Spain vs UK Healthcare: Public & Private Systems Compared

For UK citizens considering a move to Spain, healthcare is always a top concern. The UK’s NHS is free at the point of use, while Spain offers both a universal public system and an affordable private sector. Understanding the key differences in access, costs, speed—and the role of the S1 form for pensioners—is essential if you’re planning relocation, retirement, or buying property in Spain.

At Landcross Partners, we don’t just help you find your home—we ensure your healthcare and visa planning are seamless and stress-free.

Public Healthcare: NHS vs Spain’s SNS

NHS in the UK

• Funded by taxes & National Insurance.
• Free for residents, but waiting times are long.
• Limited choice of doctors and hospitals.
• Prescription charge in England: £9.90 per item (Scotland, Wales, NI = free)

Spain’s SNS (Sistema Nacional de Salud)

• Funded through taxes & social security.
• Residents and workers are fully covered.
• Convenio Especial scheme: expats can pay €60/month (<65) or €157/month (65+) for access.
• Quality of care is high, but waiting times exist.
• Prescription costs are income-based with caps for pensioners.

Bottom line: Both systems are strong, but Spain’s offers affordable entry for expats—and higher life expectancy outcomes than the UK.

The S1 Form: Healthcare Access for UK Pensioners

One of the most important differences between the UK and Spain’s healthcare access for expats is the S1 form.

• The S1 is a UK-issued certificate that allows UK State Pensioners (and certain other groups, like some frontier workers) to access the Spanish public health system at the UK’s expense.
• With an S1, you can register with Spain’s social security office (INSS) and receive a Spanish health card (tarjeta sanitaria individual – TSI).
• This gives you the same rights to public healthcare as a Spanish resident—including income-based prescription charges with monthly caps for pensioners.
• The big advantage: you don’t need to buy private insurance for visa compliance if you have an S1, since it’s widely accepted by Spanish consulates.

For UK pensioners moving to Spain, the S1 is the most efficient, cost-effective healthcare pathway. For everyone else (pre-retirement movers, families, remote workers), private insurance or the Convenio Especial is the solution.

Private Healthcare: Spain vs UK

UK Private Healthcare

• Used by ~10% of the population.
• Premiums are expensive: £1,500–£5,000/year.
• Benefits: faster diagnostics, elective care, private hospital rooms.
• Still relies on NHS for emergencies & complex cases.

Spanish Private Healthcare

• Widely used by locals and expats alike (~12.6m people insured).
• Premiums much lower: €50–€120/month (age & coverage dependent).
• Required for most visa applications (Non-Lucrative, Digital Nomad, etc.).
• Direct access to specialists, faster appointments, English-speaking doctors in expat areas.
• Top providers include Sanitas, DKV, Asisa, Adeslas, and Cigna.

Bottom line: In Spain, private cover is not just luxury—it’s often a visa requirement and the best way to guarantee speed and comfort.

What UK Expats Really Need to Do

1. Choose the right visa path (Non-Lucrative, Digital Nomad, Family, or Work).
2. Secure healthcare coverage:
   - S1 holders (State Pensioners): register in Spain and you’re covered.
   - Everyone else: visa-compliant private insurance with no copays and full risk coverage.
3. Register in Spain: After residency, apply for your TSI health card to access public healthcare.
4. Reassess annually: Keep private if you want speed, or join the Convenio Especial once eligible.

Conclusion

• The NHS is comprehensive but strained.
• Spain’s system delivers better outcomes, lower private insurance costs, and flexible options for expats.
• For UK movers, the winning strategy is usually:
  - S1 pensioners: register directly in Spain’s SNS.
  - Everyone else: secure visa-compliant private insurance and optionally add public access later.

Planning your move from the UK to Spain?

At Landcross Partners, we don’t just find you a property—we help you set up your healthcare, visas, and tax planning so you land with peace of mind.