The Government of Spain approved on Tuesday a royal decree that regulates access to public healthcare for foreign individuals who are in the country without legal residency.
The regulation, adopted by the Council of Ministers, establishes the procedure for recognizing this group’s right to health protection and publicly funded healthcare.
According to the Ministry of Health, the recognition of the right will be carried out through a responsible declaration in which the applicant must certify that they do not have health coverage through any other means.
To prove residency in Spain, one may present the municipal registration certificate or, alternatively, other documents such as school enrollment certificates, utility bills, or reports issued by social services, as announced on March 10 by the agency EFE.
The system also aims to ensure that individuals can receive assistance from the very moment they begin the process.
According to Sanidad, the application will automatically activate a provisional document that will allow access to healthcare while the process is being resolved.
The administration will have a maximum period of three months to issue a resolution.
If no response is received after that period, the application will be considered approved by administrative silence when initiated by the interested party.
Once the right is recognized, it will not have an expiration date, as long as the person does not obtain healthcare coverage through another means.
The Minister of Inclusion, Social Security, and Migration and Government spokesperson, Elma Saiz, emphasized that the regulation aims to unify criteria across the country. "This royal decree equalizes healthcare coverage for these beneficiaries throughout Spain and puts an end to divergent criteria that have been applied based on territory until now," she stated.
The regulation also stipulates that health authorities may initiate the procedure on their own if the patient is unable to do so at the time of receiving medical care.
The aim is to prevent situations that have frequently occurred until now.
"This way we prevent something that was happening until now, which is that someone would receive care and then get a bill simply for not having completed the paperwork.", explained the Minister of Health, Mónica García.
The Ministry of Health asserts that the regulation aims to ensure equity in access to healthcare and reduce inequalities, as well as facilitate better disease control from primary care and optimize the use of public resources.
"We have eliminated the administrative barriers that still left people without care," García celebrated, who advocated for a "full and effective" universality and asserted that "public healthcare is a right for all people living in our country."
The decree also expands access to public healthcare for Spanish nationals residing abroad, as well as for their relatives, during temporary stays in Spain, provided they are not covered by international agreements or social security legislation.
In cases where the administration rejects the request, the services received may be billed.
However, the decree states that there will be no billing if the individual subsequently proves that they met the requirements at the time of receiving healthcare assistance.
Immediate attention for vulnerable groups
The new regulations also identify several vulnerable groups that will have the right to receive immediate healthcare, regardless of their administrative status.
Among them are minors, pregnant women, victims of gender-based or sexual violence, victims of exploitation or trafficking, and applicants for international protection or stateless status.
Additionally, the text explicitly acknowledges the right of foreign women who are not residents to access voluntary termination of pregnancy within the public healthcare system.
Changes in the copayment for orthopedic and prosthetic products
The decree also introduces modifications to the copayment system for orthopedic and prosthetic services within the National Health System.
From now on, individuals who are exempt from paying for medications due to their income level or vulnerable situation will automatically be exempt from contributing money when receiving products such as prostheses or other orthopedic devices.
With this measure, the Government aims to equalize both co-payment systems to prevent low-income patients from incurring additional costs when receiving these types of health services.
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