ACCESS TO HEALTHCARE: E121

If you get a UK State Pension or long term Incapacity Benefit and you decide to move to Spain permanently, ask for your E121 from the International Pension Centre (IPC) in Newcastle.

Once registered with the Spanish authorities, the E121 gives you and your dependents the same medical cover in Spain as a Spanish national under the Spanish state-run health scheme. This cover may not be the same as you received on the NH in the UK so you may have to pay for some treatments or services. Remember that:

• Treatment given privately and reparation costs to the UK are not covered. Think about whether you want to take out private health care.

Some social services may not be available.

Registering with the Spanish authorities

In order to register you E121 you’ll need to get the following in this order:

Certificate of Residence n Spain (Certificado de Residencia / Numero de Identificacion Extranjero) – available from your nearest National Police station;

Certificate as a Local Resident (Certificado de Empadronamiento) – available from the local Town Hall (at the Padron Office)

Advice on how to get these certificates is on the UK in Spain website (ukinspain.fco.gov.uk), and on the website of the Spanish Ministry of the Interior (MIR) – or you can contact either your local Comisaria de Policia (Certificate of Residence in Spain) or Town Hall (Certificate as a Local Resident). Many people offer a 'paid for service' to do this for but it is a fairly simple, albeit time consuming process. Check what documents you’ll need to take and what will be the process to complete your application successfully. Also remember to make your own photocopies before you get to your appointment. If you forget something, it’s unlikely you’ll be allowed to complete the process and you’ll probably have to go back another time.

Once you have your certificates, take them, along with both copies of your E121 form, to the local Instituto Nacional de la Seguridad Social (INSS) office. They will keep both copies of your E121 and issue you with accreditation (Documento acreditivo del derecho a la asistencia sanitaria).

Take the accreditation to the local health centre. Once you are registered you will be able to access the Spanish state-run health scheme. You will be issued with a plastic card at a later date (Tarjeta Sanitaria Individualizada Nacional).

Full access to the state system starts from the day you register your E121 with the INSS so:

Don’t wait until you need treatment as you could be charged and these costs may not be refunded;

Think about taking out private medical insurance to help with the cost of any treatment needed before your E121 is registered;

Make sure you ask the International Pension Centre to include any dependents on the E121 form when you apply for it. You can also ask the INSS to apply to the UK for a new E121 if you wish to include them at a later date.

What if your circumstances change?

You need to tell the International Pensions Centre if you or a dependant family member:

• Starts work or starts getting a pension from another country;

Changes address in Spain, or moves to another country, including the UK.

Some will also need to inform the IPC in the event of your death or that of a family member in receipt of a pension or benefit.

If you travel to the UK or another EU country

If you register an E121 in Spain you need a Tarjeta Sanitaria Europea (TSE) which is the Spanish equivalent of the European Health Insurance Card (EHIC). This is what you need to get state healthcare if you travel to the UK or another EU country.

EHICs issued by the UK are no longer valid and should be returned immediately to:

EHIC Enquiries

PO Box 1114

Newcastle upon Tyne, NE99 2TL, UK

Where to get more information

If you have any queries about form E121 or healthcare cover, please phone +44 191 2181999. If you want to know about your State Pension please phone +44 191 2187777

To find your local INSS office, visit www.seg-social.es and click on the link ‘Direcciones y telefonos’ on the left-hand menu. You can find more information on the health system in your region in Spain by visiting the webpage of the Autonomous Community you live in.