Healthcare in Spain for UK retirees

The three routes at a glance

Sources: NHS Business Services Authority, Spanish Ministry of Health, Redacción Médica and Póliza Médica.

The S1 form

The NHS Business Services Authority says you may be entitled to an S1 if you are paid a UK State Pension and are living in, or moving to, an EU country. An S1 gives you the same healthcare cover as a resident of that country, with the UK responsible for the costs.

• You can apply online up to 90 days before you move.
• You need an address in the country you are moving to for the S1 to be issued.
• You will not have healthcare cover automatically. You must register the S1 in Spain.
• An S1 does not cover private healthcare.
• If you receive both a UK State Pension and a pension from the country you have moved to, you may not be eligible.

The practical catch for early retirees: an S1 depends on being paid a UK State Pension. If you move before your State Pension age you will need another route until then. Use GOV.UK’s State Pension age checker to find your date.

Private health insurance

Private cover is the usual answer for people who move before they are eligible for an S1 or the public scheme. Spanish consulates ask for proof of health insurance as part of the non-lucrative visa application.

Average premiums vary by source and by policy. Rastreator data reported by Redacción Médica put a policy without co-payments at about €96 a month for ages 55 to 64 and €145 for 65 and over. The Póliza Médica comparator put the 24-insurer average for a 60-year-old at about €139 a month without co-payments, €102 for a complete policy and €53 for a basic policy with co-payments.

When you compare quotes, look beyond the headline price at co-payments, annual limits, waiting periods, age limits at renewal, and how pre-existing conditions are treated. Get several quotes before you commit.

The public scheme: convenio especial

Spain’s Ministry of Health says people who do not have a right to public healthcare through another route can get it by paying into the convenio especial. The conditions include:

• proof of effective residence in Spain for a continuous period of at least one year immediately before applying;
• being registered on the padrón of a Spanish municipality when you apply;
• not having access to public health protection by any other route.

The monthly fee is €60 if you are under 65 and €157 if you are 65 or over. This route only opens after a year of residence, so it cannot replace private cover during your first year.

What about the GHIC?

The Spanish Ministry of Health notes that a European health card only gives access to Spanish public healthcare for temporary stays and is not a valid document for establishing residence. In other words, a UK GHIC covers a holiday, not a move.

If you do register an S1, the NHS says you can then get a new UK-issued GHIC or EHIC for visits to other EU countries.

A sensible order of decisions

1. Work out your State Pension date and whether you will qualify for an S1.
2. If you need the non-lucrative visa, get private insurance quotes that satisfy your consulate.
3. If you are eligible for an S1, apply up to 90 days before you move and register it once you are in Spain.
4. After a continuous year of residence, compare the cost of the convenio especial with your private premium.

Common questions