International health insurance plans have gained popularity over the years as more and more people who love to travel find the need for a medical coverage while they are in a foreign land. International health insurance provides broad coverage in the event of illness or injury.

So many health-related mishaps can happen while you are traveling in a foreign country, and since you are not a native of the place, you might not be eligible for government-sponsored health care. That is why if you travel overseas most of the time (either for business or for pleasure or maybe both), it is important that you have an international health insurance plan.

Basically, international health insurance offers two plans: the travel medical insurance and the expatriate medical insurance. Although these both provide coverage in the event of sickness or accident, the coverage vary on their length of the stay in the foreign country.

The travel medical insurance is the more popular type of international health insurance. This is a better option for those travelers who are making one tour or cruise and only stays in a foreign land for a shorter duration like seven days to twelve months. This usually consists of $1 million coverage for ordinary and emergency healthcare, home country coverage and trip interruption.

On the other hand, if you are an American who wishes to live in another country for an extended time, the expatriate medical insurance is the plan for you. It is essential to make sure that you and your family are covered in your new country. The advantage of this over the travel medical insurance is that this can be renewable annually and has a bigger coverage of up to $5 million.

Getting an international health insurance plan is indeed a wise move, whether you are traveling just for few days or for a longer duration. But see to it that what you choose is exactly the plan that will best work for your travel insurance needs.

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The most important thing to appreciate about Spanish health care is that it is not necessarily free to you – just because you are an EU national. This is a common misconception.

Spanish health care is ‘free’ only to those who are tax resident or properly registered pensionistas (people over the age of 65). In either case, you must apply for your SIP (Sistema de Informacion Poblacional) card. This is your individual Spanish health card and is needed whenever you attend a Spanish doctor or hospital. It is something that you can apply for yourself or (more easily!) through the services of a gestor.

Certainly, you should note that having a NIE number or having inscribed yourself on the Central Register of Foreigners (Centro Register de Extranjeros) will not automatically provide you with free healthcare in Spain. To be tax resident is also not a ‘negative’ function. You must either actually be paying tax to the Spanish state or making an annual Spanish tax return to be considered as tax resident. The mere fact that you are deemed to be tax resident after 183 days within the country does not mean that you are tax resident and thereby gain free healthcare in Spain – if you make no effort to pay any tax!

Spanish health care from the State is generally considered very effective.  There are some 800 hospitals and 2,700 medical centres (Centros de Salud) thoughout the country with almost every village having a doctor (medico) who will attend his medical centre daily (even if it is just for a few hours before he goes to the next village or district).  Normally a nurse (enfermera) will be in attendance and sometimes, as a patient, you can see your Spanish doctor the same day.

However, note that children under the age of fourteen must be treated in specific children’s health centres in Spain which are staffed by specialist paeditricians. These are normally located in the nearest town of any size.

Meanwhile, there is a network of Spanish hospitals with accident and emergency departments (urgencias) throughout the country which operate in a very similar way to that of the UK. You are normally seen by a member of the triage staff promptly and then treated as quickly as necessary given your degree of injury.

My family have now lived in Spain for over six years and we have relied upon the state for almost all our Spanish health care needs. Whilst we have been fortunate to have experienced excellent health whilst living here, we have been through A&E twice (a road accident and serious sudden illness) and our daughter has been attended to by our local Spanish children’s clinic. On each occasion we have been left stunned by the quality and efficiency of the health care provided.

Indeed, access to a consultant doctor seems much better than it was in the UK and in our (perhaps subjective) judgment state health care in Spain seems better than that of the UK. This is a view that has been expressed many times by local (Comunidad de Valencia) ex-patriot friends of ours who have, between them, suffered a full range of health problems in Spain – from minor to life threatening.

Of course, Spain is an enormous country with 17 different autonomous regions and two autonomous cities. It is therefore difficult to provide an accurate qualatitive assessment beyond one’s own experience. So, different areas may provide different levels of excellence. However, it is safe to state that if you are thinking of moving to Spain then you can rely upon state Spanish healthcare for all your and your children’s needs.

One problem with Spanish health care is the language barrier for anyone not reasonably fluent in Spanish. Interpreters are not supplied in Spanish hospitals or Spanish clinics. This means that when you are feeling most vulnerable you can encounter real difficulties in being understood – or understanding your attending doctor. Whilst some doctors in Spain do speak English this can never be taken for granted.

In fact, usually, within areas of high density ex-patriots (such as along the Spanish coastine) there are interpreters available. If you tap into these communities, invariably someone knows of a person who will interpret for you and attend an appointment with you (albeit normally for a fee).

If you do not wish to use Spanish state health care then you can take out private health insurance in Spain to provide you with any necessary cover. All the major health care insurance companies have facilities available in Spain. There are also private ‘walk-in’ clinics and hospitals in some of the towns.  We used one of these (in Gandia) on one occasion and found it effective and the attention professional.

Of course, thankfully, life in Spain tends to be healthy. The country has the longest longevity rates for women in Europe and the second longest for men (after Sweden). So, hopefully, you will rarely need healthcare in Spain!

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