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HEALTHY IN SPAIN

By Jan Otto Landman, GP

By Jan Otto Landman, GP

En emigration from Northern Europe to Spain will benefit your health. Less stressful environment, outdoor life, sun as acknowledged antidepressant and a Mediterranean diet (especially olive oil and fish, few meat) which, according to research, helps avoiding heart and vascular diseases.

Plenty of reasons to be optimistic, but what if you, unexpectedly, should need medical care?

HEALTH CARE IN SPAIN

Your experiences with health care in Spain will mainly be determined by which assurance you take out. In Spain, health care is arranged by the Spanish Government, by means of social security, called Seguridad Social. Any resident of Spain pays a monthly premium and is insured against medical costs. The Seguridad Social offers a health care system with amongst others own GPs, specialists and hospitals. Besides, there is a large private sector which offers private facilities.

If you live in Spain with no additional private insurance, you fall under the Seguridad Social system. If you stay in Spain but officially live in the Netherlands (holidaymakers, hibernators) you can claim private health care in Spain both through the Dutch medical insurance and through the traveling insurance. In case you will emigrate from Holland or Belgium to Spain soon, please realize that once you become Spanish resident, without residence in your country of origin, your medical costs will not be covered by the Dutch or Belgian insurance anymore. Special “Expat insurances” and some “World policies” are an exception to this rule. It is important to gen up about this before moving to Spain.

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SEGURIDAD SOCIAL, STATE HOSPITALS

The Seguridad Social has own GPs, as primary health care, who refer patients to second-line medical care, the state hospitals. The Seguridad Social assigns a GP, usually working in an ambulatorio in the surrounding area of the insured person. For a consultation you should, in general, make an appointment by joining the queue or by telephone. You will consult the GP, 1 or 2 days later. The ambulatorio in the surrounding area also often acts as First Aid post.

If necessary, the GP can refer the patient to a specialist; dependent on the nature of the complaint and its urgency waiting periods of several months could occur. The state hospitals dispose of well-educated medical employees and modern means. The lack of money is mainly characterized by the often somewhat shabby buildings and long waiting lists for certain examinations and surgeries. In general, you will get fast and high-quality medical care in case of an acute life-threatening condition, such as for example heart attack, cerebral haemorrhage. For less acute conditions such as new hip, knee, MRI-scans the waiting times are, in general, considerably longer.

10 years ago Spain had a surplus of doctors, at the moment there is a shortage. GPs in the Seguridad Social suffer from a huge workload. Because of this, they don’t have much time for a consult. If you don’t speak Spanish well, please consider the fact that many Spanish doctors don’t speak English. Therefore, we advise you to bring someone who speaks Spanish and can assist you. English and even sometimes Dutch interpreters work in large state hospitals.

PRIVATE SECTOR, PRIVATE CLINICS/HOSPITALS

Spain has a large number of self-employed GPs and specialists. Many GPs partially work in the Seguridad Social and partially in the private sector, self-employed or in a clinic/hospital. Thanks to the increased prosperity and possibly also thanks to the overload of state hospitals the number of privately insured people and private hospitals has heavily increased. At the moment the province of Malaga offers more hospital beds in the private sector than in the state health care.

The quality of health care strongly varies, dependent on specialist and/or clinic. Private hospitals are smaller and more luxurious than state hospitals. Furthermore, private clinics, in general, have a profit motive. Because of this profit motive “too much” is often done in private clinics, not only in Spain, compared to state hospitals which suffer from a shortage of GPs.

A good private clinic is very clean, has sufficient, modern equipment, has top-specialists from academic (state-) hospitals and no waiting lists. A good Spanish private clinic can be compared to Dutch and Belgian hospitals. Not all private clinics, however, are good. Everything may seem fantastic, but it is often hard to judge whether you will get the best possible treatment or not. My own experiences as GP in Spain initially varied, but once you know who to turn to for certain complaints you will get the best possible medical care.

GP IN PRIVATE HEALTH CARE

A privately insured patient doesn’t need to visit primary health care (GP) in order to be referred to a specialist. You can contact the hospital yourself and make an appointment with a specialist.

For many Spaniards who can afford a private insurance this is a main reason to take out additional insurance. It saves much time. You, however, must know which specialist you should turn to for your complaint. By the way, the Seguridad Social doesn’t prefer this situation as, in many cases, it leads to more costs: patients could end up with the wrong specialist and it mainly concerns complaints which could also be solved outside the hospital.

A couple of years ago a large Spanish private health insurance company started a cooperation with Dutch GPs at the Costa Blanca and the Costa del Sol. This insurer offers, in a separate insurance, the possibility (not the obligation) to consult a GP for a possible referral to the hospital. In this way the patient will be better informed/prepared for his visit to the specialist and the specialist will, despite of the language barrier, find out the reason for the consult and the background of the foreign patient. This approach has been very successful: a large number of North-Europeans living in Spain has taken out this insurance.

The Dutch and Belgian GPs working at the Costa Blanca and Costa del Sol are self-employed and don’t work for the Seguridad Social. They can refer a patient to a state clinic, but usually the patient will be referred to a private clinic as the patient is privately insured. Since private clinics are relatively small your GP will definitely know many specialists and can directly arrange an appointment by making one phone call. Usually the patient can consult the specialist within a couple of days, in case of urgent matters even the same day. Should a hospitalization be desired, the GP can play a main role in it. Many Dutch GPs regularly visit their patients in the hospital, they check the medical data and can consult with the specialists. So, they can play a role in the patient’s treatment, in tearing down the language barrier and in supplying information.

PRIVATE INSURANCE = TAKING OUT DDITIONAL INSURANCE

In Spain, practically everybody has a compulsory medical insurance (Seguridad Social) and a part of the people has taken out an additional private insurance. Apparently many Spaniards and foreign people living in Spain are prepared to pay an additional premium to get access to private hospitals. In general, the insurance premiums in Spain are not very high. The premium you pay to the Seguridad Social doesn’t change or isn’t cancelled if you take out an additional insurance.

One of the main reasons for the low premiums in Spain, is that many private insurance don’t cover the costs of medicines, since they are already covered by the Seguridad Social. Many privately insured people however visit their Seguridad Social GP, for prescriptions. Also, the private insurers can’t always provide all types of medical care, some very specialist issues require the expertise of an academic hospital and all academic hospitals fall under the Seguridad Social. By the way, this doesn’t occur often, many private clinics dispose of academic know-how as professors work there as consultant.

SUMMARY

If you decide to emigrate to Spain make sure you know if and how long your medical insurance will be valid in Spain. Enquire in Spain about Seguridad Social and private insurances; many people consider an additional (private) insurance as really necessary. Ask people who have lived here for a long time about their experiences and if necessary go to an insurance adviser for information. In Spain a GP can play a role in your hospitalization.

Make sure you arrange thing well. Staying healthy, however, is top priority! 

Dr. Jan Otto Landman, GP in Torremolinos and Fuengirola ( Espana )

Phone number Open hours
Torremolinos: (0034) 95 238 88 72 mo to fr 11.00 – 13.00
Fuengirola: (0034) 95 266 59 85 mo to fr 09.30 – 10.30

Website: drlandman.nl

Read all about the Spanish health care on the website www.zorginspanje.com

* The information is based on the Dutch website

You and the Law in Spain


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