Spain · Healthcare and State Pension
If you live in Spain and draw a UK State Pension, the UK pays for your Spanish state healthcare through an S1 form: you request it from NHS Overseas Healthcare Services, register it with Spain's social security institute (INSS) and then join your local health centre. If you only visit, a UK GHIC covers medically necessary state treatment. Before State Pension age you need your own cover: private insurance, or the convenio especial, a public scheme you pay into once you have been resident for a year.
Looking at a home in Spain? Four quick questions, then Rory tells you plainly what your budget reaches and whether the timing works.
See what fits →The route depends on where you live and whether your UK State Pension has started; every resident must register to use Spain's health system.
| Your situation | What covers you | Good to know |
|---|---|---|
| Living in the UK, visiting Spain | UK GHIC, or a UK EHIC still in date | State care that cannot wait; take travel insurance too |
| Living in Spain, drawing a UK State Pension | UK-issued S1, registered with the INSS | Spanish state care as for a Spanish citizen, paid by the UK |
| Living in Spain, below State Pension age, not working | Private health insurance; later, the convenio especial (€60 or €157 a month) | Insurance is a condition of the non-lucrative visa |
| Legally resident in Spain for five years | Permanent residence gives access to state healthcare | The INSS asks for a UK 'legislation letter' |
| Working or self-employed in Spain | Spanish social security | Dependants register separately with the INSS |
| Drawing a Spanish state pension as well as the UK one | Spain, not the UK | You cannot get a UK S1 |
Your S1 can cover dependants; a dependant who later claims their own UK State Pension is sent a new S1 to register. Any change of address or circumstances must be reported to NHS Overseas Healthcare Services. The NIE is explained on our NIE page, and the rest of the move in moving to Spain from the UK.
A registered S1 gives you and your dependants Spanish state healthcare on the same basis as a Spanish citizen, with the UK paying. It also brings a UK-issued GHIC or EHIC for trips to other eligible countries, and planned treatment in another eligible country through the S2 route.
Prescriptions carry a co-payment: after a May 2026 reform, Spanish Social Security pensioners pay 10% of the price, capped each month at €8.23 on incomes under €18,000, €13.37 under €60,000 and €18.52 under €100,000; from €100,000 they pay 60%, capped at €61.75. The rules do not say how this applies to S1 holders, so ask your health centre which rate your card carries. Some basic dental care is available, but GOV.UK notes most people use private dentists; private clinics are outside the S1.
On visits to the UK, official sources differ. The NHS says a registered S1 entitles you to NHS treatment when visiting the UK. GOV.UK lists that exemption only for UK nationals living in the EU on or before 31 December 2020, and says treatment that is charged costs 150% of the NHS rate. Ask NHS Overseas Healthcare Services where you stand before a trip home.
If you live in the UK and winter in Spain, you are a visitor, so the S1 is not for you. A UK GHIC gets you state treatment that cannot wait until you are home, on the same terms as a Spanish resident, including emergencies and care of existing conditions; dialysis must be arranged in advance.
The card does not cover private treatment, mountain rescue or being flown home, so the NHS advises travel insurance as well. It is free, lasts up to five years and is issued through the NHS website; unofficial sites charge a fee. GOV.UK's guidance, written before Spain's 2026 reform, says visitors pay 50% of the prescription price, or 10% with proof of a UK State Pension.
If you move before your State Pension starts and do not work in Spain, you need your own cover. For the non-lucrative visa, the Spanish consulate in London asks for public or private health insurance from an insurer authorised in Spain, covering all the risks Spain's public system covers; it also accepts a receipt of S1 registration on the Spanish Social Security website. GOV.UK adds that anyone resident under a year without state cover needs private insurance.
The convenio especial is a public scheme you pay into through your regional health service: €60 a month under 65 and €157 from 65 under the national decree, the amounts listed by the six regional services we checked. It gives basic state care without co-payments, but members pay the full price of prescription medicines, orthopaedic and dietary products and non-urgent transport. The decree requires a year's residence in Spain before you apply; the Health Ministry says time lived in the UK or the EU counts towards it, while GOV.UK says a year on the padrón, so ask your regional service which it applies.
After five years of residence you can apply for permanent residence, which gives state healthcare as a Spanish citizen; the INSS asks for a 'legislation letter' (documento de no exportación) from NHS Overseas Healthcare Services. Once your State Pension starts, you may have the right to an S1. Other countries are compared in retirement visas compared.
You can claim your UK State Pension from Spain through the International Pension Centre once you are within four months of your State Pension age, which you can check on GOV.UK. It can be paid into a Spanish or UK account every 4 or 13 weeks, and a 0.39% charge applies when it is converted into euros.
Spain is in the European Economic Area, so the yearly uprating applies to you; at the full new rate that means £241.30 a week for 2026/27. If you split the year between the two countries you must choose one for payment, and the DWP may send a life certificate to check you are still eligible. Where it is taxed depends on your tax residence and double taxation rules, covered in retiring to Spain; a tax adviser can confirm your own case.
Weighing up a home in Spain?
Rory speaks to every buyer before anyone is introduced: fifteen minutes, your budget and your timing, and a straight answer on whether it fits.
Talk to us about Spain →Phone NHS Overseas Healthcare Services on +44 (0)191 218 1999, as S1 applications are requested by phone. You must be legally resident in Spain and drawing a UK State Pension or another qualifying UK benefit. When it arrives, register it with the INSS in person or online, then take the social security number it sends you to your local health centre.
With a registered S1, basic Spanish state healthcare is free to you on the same terms as for a Spanish citizen, with the UK paying. Prescriptions are not: Spanish pensioners pay 10% of the price, capped at €8.23 to €18.52 a month for incomes under €100,000, and your health centre can confirm how that applies to an S1. GOV.UK says most people use private dentists, and private clinics are not covered.
No. The GHIC is for temporary stays, which the NHS puts at usually up to 90 days. Residents need a Spanish health card instead, through an S1, work, the convenio especial or permanent residence. A registered S1 does bring a UK-issued GHIC or EHIC, but that is for trips to other eligible countries.
Yes. GOV.UK says the State Pension rises each year for people living in the European Economic Area, which includes Spain, as well as Gibraltar, Switzerland and countries with a social security agreement with the UK. It can be paid into a Spanish or UK bank account, with a 0.39% charge on conversion into euros.
You need your own cover until your UK State Pension starts, and the non-lucrative visa requires health insurance. After a year's residence you can pay into the convenio especial, at €60 a month under 65 or €157 from 65, and once your State Pension starts you can apply for an S1.
Last checked 2026-09-28. Rules and rates change; this is general information, not legal, tax or financial advice. Confirm your own position with an independent Spanish lawyer or tax adviser before you act.