Expanded Understanding of Spain's Medical Systems
The other week I got to speak to an orthopedic surgeon, who is a good friend of my friend Gerardo. I pumped him with lots of questions about the medical system here. Here is what I learned. There are basically three types of medical systems in Spain. First, there is what is called here social security (La Seguridad Social). This is much larger than the U.S. Social Security system, as it covers universal health care, worker's compensation, disability, unemployment benefits and retirement.
Social Security health care covers all national residents of Spain, and up until 2012, also covered legal foreign residents. However, they changed the law at that time and now only foreign residents who are paying into the system through their payroll taxes can access the public health care system unless they are citizens within the European Union. This system seems to operate very well and is especially good when you have major health issues that need to be addressed. In times of health crisis or emergency they respond quickly and effectively. This service is free to all who are covered by the system. There is no co-pay for services but there is a co-pay for pharmaceutical drugs. However, this system does not tend to be as responsive to minor health issues that do not require immediate attention.
As a foreign retiree who emigrated to Spain after 2012, I am not automatically covered by the public health care system. However, in Catalunya, if you have registered and lived here for a minimum of one year, you could begin to pay into the public health care system for 60 euros or more a month if you are under 65 and 157 euros or more a month if you are over 65. At this point in time, I am NOT considering participating in the public system.
Some Spanish citizens also purchase private plans. This is the second type of medical system here. About 15% of the Spanish population are covered under a private plan as of 2013. Citizens will use these plans for routine or preventative medical visits. They tend to be designed to complement the public health care system, rather than replace it.
The third type of medical plan are those offered by private companies for their employees. Although I know these exist, I know little else, as far as whether there is an employee premium, etc. I don't believe that many employees have access to this type of medical insurance, but that is based only on my anecdotal experience.
BTW - being a federal retiree, I have access to my federal health plans. A few of these plans cover federal employees and retirees overseas. This has worked very well for me over the last year.
HIV and Access to the Public Health System
I did some research for a friend who is HIV positive and is planning on moving to Spain from the U.S. He found that private health plans are very expensive here and would even be more expensive having HIV as a pre-existing illness, if that would be covered at all. Luckily a friend of mine at the Barcelona Shambhala group has worked in this area and her brother is employed by an organization that is dedicated to helping those living with HIV.
Through him I found out that for those living with HIV who live in Catalunya (the autonomous community of which Barcelona is a part), regardless of whether they have general access to the public health care system, have free access to be treated for HIV if they have been registered in their town or city for a minimum of three months. This should also be true of all other autonomous communities in Spain (you can consider these communities to be regions in Spain). However, the law may be implemented differently depending on the region.
Coordinator of a Shambhala Weekend Course
