While living in Spain it is beneficial to get familiar with public services available for residents. The main public services of most interest include: healthcare, social security & welfare, employment services, social services and access and administration.
I would focus here mostly on healthcare as this service concerns everyone, regardless of age or employment status. The National Health System (Sistema Nacional de Salud) provides universal public healthcare, largely managed by regional health services. This system is funded largely by taxes and social security and legal residents get free or low-cost medical care.
How We Did It
As mentioned in the post regarding my husband’s residency, it was required of us to provide proof of some kind of health insurance. As neither of us was working at that time, we were not allowed to apply for public healthcare in Spain, therefore we bought private health insurance for all members of our family. We decided to go with DKV which was recommended to us through our gestor. We were paying 235 euros per month and this was no co-payment insurance. In order to set up our policy, we were asked to provide a few personal details for everyone in the family:
- Height and weight measurements
- Medical history, including past surgeries, chronic illnesses, or major health issues (excluding minor things like common colds)
- Vision details, specifically whether anyone wears glasses and the exact diopters for each eye
- General lifestyle details, such as smoking or alcohol consumption habits and frequency
Policies like that often run by the calendar year so ours would finish in December 2025 and to cancel it we would have to notify the insurer at least a month ahead before the policy runs out.
When we found out about it, we decided to cancel our private insurance as the policy would renew from January. We were thinking that if I was paying the contributions and could attach everyone under my insurance, why should we pay double? We obviously didn’t take into account the fact that the Spanish system is slow and that there are many steps to follow before you add all the beneficiaries. It took us months before we received the certificate confirming that my husband and my daughters are now registered on the system.
I had also written before that in order for me to obtain the residency permit I had to set myself up as Autonomo in Spain. Being self-employed comes with some monthly costs; one is the payment made to the Seguridad Social (something like NI in the UK) which are your contributions to social services and pension. The second cost is the cost of doing your taxes which you can do yourself or pay your gestor to do it. When I registered I got my Social Security number and was allowed to access the public healthcare system. The benefit of paying the contributions to the Seguridad Social is that you can attach all your family members as beneficiaries under your own insurance. Once registered on the system, they obtain the right to public healthcare.
Adding Beneficiaries To Seguridad Social
First of all we needed to get NIE numbers for our daughters. My husband had already got his NIE number in the process of applying for his residency. Securing the appointment was one story, attending the appointment was completely different. It happened that our daughters went to school camp but on two different weeks so one week we had an appointment for our youngest daughter, next week for the older one. The first appointment went smoothly. At the same time I was also sorting out my blue residency card which I had laminated before (read my post about that). The police officer serving us was nice and efficient. No unnecessary questions or extra documents. 5 minutes and we left with my new residency card and my daughter’s residency card with her NIE number on it.
Next week we were going in quite relaxed, it was supposed to be the same procedure. How wrong we were. We already had a bad feeling when the person in the queue in front of us let us pass. She must have known the person. So we went, sat down and the first thing we hear is that we had booked the wrong appointment. But how come it was the wrong appointment? We had the same appointment the week before I tried to explain in my broken Spanish. He rudely explains that for children you don’t book a NIE appointment, you book a residency one. So I said again that we came last week with my other daughter and I pointed out the official who served us and explained that he didn’t mind. No, he wasn’t having it. I got so upset by that point that I started crying. In the meantime the official asked me to show him all the supporting documentation (I wrote about the documents needed for applying for NIE in this post). When I handed it in he requested… Vida de laboral. There hadn’t been any mention anywhere about that before. This is your work history in Spain and can be downloaded as a PDF report from Import@ss Portal provided by Social Security. You will need to identify yourself when you login using, for example, your Digital certificate but you can also be verified through SMS if your phone number is registered within Social Security. So I managed to access it online on my phone and then I had to go and print it out for him. We left the police station to look for some sort of stationary shop that would print it out. Fortunately, there was one closeby. When we returned “our guy” was standing outside smoking. I handed him the printout and he started his speech again – that we booked the wrong appointment. I started getting upset again and then I looked and he was handing me my daughter’s passport and…her Spanish residency card. We left quickly before he would start his tirade all over again.
The next step was adding the beneficiaries to my Social Security account. To do that you need to login into Tu Seguridad Social site and find the link which says Anadir beneficiario. There you will need to fill in all the information, and on the second page also attach supporting documents. For my husband I attached his TIE card and marriage certificate and for my daughters their Spanish residency cards and their Polish passports. Before submitting, the system asks for a digital signature. I must say that it wasn’t possible for us to do it on Macbook which kept returning error messages. In the end I did the application on our Windows PC.
After around a month I received an email from Social Security with the certificate attached which listed all three of the beneficiaries. With this certificate I went to our local Centro de Salud to obtain the SIP card. The other document needed was the Empadronamiento (I wrote about obtaining that in this post) but you need to be careful as this needs to be no more than 3 months old. We are lucky because in La Eliana where we live we can go to our local Ayuntamiento and get everything the same day. I heard that getting an appointment in Ayuntamiento in Valencia can be tricky. So you need to take this into account as well when registering for public healthcare.
As you can see the process of adding the beneficiarios to your Seguridad Social, although not very complicated, is time consuming and requires many steps. I have read and heard that the Spanish healthcare system is one of the best in Europe. It is always handy to have your local doctor, especially if you have children and if you don’t want to pay for the expensive private insurance, using public services is a good alternative.