Spain/Healthcare
Spain has a strong public healthcare system that ranks pretty highly.[1] Private insurance is optional and offers direct access to specialists and a dedicated set of clinics.
Coverage
The Spanish are proud of their healthcare system. It is very efficient and has a wide reach. Healthcare in Spain is generally seen as a right, not a paid commodity.
For Spanish citizens and foreigners who are on a work visa, the public system is free. If you are on a non-lucrative, digital nomad, or study visa, you must purchase international health insurance coverage which will give you access to the public system and may also include private providers.
When you register your residence at your town hall, you are assigned a local CAP that is your "home base" for medical care. Your doctor can then refer you to specialists as needed. You can elect to have private insurance on top of the public system. Private insurance gives you direct access to specialists.
Practices
No information yet.
Organization
There are 4 levels of healthcare in Spain:
- Farmacias offer OTC and prescription meds, as well as informal advice for minor maladies.
- Centre d'Atenció Primària (CAP) is for non-emergency visits.
- Hospitals provide emergency rooms.
- Specialists provide specialist consultations.
Farmacia
These are located on nearly every block in large cities. They do not, however, provide any traditional or herbal medicines.
CAP
These are very efficient public health centers. You check in at the front desk and tell them what is troubling you. They will assign you a room to visit at a certain time (could be just a 15min wait on a slow day). When the doctor is ready they will open the door and call for you. The doctor can then recommend a specialist, provide prescriptions, and post a notification to your employer (if employed by a Spanish company) to excuse your absence.
If you have social security (public health insurance) these visits are free. If you have private insurance you will pay a small fee.
In Catalonia, on your first visit, they will initiate the registration for web/mobile access to the patient portal, La Meva Salut.
Hospitals
Aster's coworker mentioned that going to the emergency room with private insurance is not something that will have astronomical costs like in the US.
Specialists
Some specialists work for the public system but waiting times to see them can be longer than seeing a private specialist. Some private clinics include Barnaclinic and Privaclinic.
Further info needed:
- How is somatic and psychosomatic healthcare divided?
- Mental health
- Long term care and care for children
Finding a GP
You are assigned a GP when you register with your local CAP. If you have private insurance you can choose a specific GP at the private clinic.
Mental healthcare
In the public system, your doctor at your CAP can refer you to a therapist.
In Catalonia, the Transit gender clinic offers therapists who assist with transition-related therapy.
Emergency care
Most Hospitals have emergency rooms. You will first check in with a receptionist who will categorize the urgency of your visit and you will be given a number. When your number is called you will be seen by a triage nurse. You will then wait again and be called for treatment if needed. After treatment you will be placed in a recovery room, typically with other patients.
Emergency rooms cover any kind of care, but for minor issues, you will receive faster care at your local CAP.
If you visit a CAP for a non-urgent issue, your doctor may refer you to an emergency room if they deem the issue to need more immediate attention.
Trans/LGBTQI specific Healthcare
Trans care in Spain varies by autonomous community. In most of Spain outside of Madrid and Catalonia, accessing care via the public system involves talking to your GP who will refer you for a psychological evaluation.
If you can't or don't want to go through the public system, Imago is a virtual clinic that covers the whole EU.
In Catalonia
The Transit Clinic in Catalonia operates on an informed consent and on-demand model. You can phone or email them for an intake appointment where they will ask about your life history, support systems, and transition goals or needs. From there they can provide prescriptions and referrals.
Trans/queer friendly health professionals and services
No information yet.
How to approach continuation of HRT
At the Catalonia Transit clinic, you can provide your past prescriptions and they will work with you to choose from various HRT options. They may ask for the results of your last blood test and schedule a new test to get a baseline.
COVID practices
Masking is rare in public in Spain but it is not shunned. At times, such as during the height of flu season, CAP clinics and hospitals require masks.