New rules on who gets public healthcare and how much they pay

Automatic summary, not yet reviewed

1. Public healthcare becomes tied to insured status: Social Security workers and pensioners, people receiving benefits such as unemployment benefits, and those who have used up those benefits and are registered as job seekers. Their relatives living in Spain (spouse, former spouse they support, and children under 26 or with a disability of 65 % or more) are beneficiaries.
2. People who are neither insured nor beneficiaries can still be covered if they show income below the limit set by regulation. Those who meet none of the conditions can access healthcare by paying a fee through a special agreement.
3. Foreigners without a residence permit will still be treated in emergencies for serious illness or accidents, for pregnancy, childbirth and postpartum care, and those under 18 will be treated on the same terms as Spanish nationals.
4. The National Health System service portfolio is split into three levels: a basic portfolio of healthcare services fully funded publicly, a supplementary portfolio (medicines, orthopedic products, dietary products and non-urgent medical transport) with a user copayment, and a portfolio of accessory services, not essential, subject to copayment or reimbursement.
5. A Care Guarantee Fund is created to compensate the autonomous communities for healthcare given to insured people who temporarily travel outside their region, with different rates for short and long stays.
6. The copayment for pharmacy-dispensed medicines changes: generally between 40 % and 60 % of the price depending on income, and 10 % for pensioners, with monthly caps for them (8, 18 or 60 euros depending on income). Some groups are exempt, such as recipients of non-contributory pensions or unemployed people who have used up their benefits.
7. Prescribing by active ingredient is reinforced: pharmacists must dispense the cheapest medicine in the group, with limited exceptions. The list of medicines excluded from public funding also grows, covering minor-symptom drugs and those with an over-the-counter version.
8. For health staff, a State Register of Health Professionals is created, a uniform catalog of professional categories is approved to make it easier to move between health services, and Specific Training Areas are regulated in specialist training.

Who it affects

• People without Social Security coverage: They no longer get automatic public healthcare: they keep it only if they show low income, or can pay for a special agreement.
• Users of prescription medicines: They pay a higher copayment based on income, with monthly caps for pensioners and exemptions for vulnerable groups.
• Pensioners: They pay 10 % of medicine prices, with a monthly cap between 8 and 60 euros depending on income.
• Health professionals: They are listed in a state register and get a catalog of equivalent job categories to work in other regions.
• EU citizens living in Spain: To stay more than three months they must show sufficient resources and, in some cases, health insurance.

Words worth knowing

Asegurado (insured person)

Someone entitled to public healthcare because they work, are a pensioner, or receive a Social Security benefit.

Cartera de servicios (service portfolio)

The set of health services (appointments, tests, treatments, medicines) funded by the National Health System.

Principio activo (active ingredient)

The substance in a medicine that produces the healing effect. Prescribing by active ingredient allows choosing the cheapest brand with the same substance.

Convenio especial (special agreement)

An arrangement by which a person without public healthcare rights pays a fee to receive medical care.

Prestación farmacéutica (pharmaceutical benefit)

The set of medicines and health products the National Health System funds with a prescription.

It summarizes the law as published in the BOE. It is written by artificial intelligence and may contain mistakes: the official text is what counts. Read the official text · How we make summaries