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New Universal Healthcare Law July 27 2018 FAQS - Spain

14-Aug-2018


We are receiving many questions about the new royal decree which was only published in the State Bulletin on the 30th of July 2018. Citizens should be aware that the various autonomous regions as well as the INSS (social security) are making preparations to put out their internal instructions to be able to implement this new law.

You do have to consider that this is a huge undertaking and not something that they can do overnight. Please be patient as residents have already been visiting their health centres in their hundreds. In some cases resulting in that the staff have not been able to continue with their normal workload. Emailing also means that the staff are answering questions rather than taking the time to deal with the matter in hand. Below are some questions and answers.

Q) Is this new law in force at present?
A) Yes the law has been in force since July 31st 2018.

Q) Will everyone who is a resident now receive full NHS care paid for by public funds?
 A) No they will not. The following are some of those that need not apply (anew). Those who are entitled to an S1
 will continue to use that method. Those who are self employed or in employment will already be covered. Any other resident whose country or employer have the obligation to provide this care.

Q) What about post April 2012 residents who have been employed but contract ended or dismissed?
 A) Those in that situation were always covered for healthcare, as long as they are in a ´legal situation of unemployment´ (excluding those that resigned) and remain registered as unemployed and looking for work. Even after unemployment benefits ´paro´ or unemployment ´subsidio´ entitlements have run out.

Q) What about those that are registered as Autonomo but cannot afford the contributions, will they be covered when they stop?
 A) Yes, they should, provided they are registered or authorised residents.

Q) What about those here on a non-lucrative visa?
 A) Those should be covered under the new law as well, provided they applied and obtained residency authorisation.

Q) Does the new law include prescription charges and reductions?
 A) Yes it does, including reductions where applicable.

Q) There has already been news from the Junta in Andalucia that the Convenio Especial has been annulled?
 A) Yes that is correct, as the law states, the convenio (special agreement) would be abolished on August 1st 2018.

Q) Registered members have received some notification but can CAB assure us that this is the case?
 A) We can indeed and will use the words of the Junta Health Department “Indeed, the special agreements that were in force have been extinguished by the Management of the Andalusian Health Service. The interested parties have been informed that they will have public health assistance without payment of fees”.

Q) Does that mean that those of us with the Convenio in Andalucia are now in Healthcare limbo?
 A) No it does not, the Junta have told CAB that healthcare will continue. Here is what they wrote to CAB “The Ministry of Health, Consumption and Social Welfare has to develop the new regulation according to the law so we can not yet inform you of the procedures to be followed in each case”.

Q) We have had our DD debit cancelled and are very nervous, should we be?
 A) From the Junta “What can be done at this time is to reassure foreign people because in one way or another they have public health coverage in Andalucia”.

Q) We are still paying for our Convenio what should we do?
 A) CAB suggests that you wait as you will receive notification from the various Junta (Xuntas).

Q) We were about to apply for the Convenio. Should we still proceed?
 A) We suggest you continue to do so. You will likely be refused but may put your mind at rest to receive instructions which some already have.

Q) That is Andalucia but what about Valencia, Murcia and the other provinces?
 A) Valencia regional Health Department has said that it is waiting for full instructions so that they can implement the law. Though a national law, the State has asked each CCAA region to deal with the due process.

Q) What about the Canary and Balearic Islands. Will they have to comply?
 A) Again this a national law and all the Spanish autonomous regions have been instructed that it is their responsibility to implement the law.

Q) Will this law also provide this healthcare for those with private health insurance?
 A) The law makes it quite clear that this is for all residents in Spain.

Q) Our insurance cover is due to run out, should we not renew and wait for healthcare from public funds?
 A) It would be irresponsible for CAB to tell anyone that they should be without healthcare cover. We still do not know when the INSS will implement the law. Would some companies provide healthcare on a quarterly basis for example? Also please check your policy as although first contracted at another date, health insurance policy renewals often run from January-December.

Q) I have no health cover of any sort. I am concerned. Should I apply for healthcare now?
 A) We understand that those who for some reason or other are without healthcare are worried. Those can by all means apply at their INSS office. Again you may be told that you will have to wait until the INSS has implemented the new law.

Q) Is this law only in place for residents?
 A) As CAB has always advised its members, this new law is actually part of the law of 2003. “healthcare paid for by public funds for residents¨. The ruling has been in place since 2003. All residents on Spanish soil have always been entitled to this cover. It has been the INSS who basically chose to interpret the 2012 law which denied healthcare to illegal residents and applied this to registered and/or authorised residents as well.

Q) Will those that apply for free healthcare post July 2018 still be entitled to TSE (Spanish EHIC) cards or temporary certificates?
 A) As we understand it, they will NOT. Reference article 3ter.2 from the new law that states that those now entitled do not generate the same entitlement when abroad. We will seek confirmation from INSS, once their regulations on how to implement the new law are in place.

Q) Is there a possibility that the INSS would do the same and ignore this further instructions?
 A) We are aware that they have their legal teams looking at the royal decree. This time around with all the publicity surrounding this royal decree, I suggest that they will find it difficult to ignore. What they have done since 2012 in refusing residents this cover is tantamount to deception. They also lost cases against their decision in the Spanish courts.

Q) Will this apply to those residents who having been residing in Spain but not residents?
 A) The law included those without papers which generally refers to illegal immigrants. It does not differentiate between EU or non EU or how a citizen arrived in Spain. CAB advisers believe it would be discriminatory to leave EU non legal residents out of the equation.

Q) What about those seeking residency, are they entitled to free healthcare?
 A) It is early days yet to answer this question honestly. Consider that those who arrive have the right of 90 days before residency applications need to be made, they are then here legally. The residency law still states that they need proof of cover. We are wondering if there will be an option for these new applicants to apply for healthcare first from the INSS. Again at the moment of making the application, they would neither be illegals or residents. We ask for patience whilst CAB works on the these issues.

Q) Should we visit the INSS to ask about our entitlements?
 A) CAB suggests waiting for the INSS to receive their instructions and implement the law. They have nothing to report as yet. Of course we will provide updates for our members whenever we receive more information from our sources at the INSS.

Source:- CAB Spain