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Private Healthcare in Valencia vs Public?

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carorueil

Having lived in France for over 30 years we've always had private healthcare. As we're planning on retiring to Spain in the next few years we're hesitating to stay with our current private healthcare system (which would have to continue to cover us if we have no other form of healthcare) or sign up the public health care system with a Convenio Especial.


As we've gotten used to choosing our own gp /specialists etc we're just not sure which options we should choose.


any suggestions advice is gratefully accepted

gwynj

@carorueil


Public healthcare is pretty decent in Ireland, France, Spain and elsewhere in the EU.


But if you can afford private healthcare, then you'll always prefer VIP treatment and no waiting in line. What's not to like? :-)


If you want private care, you probably will get a better deal from a Spanish company (ASISA, DKV, Mapre, Sanitas, etc.). You can find them all (and prices) using a comparison engine like Rastreator and Acierto. In any case, you'll need a policy for your first year when you do your EU Citizen Registration.


As you're EU, you might be able to enroll in Spanish social security and make contributions immediately (and hence qualify for public healthcare). If not, you can get healthcare via the Convenio Especial route after a year.


Even if you can afford private, it might be worth contributing to the public system just in case you ever have some horrible chronic condition that your insurer wriggles out of covering. And you can get an EHIC to cover your travels in the EU. If you've already been abroad for 30 years, perhaps you're close to retirement? If so, you can soon get an S1 which entitles you to free care in the EU.


I've got my residence permits sorted in Bulgaria and Cyprus, as well as Spain. I pay into the public system in Bulgaria at 20 euros per month, and they give me an EHIC for my stays in Cyprus and Spain. Bulgaria has this amazing situation where PRIVATE hospitals are affiliated with the public system and get reimbursed by it. So I always go to a private hospital and pay the private surcharge (private is obviously more expensive than public, but only by a few euros). At my last private hospital visit my GP charged me 2 euros for the consultation, and 2 euros for the x-ray. Outrageous! :-)

carorueil

Thanks gwynj for the advice

' \

As we've been living in France for over 30 years we've just recently retired. But as we weren't in the French healthcare system I don't think we can get the EHIC card?  Any time I've had to go to an A&E in a Spanish hospital we've always paid up front (French private healthcare seems to do everything to NOT reimburse me).  As with most private healthcare the one 'advantage' of staying with this one is the 'existing medical conditions'... One of the questions we had was whether even if we contribute to the Spanish public healthcare system (I think there's an age-limit to do a Convenio?) whether that would enable us to have EHIC card?  The Bulgarian healthcare system sounds a bit like in France: there are private/public hospitals we've always gone private (because of our insurance) - can't say that the prices are anything like in Bulgaria though!  I think even blood tests done in France are cheaper than doing them privately in Spain. Can you explain to me how your residence permit gives you access to EHIC?  Might be something we can investigate1 thanks

gwynj

@carorueil


Correct, if you're not in the French public system, they won't give you a French EHIC. But I'm a little puzzled by how you could be in France for 30 years without making some social security contributions.


But, if you're recently retired (and get a public pension from France or Ireland) that should entitle you to get an S1 form. And the S1 entitles you to free healthcare in the EU. This is probably your best option.


I'm not very knowledgable about the Convenio Especial or how it differs from making social security contributions. My understanding is that folks typically make social security contributions (usually as employed or self-employed, but sometimes as students or unemployed). And contributing to the social security system entitles you to public healthcare (and an EHIC). I believe that the Convenio Especial is a separate access to public healthcare system for those that don't make social security contributions and cannot affordably be insured privately. I think you have to be a Spanish resident for a year before you can enroll, but I doubt there are any restrictions (in terms of age, preexisting conditions, or otherwise).


I've read that the Convenio Especial is about 160 euros per month, per person. And I don't believe it includes an EHIC or cover in other EU countries.


Bulgaria allowed us to enroll in the social security system, and make monthly contributions. In our case, as unemployed. This monthly contribution of 20 euros per month is significantly lower than as an employee or self-employed. These contributions entitle us to public healthcare (and, by extension, an EHIC). This is roughly how it works in most of the EU, but with restrictions (the unemployed, or "economically inactive" option is often precluded for new residents). As you're interested in Spain, this isn't really relevant, and I apologize for the digression. :-)


But I find the comparisons interesting, and it's certainly a big factor in why we spend so much time in Bulgaria. I used to spend thousands a year on a private health policy, and it had big deductibles and many exclusions. But it's risky to be without any cover at all. The Convenio Especial seems to run at c;lose to 4,000 euros a year for a couple. Our Bulgarian unemployed option is just under 500 euros per year for a couple... and it's the only one of the 3 options to also get an EHIC. The added benefit of private hospital treatment being covered (let's say 95% ish) by the public system is entirely unexpected (but absolutely delightful). Our Bulgarian EHICs would be accepted in Cyprus and Spain, but for accidents/emergencies rather than elective surgery. And we'd have to rough it in the public hospitals. :-)

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