The Spanish health system is a contribution-based system. This means that normally you must have paid into the social security system in order for you and your dependants to be eligible to receive healthcare from the state.
These social security contributions can be paid by your employer or by yourself if you are a registered self-employed worker (autonomy).
If you are not employed or self-employed, you may also be eligible to register and pay voluntary contributions. To be eligible for the payment of voluntary contributions, you will have had to make previous contributions in Spain at some point and also have paid contributions for 3 out of the last 12 years in any EU country.
There are several situations where you can receive state healthcare even if you have are not paying into the Spanish social security system :
- You receive a state pension, long-term contribution-based Incapacity benefit, or Bereavement benefit from an EU country
- You are a temporary visitor to Spain and have a valid UK European Health Insurance Card (EHIC)
- You are a posted worker for a UK company
- You are an early retiree to Spain and have been resident in Spain for less than two years
- You are a dependant of someone who falls into one of the categories above
In some circumstances, you may be asked to provide evidence of your income from your home country when applying for health care or social security benefits in Spain.