COMPARISON OF HEALTHCARE USA TO SPAIN.

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Okay, first things first, healthcare is significantly better in Spain than it is in the United States. In 2024 Spain’s healthcare system was ranked 26th in the world by Statista, with the U.S. coming in at a lowly 69th place. Spain's system is based on universal coverage, it offers free access to public healthcare for residents, while the US relies on a mix of public and private insurance with varying levels of access and affordability. Spain’s healthcare is based on principles of free access and equity for all, free access for all citizens and the option of private healthcare for those who can afford it.Spain's healthcare system is generally considered better than the US system in terms of access and cost. 

Private insurance in Spain is relatively affordable compared to the US. Private healthcare in Spain can cost around $60-$150 per month, while US premiums can range from $300-$500.

Note: It's important to compare different plans and providers to find the best fit for your individual needs and budget. 

Can I get it with pre-existing conditions as an American expat.

Yes, you can obtain health insurance in Spain with pre-existing heart and other conditions, but your options and costs will depend on the type of insurance and your specific condition. While public health insurance does not exclude conditions, private health insurance plans often exclude or limit coverage for pre-existing conditions unless you purchase a specific policy or pay a higher premium.

Understanding Public vs. Private Insurance 

Public Health Insurance (Sistema Nacional de Salud): 

As a resident, you are entitled to coverage from the Spanish public healthcare system, which generally does not exclude pre-existing conditions. 

This is largely free at the point of use for residents with social security contributions and eligible individuals like children, pregnant individuals, and students, thanks to taxes funding the National Health System (SNS). However, there are small co-payments for prescriptions, the amount of which depends on your income. 

Who is covered?

Residents: Anyone living in Spain and contributing to Social Security is entitled to access the free public healthcare system. 

Eligible groups: Children, pregnant individuals, and students under 26 are also eligible. 

Retirees: They have access to the system and only pay a small co-payment on their medications. 

Tourists: Non-European visitors are often required to have private health insurance, although vital emergency care is provided regardless of payment ability. 

What are the costs?

Free at the point of service: Most services, including doctor's visits, hospitalizations, specialized treatments, and emergency care, are free. 

Prescription co-payments: You will need to pay a small co-payment for prescription medications. The percentage of the cost you pay depends on your income level. 

No cost for care for non-European residents: In an emergency, non-European visitors are guaranteed essential medical care at public hospitals regardless of their ability to pay. 

How to access public healthcare

Obtain a social security number: You must be registered with Social Security to access the system. 

Get a health card: Once registered as a resident in your Autonomous Community, you can apply for a Tarjeta Sanitaria Individual (TSI) or health card, which grants access to services. 

Private Health Insurance: 

Many people opt for private insurance for quicker access to specialists and a wider choice of doctors. These policies typically have clauses for pre-existing conditions.

Navigating Private Health Insurance with Pre-existing Conditions 

Declare Your Condition: 

Be truthful and declare your heart condition when applying for private insurance. Failure to disclose can lead to the cancellation of your policy and rejection of claims.

Seek Out Specialist Providers: Look for insurance providers that specialize in covering pre-existing conditions. You may need to contact multiple providers to find one that offers appropriate coverage.

Consider Higher Premiums or Limited Coverage: Insurers may charge higher premiums, or they may offer a policy with exclusions or limitations on the treatment of your heart condition.

Look for Specific Policies: 

Some providers offer special policies designed to cover pre-existing conditions, or they may offer riders that you can add to a standard policy.

Tips for Finding Coverage

Get a Medical Report: Obtain a report from your cardiologist or doctor stating your current medical status and prognosis. This can help insurers assess your risk accurately. 

Compare Offers: 

Don't settle for the first offer you receive. Compare quotes from different insurance providers to find the best coverage for your needs. 

Seek Expert Advice: 

Consult an independent insurance broker who can help you navigate the complex world of health insurance and find a policy that meets your specific requirements.