The purpose of the Social Security health care is to provide the medical and pharmaceutical services necessary to preserve and restore the health of its beneficiaries, as well as their aptitude for work.
They will have the status of insured , among others, people who are in any of the following cases:
Being an employee or self-employed, affiliated and registered or in a situation assimilated to registration.
Hold the status of pensioner of the Social Security system.
Be a recipient of any other periodic Social Security benefit, including unemployment benefit or subsidy.
Having exhausted the unemployment benefit or subsidy or other benefits of a similar nature, and being unemployed, not proving the condition of insured by any other title, and residing in Spain.
People who, not having mandatory coverage of health care by other means, are in certain cases.
Minors subject to administrative guardianship.
Beneficiaries / Requirements:
They will have the status of beneficiaries of an insured, who are who are, among others, in the following situations:
Being the spouse of the insured person or living with a similar affective relationship, constituting a common-law partner.
Being a former spouse or being judicially separated, in charge of the insured for having the right to receive a compensatory pension.
Being a descendant, or an assimilated person, of the insured person or their spouse, even if they are judicially separated, from their ex-spouse in charge or their common-law partner, in both cases in charge of the insured and under 26 years of age or, in case if they are over said age, have a recognised disability equal to or greater than 65%.
The sisters and brothers of the insured person.
They will have the status of beneficiaries if they meet the requirements of:
Not hold the status of insured persons based on article 2.1.a RD 1192/2012.
Have authorised and effective residence in Spain, except for people who temporarily move to Spain and are in charge of workers transferred by their company out of Spanish territory, provided that they are in a situation assimilated to registration, and are listed under the corresponding regime of Spanish Social Security.
The catalog of benefits National Health System comprises the corresponding benefits to public health, primary care, specialty care, emergency care, pharmaceutical benefits , the ortho prosthetic, dietary products and medical transport .
The benefits are made effective through a set of techniques, technologies and procedures that make up the common portfolio of services, which is articulated in the modalities of:
Basic care services : It includes prevention, diagnosis, rehabilitation, urgent medical transport activities that are carried out in health and social-health centres; it is fully covered with public funds.
Supplementary : Includes benefits whose provision is made through outpatient dispensing, such as pharmaceuticals, orthotics, health products, non-urgent health transport; is subject to user input.
Ancillary services : Without having the character of provision, they are considered supportive to improve pathologies; They are subject to user contribution and / or reimbursement.
The insured and their beneficiaries , while the pathological process lasts.
In the case of workers discharged from Social Security and their relatives , the duration varies according to the amount of time contributed.
The right to health care, both for the insured and for their dependents, arises on the day of affiliation to the Social Security System and becomes effective from the day following the presentation of the discharge in the corresponding Regime .
Denial / Extinction:
When the conditions required to be insured or beneficiary of the right are lost.
Due to death.
The application form for the recognition of the right to healthcare, both for the future insured and for the beneficiaries.
DNI or official document that identifies the insured and their beneficiaries.
Family book or certificates from the Civil Registry that prove the relationship with the insured, when the right is requested for the beneficiaries …
Where to process it:
In any of the Social Security attention and information centers , the provincial directorates of the Marine Social Institute (ISM), or through the Electronic Headquarters if a digital certificate is available.
The recognition and control of the condition of insured or beneficiary of the same will correspond to the National Institute of Social Security (INSS) or, where appropriate, the Social Institute of the Navy (ISM).
The right to healthcare is made effective by the competent healthcare administrations; The health centres of the autonomous communities facilitate access to health benefits with the issuance of the individual health card .
Other data of interest: