EU, UK and S1 healthcare rights

It is for anyone thinking about moving to Spain, planning a move or already making it. By the end you will know which route applies to you, which card or form to use, and when a temporary card stops working.

Start with "Does being an EU citizen change your healthcare route in Spain?" It helps you choose between staying under your home-country cover and joining Spanish cover.

From there, pick the page that matches your situation:

• Pensioners: the S1 form and how a foreign state pension can pay for Spanish healthcare.
• UK nationals: healthcare under the Withdrawal Agreement.
• Posted or cross-border workers: where you are covered and which document proves it.
• Visitors and new arrivals: what your EHIC or GHIC covers, and why it stops working once you move.
• Travellers: using your Spanish cover abroad.

Key rules

• GHIC validity: A UK GHIC is valid for up to five years, and it is only for people who normally live in the UK, not for people who have moved to Spain.
• When the card stops: An EHIC or GHIC stops being valid once you make Spain your habitual home, even if the card is still in date.
• EHIC: An EHIC is for temporary stays only and does not cover you as a resident.
• Work: If you work in Spain, you normally enter Spanish cover, unless you are a posted worker with an A1 certificate.
• Who pays: The state paying your pension covers the cost of your Spanish care, not you.
• Residence: You must live in Spain, and an S1 for a temporary stay will not work.

EU, UK and S1 healthcare rights: the whole process, step by step

From first check to changes after you arrive

• Work out which country is responsible for your healthcare (Does being an EU citizen change your healthcare route in Spain?): before you move

• If you are a posted worker, get an A1 certificate from your home social security office and carry it with your ID and contract (Posted to Spain or working across a border): before you start work in Spain; the standard maximum posting is 24 months

• If you draw a foreign state pension, ask the paying state for an S1, then register it with the INSS (Form S1; UK nationals in Spain): before or soon after you settle in Spain

• Use your EHIC or GHIC only for necessary care during a temporary stay (What your EHIC or GHIC covers in Spain): while you are visiting and still insured at home

• Stop relying on your EHIC or GHIC and move to Spanish cover, such as an S1 or work-related insurance (Why your EHIC or GHIC stops working once you move to Spain): on the date you make Spain your habitual home, even if the card is still in date

• Tell the INSS and the paying institution about any change that affects an S1, such as a new address, a divorce, a new job in Spain or leaving Spain (Form S1): promptly after the change happens

• Get a Spanish European Health Insurance Card to use your Spanish cover when travelling (Travelling or being treated back home): once you are covered in Spain and before your next trip

Documents you may need

Identity and residence

• Your ID — Form S1: how a foreign state pension can pay for Spanish healthcare, Travelling or being treated back home: using your Spanish cover abroad
• Padrón registration — Does being an EU citizen change your healthcare route in Spain?
• Photo ID — Posted to Spain or working across a border: where are you covered?

Guarantees

• Comprehensive private health insurance policy — Does being an EU citizen change your healthcare route in Spain?

Other documents

• A1 certificate
• S1 form — Does being an EU citizen change your healthcare route in Spain?, Form S1: how a foreign state pension can pay for Spanish healthcare
• Certificado de registro — Does being an EU citizen change your healthcare route in Spain?
• A medical report from your public-system doctor — Travelling or being treated back home: using your Spanish cover abroad
• Portable Document S1 — Posted to Spain or working across a border: where are you covered?

EU, UK and S1 healthcare rights: questions that cross several articles

Which country pays for my healthcare if I work in Spain as an EU citizen?

Spain pays for your healthcare if you work there as an employee or self-employed person, whatever your nationality or where you live. Cover follows your Social Security registration and contributions. The exception is a posted worker with an A1 certificate, who stays in the home system. Read "Does being an EU citizen change your healthcare route in Spain?" and "Posted to Spain or working across a border".

Who pays for healthcare if I am a student or job seeker in Spain?

It depends on your situation: a student insured at home is covered through the EHIC for necessary care, and a job seeker exporting unemployment benefit stays covered by the paying state through an S1. Students with no home cover usually need private insurance or a paid scheme called the convenio especial. Read "Does being an EU citizen change your healthcare route in Spain?" and "What your EHIC or GHIC covers in Spain".

How do I get Spanish public healthcare if I do not work and have no S1?

You generally need private health insurance to register as a resident, and public cover is not automatic. You can then join the convenio especial, a paid scheme with a monthly fee and a one-year residence requirement, or meet the conditions for the INSS to recognise your right to care.

Can I keep using my EHIC or GHIC after I move to Spain?

No, your EHIC or GHIC stops being valid once you make Spain your habitual home, even if the card is still in date. It only covers necessary care during a temporary stay. Move to Spanish cover such as an S1 or work-related insurance. Read "Why your EHIC or GHIC stops working once you move to Spain" and "UK nationals in Spain: healthcare under the Withdrawal Agreement".