Until the end of the Brexit Transition Period on 31 December 2020, those with a right to treatment with the British National Health Service had their access to the Spanish public health system guaranteed under the Withdrawal Agreement ratified earlier that year. Since 1 January 2021, however, this access has been governed by the Protocol on Social Security Coordination under the Trade and Co-operation Agreement finalised between the EU and UK on Christmas Eve. Here is what this change means in real terms for Britons in Spain.
1. I am a British citizen travelling to Spain as a tourist after Brexit, will I have the right to healthcare in Spain? What documents will I need to show?
Yes, according to the Protocol mentioned above, coverage is available. The European Health Insurance Card (EHIC) or UK Global Health Insurance Card (GHIC) can be used to get medically necessary state healthcare in Spain for free or at a lower cost. This is not a replacement for travel insurance and does not cover, for instance, private healthcare or planned treatment. See the UK Government website for more details.
2. I am a British citizen studying a PhD/Master’s or doing an ERASMUS internship in Spain. Will I have a right to healthcare?
In principle, yes. You can use the EHIC or GHIC to get necessary state healthcare, but you should also acquire insurance.
3. British workers resident in Spain
a. I am a British citizen working permanently in Spain, do I have the right to free healthcare? What do I need to prove it?
Spanish law automatically guarantees healthcare to all registered workers, regardless of their nationality. To receive healthcare, you should present the Health Card issued to you by the Autonomous Community where you live. Health Cards issued before Brexit are valid as long as you are still a registered worker.
b. I work in Spain, does my family have a right to healthcare?
Yes, so long as they reside and are authorised to reside in Spain, family members of Britons working legally in Spain have a right to healthcare. This includes descendants of the worker under the age of 26, the worker´s spouse or civil partner, and older, legally incapacitated relatives who live with and under the care of the worker.
c. Which of the Spanish Healthcare System´s services are free?
So long as you have the Spanish Health Card, are temporarily in Spain or have a right to healthcare paid by the UK government, you do not need to pay for public Spanish healthcare. You will only have to cover the relevant pharmaceutical co-payment.
d. Will I have to pay for healthcare if I am not a resident in Spain?
If you do not have a Spanish Health Card, EHIC or GHIC, the Spanish Health System may charge you for services provided.
e. How will Brexit affect planned medical treatment?
Planned medical treatment will not be affected by Brexit.
4. I am a British citizen working for a UK company and I am being sent to work temporarily in Spain, do I have a right to healthcare?
Yes, both the Withdrawal Agreement and the Social Security Protocol guarantee that as a British citizen you can work for up to 2 years in Spain while being registered on the NHS and keeping your rights to healthcare.
5. I am a British pensioner and have been legally resident in Spain since before 31 December 2020, will my access to healthcare in Spain be affected?
No, your access to healthcare in your place of residence will not be affected, European Union rules will continue to apply to you.
For the Spanish Government website for advice relating to Brexit, click here. For the UK Government website giving healthcare advice for British nationals living in Spain, click here. For the full EU-UK Trade and Cooperation Agreement, including the Protocol on Social Security Co-ordination, click here.