Advisers with British clients in Spain say the requirement to prove that one has private health insurance, for those individuals who are not employed in Spain by a company that contributes to the Spanish national healthcare system, could be a surprise for any Britons retiring to Spain who are accustomed to relying on the British National Health Service for care.
In what published reports say is an effort by cash-strapped Spain to save €1m a year, EU citizens applying for residency in Spain henceforth “may be required to produce evidence of sufficient financial means to support themselves (and dependants)”, according to an “unofficial” translation by the British Embassy of the key parts of the Spanish legislation, which was unveiled on 10 July.
“Applicants may also be asked for proof of private or public healthcare insurance,” it adds.
The new requirements, along with a list of some of the documentation applicants may be asked to present, are included in the Ministerial Order that sets out the new regulations, a translation of which may be viewed here.
“It’s early days to see how this is going to pan out,” says Robert Mancera, general manager at Blacktower Financial Management Group, which looks after expat clients in Spain, out of offices there and in Gibraltar.
“The important point is that EU citizens are required to demonstrate that they will not be a burden on the Spanish health service – either via [showing they have] private medical cover or [sufficient] income/assets.”
While the new regulations could be good news for providers of private medical insurance, a Spanish official quoted in an article on the SurinEnglish.com news website said that new arrivals could present an "S1 from the public health service" of their home country in lieu of proof of private healthcare cover.
Pressures on health care systems
That said, though, Francesco Bertagnin, managing director of Gibraltar-based Foresight Consultancy Ltd, which specialises in looking after high net worth expatriates in Gibraltar and Spain, noted that there is a trend throughout Europe, not just in Spain, for countries to tighten up on their provision of free health care, even to nationals who are not contributing into the system.
Paul Barnett, a director at Totus, an advisory firm with offices in a number of Spanish towns popular with expatriates, including Sotogrande, Almeria and Alicante, agrees, noting that “the days of the E111 [the card that Britons used to use to obtain free healthcare while in the rest of Europe, replaced by the European Health Insurance Card] are long gone”.
"This change has been inevitable for some time,” Barnett added.
“Although Spain has spent significantly on its hospitals, and indeed, it has services that are second to none in Europe, they clearly want to ensure that expatriates are paying their way in the economy.”
However, any expatriate Britons who are already drawing a UK state pension and receiving it in Spain “should, in principle, be unaffected” by the changes, according to Barnett.
“Also, working expatriates will be continue to covered by their Spanish national insurance contributions in the usual fashion.”
‘Sympathy’
Stephen Ward, managing director of Alicante-based Premier Pension Solutions, which specialises in providing international pensions to British expatriates, believes that there is likely to be some sympathy among the expat community for the Spanish government’s position, as the country’s problems – which include a 25% unemployment rate, and a youth unemployment rate running at more than 50% – become increasingly obvious.
“I am told that the Spanish healthcare system is fantastic, with new, spotlessly-clean hospitals and highly competent staff; and the computer systems of the local surgeries and the hospitals are integrated,” he said. “If I were to need an appointment at the hospital it would be made for me online at the surgery.”
Andrew Hosking, business development manager at Gibraltar-based Fiduciary Wealth, noted that the kind of expatriates his company looks after, in common with other wealthy people in Southern Spain, already “prefer to have private healthcare provision in place”, so for them, the new regulation will involve little inconvenience or added expense.
“We would certainly encourage anyone considering moving to [any] new country to review their healthcare provision alongside their other insurance arrangements prior to making a move,” he added.
