The
vast majority of people in Spain are covered for health treatment
under the social security system, though the more affluent
also take up supplementary private health insurance. EU nationals
transferred to Spain by an employer in their home country
can continue to pay the social security contributions. After
working in Spain for two years, EU nationals must contribute
to the Spanish social security system. Generally, if you are
an employee in Spain you will be insured under social security
legislation and you will not have any liability for social
security contributions in your home country. An expatriate
would need to effect supplementary insurance and would probably
be advised to effect full private
insurance.
Other
risks: Rabies is present. For those at high risk, vaccination
before arrival should be considered. If you are bitten, seek
medical advice without delay.
Health
care: There is a reciprocal health agreement with the UK.
Medical treatment provided by state scheme doctors at state
scheme hospitals and health centres (ambulatorios) is free
to UK citizens if in possession of form E111. Health insurance
is required for private medical care. Prescribed medicines
and dental treatment must be paid for by all visitors.
France
The
number of people who enjoy private healthcare insurance in
France is 84% of the population. Healthcare costs are approximately
9.9% of GDP. Most schemes only cover risks not covered by
the main social scheme, and they usually cover that part of
medical expenses that are not refunded under the state scheme.
Many plans also offer cash allowance benefits in case of temporary
or permanent disability.
Private
healthcare is available through two types of hospitals: private
hospitals, called cliniques, which are managed like a company,
and public hospitals - hospitals pubiques. Approximately 99.6%
of the population benefits from social coverage with 84% of
people effecting private supplementary healthcare coverage.
Expats
working in France on a salaried basis will be required to
be part of the social security arrangement. So the employer
will have the choice of either providing health insurance
which is supplemental to the expatriates state entitlement
under French law or, alternatively, paying for a separate
and totally private arrangement. However, this cost will be
in addition to cost paid to the social security scheme.
A
yellow fever certificate is required for travellers coming
from South American and African countries.
Visitors
to forested areas should consider vaccination for tick-borne
encephalitis.
Rabies is present. For those at high risk, vaccination before
arrival should be considered. If you are bitten, seek medical
advice without delay.
There
is a reciprocal health agreement with the UK. On presentation
of Form E111 (which must not be more than 12 months old to
avoid the possibility of bureaucratic non-acceptance) at an
office of the Caisse Primaire d'Assurance Maladie (Sickness
Insurance Office), UK citizens are entitled to a refund of
75 per cent or more of charges incurred for dental and medical
(including hospital) treatments and around 35-65 per cent
of charges incurred for prescribed medicines. Application
forms for Form E111 are obtainable from post offices. The
standard of medical facilities and practitioners in France
is very high but so are the fees, and health
insurance is recommended - even for UK citizens.