If you are not paying into the Spanish social security system you may also get state

The rules for getting state healthcare in Spain are different from those in the UK. The NHS is a residence-based system, which means that all you need to access healthcare in Great Britain is to be ‘ordinarily resident’ (see Returning to the UK).
In Spain however, the system is contribution-based, which means that normally you must have paid into the social security system in order for you and your dependants to get state healthcare. These social security contributions can be paid by your employer or by yourself as a self-employed worker. You may also be eligible to register to pay voluntary contributions if you have paid contributions at any point in Spain and have paid contributions for 3 out the last 12 years in any European Union Member State – apply at your local Tesoreria .
If you are not paying into the Spanish social security system you may also get state healthcare if:

If you get a UK State Pension or Long Term Incapacity Benefit and you decide to move to Spain permanently, ask for your S1 (previously E121) from the International Pension Centre (IPC) in Newcastle. Once registered with the Spanish authorities, the S1 gives you and your dependants the same medical cover in Spain as a Spanish national under the Spanish state-run health scheme. This cover may not be the same as you received on the NHS in the UK so you may have to pay for some treatments or services. Remember that: treatment given privately and repatriation costs to the UK are not covered. Think about whether you want to take out private health insurance. some social services may not be available. You are an early retiree to Spain and have been resident here less than two years (apply for an S1 form); You are a posted worker for a UK company; You are a dependant of someone who falls into one of the categories above; You are a temporary visitor to Spain and have a valid UK European Health Insurance Card (EHIC); Access to healthcare: S1 (previously E106) This is how you get Spanish state healthcare if you’re a posted worker or early retiree living in Spain. In most cases, an S1 (previously E106) is issued to people who are posted to Spain to work for a period of 2 or more years, and who carry on paying National Insurance contributions in the UK. In this case the S1 is issued by: HM Revenue and Customs CAR - Residency Room BP1301. Benton Park View.Newcastle upon Tyne NE98 1ZZ, UK Tel: 0845 915 4811 From outside the UK: +44 191 203 7010 Early retirees in Spain who have worked in the UK prior to their move may be entitled to an S1 for a limited period. In this instance the S1 is issued by: DWP International Pension Centre Room TC001. Tyneview Park. Whitley Road Newcastle upon Tyne NE98 1BA, UK Tel: +44 191 218 1999 Registering with the Spanish authorities In order to register your S1 you need to get the following in this order: i) Certificate of Residence in Spain (Certificado de Residencia/Numero de Identificacion Extranjero) – available from your nearest National Police station. ii) Certificate as a Local Resident (Certificado de Empadronamiento) – available from the Local Town Hall (at the Padrón Office). Advice on how to get these certificates is in the Living in Spain section of this website, and on the website of the Spanish Ministry of the Interior (MIR) - or you can contact either your local Comisaría de Policía (Certificate of Residence in Spain) or Town Hall (Certificate as a Local Resident). Check what documents you’ll need to take and what will be the process to complete your application successfully. Also remember to make your own photocopies before you get to your appointment. If you forget something, it’s unlikely you’ll be allowed to complete the process and you’ll probably have to go back another time. Once you have your certificates, take them, along with both copies of your S1, to the local Instituto Nacional de la Seguridad Social (INSS) office. They will keep one copy and return the other copy signed and stamped. This copy can now be used in order to access the healthcare system. You don’t need to register with a local GP but be aware this may mean that you’re not seen by the same doctor every time. The S1 is valid until the expiry date shown on the document and you may be treated as a private patient if the form has expired and you haven’t got any other right to Spanish State healthcare. If there isn’t an end date, the document is valid until the International Pension Centre (IPC) tells Spain that the cover has to end. When visiting the UK, you will still be able to access NHS services under the normal rules. S1 holders should continue to use their UK-issued EHIC when visiting a third EU Member State. Where to get more information If you have any queries about form S1 or health care cover, call +44 191 218 1999 (Monday to Friday: 8am - 5pm, UK time). For general information and enquiries regarding healthcare abroad, check www.dh.gov.uk/travellers. To find your local INSS office, visit the Direcciones y teléfonos page on the INSS website. You can find more information on the health system in your region in Spain by visiting the webpage of the Autonomous Community you live in. You will be receiving planned treatment abroad or are in receipt of UK sickness or maternity benefit - apply for an S2 form (previously E112). For more information, please visit the NHS website You are a child under the age of 18 and have no access to healthcare through your own or your parents means. This is called ‘La Ley de Minor’ and you apply through the social worker at your local health centre. Please remember - if you do register with the state health system in Spain, it is important to de-register with your GP in the UK. Likewise, if you decide to return to the UK, then you must de-register with the Spanish authorities.


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