing. Lists of hospitals and health centres can be obtained from local offices. 

Through the National Health System, the State acts as guarantor of the quantity and quality of provision in any part of national territory. 

Text last edited on:06/2005 

Source: European Union
© European Communities, 1995-2006
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