Insurance, Spain & E111

E111 and E121 Information for your visit to Spain

If you are covered by the national health services of your country, and that country has an international agreement on reciprocal health services, the best solution for someone who wants to stay in Spain for one or more shorter periods without becoming resident, is the form E111.

This form is issued by the national health services in your own country, and you should have it together with your passport, ready for any emergencies if you have to use the medics, health stations or hospitals of the Spanish national health services, called INSS.

In almost all tourist municipalities you will find a "Centro de Salud" if you require treatment go there in the first instance.

To go straight into hospital, you must ask to be taken to one of the hospitals of the INSS, or if you have been taken to a private hospital you should communicate this to the INSS within 24 hours. The personnel at the hospital will assist you. If you go to a private doctor or hospital, they will ask you to pay.

If your E111 is valid and you are using it for emergency treatment, you will not have to pay for the intervention of the medic, the stay in the hospital or for the medicines.

Should you require emergency treatment have a photocopy of your E111 ready; show the doctor the original and hand over the copy.

The E111 should only be used in emergencies, not for treatment of chronic illnesses or seeking an operation in Spain that you would have to wait a long time for in your home country. But if you run out of your normal medicine while staying in Spain, the E111 can be used to obtain further supplies.

You may obtain information on where you may use the E111 (IRL) at the following offices in Spain:

The District Office of the National Social Security Institute ( Direccion, Institute Nacional de la Seguridad Social - INSS)
The Social Security Office of the autonomous regions ( Instituto ( name of area) de la Salud)
The National Institute for Health (Instituto Nacioanl de la Salud)

Doctors, Dentists & Prescriptions Only family doctors within the Spanish Health Service provide emergency treatment under the E111 arrangements. In some parts of the country, particularly the outlying islands, you may have to travel some distance to attend a surgery (consultorio), health centre (centro sanitara or hospital clinic (ambulatorio) that gives treatment within the health service.

lf any need to call out a doctor in an emergency, make it clear that you have an E111 and that you that you want treatment under the European Communities E111 arrangements.

IMPORTANT: In Spain. doctors, health centres and hospitals have separate surgery times for private patients and those treated under the health service. A request for payment means that your treatment is not covered under the Spanish Health Service, and is private and your E111 will not cover the cost.

Hospital treatment Usually the doctor will arrange any hospital emergency treatment you may need. Emergency treatment is given free of charge only in a public ward at a public hospital. Make sure the hospital admits you as a health services patient. Show your E111 at once and hand over a photocopy. If you do not show your E111 you must pay private health charges. You are unlikely to get your money back either in Spain or in your home country for private patient charges.

What emergency treatment means Emergency treatment is treatment that the Spanish Health services practitioner says cannot reasonably be postponed until you are well enough to go home. It does not include going to Spain on purpose to get treatment. It does not include going to Spain to give birth, or maternity treatment in Spain after the 36th week of pregnancy.

Persons taking medicines or drugs The law in Spain may not let you get or use some drugs or medicines that are legal to get and use in your own country. Before you leave it is in your own interest to ask your doctor or chemist about using those drugs or medicines in Spain. You may have to change to different brands or take enough drugs and medicines with you to last you until you get back.

Debts for emergency treatment If you do not pay amounts due for medical, dental or hospital treatment or for prescriptions, the doctor, dentist, hospital or chemist in Spain may take legal action against you in Spain or in your home country.

Retiring in Spain E111 will not cover you for emergency or elective treatment if you go to live or retire in Spain. Follow this link for the E-121 form, for permanent residents.

Private health & travel insurance It is in your own interest to take out private medical insurance and private travel insurance before travelling to Spain. Your E111 will not cover the cost of sending you home or funeral expenses. In addition, it may not cover treatment because of a road traffic accident or as sports accident. If you pay private health insurance, and before you travel abroad, contact the company about what is covered for your visits to Spain.

Motor vehicle insurance (including motor cycles etc.) Your E111 may not cover your medical, hospital or dental expenses if you are driving in Spain. You should check with your motor insurance company before going abroad that you have enough motor insurance cover before you leave.

NOTE: to the best of our knowledge and belief the above is true but is intended for informative purposes only and is not a legal interpretation of the emergency State Health Services in Spain. The responsibility lies with you to verify the validity of this information.