Living in Spain - cost of treatment?

[FoggyFlo]

I wonder if anyone has experience of living in Spain and getting RA meds and blood tests over there, as well as regular consultant and rheumy nurse check ups? I will possibly be making a career move over there in 2017/18, but will only be working part-time, so money will be an issue. Does one get their state healthcare if working part-time? Do you have to pay prescription charges, if so, does anyone know how much the contribution is for metoject pens (20mg weekly) and hydroxychloraquine tabs? Any advice gratefully received! Thanks.

[cathie]

While the uk is in the eu you can get a medical card to use in other European countries which should help. I don't know much more than that !

[helixhelix]

I'm sure No More Heels will be along  in a while to share her experience... But remember all bets are off until after  the referendum as could change hugely if there is a vote to leave Europe.  

[sunshinegal]

Hi I reside and work in Spain full time and I'm on MTX.

As I work full time it is heavily subsidised. You should be entitled to a healthcare card as you're working but it all varies also according to which region you're looking at. What part of Spain are you moving to?

Next time I head to the farmacia I'll find out prices so you have an idea. 

Also I've never been giving a MTX pen, always a preloaded syringe. 

I'll get back to you soon...

[FoggyFlo in reply to sunshinegal]

Thanks Sunshine Gal, that's very helpful. I'm not sure where I'll work if I do go, it depends on where the jobs are! I'm a qualified teacher and also have TESOL qualifications, so hoping to get a job in a school. But because of my RA and fibro I can only manage part time. Have to save up first and also learn the language! Yes please do let me know the prices, if you can find out easily. I've looked it up and if you earn less than 18000 euros PA, which I will, then you pay 40% of the full cost of the drug.

Is there any part of Spain you can recommend as a good place to live for expats who want a more traditional Spanish life but still ties with other English folks?

[sunshinegal in reply to FoggyFlo]

Hi there!

Ok so I went to the farmacia and the full cost of 20mg mtx in preloaded injection is 29€. 

If you want to work in a school I recommend you check out this link to see that your qualifications are accepted and that they do not need to be convalidated: enic-naric.net/spain.aspx

You can also contact the British Council for advice re: teaching in Spain britishcouncil.es/en

If  you find work in a language school instead, there is a possibility that you might not get a contract and get paid under the table so make sure you check that out.

Unemployment is ridiculously high however native English speakers for schools are always in demand so I'm hoping you won't find it too hard to find work. 

Hope it goes well

[FoggyFlo in reply to sunshinegal]

Thanks, Sunshinegal. That's a lot, 29 euro per week, even if I only have to pay 40% of that! Plus there is the cost of my other meds on top, I'm not sure I'll be able to afford it.

[sunshinegal in reply to FoggyFlo]

My contribution for meds is 50% and I'm on MTX 7,5mg and the full cost is 11,18€ HOWEVER for this particular med a special rate is applied as it's in a special category and I ONLY PAY 1,12€ i.e. 10% 

[FoggyFlo in reply to sunshinegal]

Ahh, that's cheered me up! Thank you. A step closer to my dream. I know teachers in Spain aren't well paid. I think my qualifications will be okay, I've got a BEd Hons Primary and a Trinity cert TESOL, and several years experience, but I will check them out via your link. Thank you so much!

[AgedCrone in reply to FoggyFlo]

Depending on where you re-locate in Spain medical systems/contributions are different. If you are resident & registered to work & pay the equivalent of Spanish NI you get their state health...but it is not as generous as ours,

if that doesn't ,apply there is " convenio especial" where you pay a monthly fee...roughly €50 under 65 & €160 over 65.

In continental Europe as a whole people pay a private insurance as well as NI as usually only clinical care is covered...not social care or prescriptions

Enquire at the Spanish Embassy & make very sure you understand what you would have to pay for.

Good Luck

AC

[hoppy77]

You cannot use the British EHIC card if you are a resident in Spain. This is only for visitors/holidays 

[earthwitch in reply to hoppy77]

It is also only for emergency or urgent treatment - just enough to stabilise you so you can get home again or continue with your holiday, not for ongoing care.

[nomoreheels in reply to earthwitch]

Not specifically emergency or urgent treatment, it covers anything that is considered medically necessary before your return home. What may also be covered is routine or specialist treatment including the monitoring of pre-existing conditions, repeat prescriptions, oxygen & such. However it's up to the healthcare provider to determine if treatment is necessary & is only applicable to state healthcare (hospitals & health centres). In the main care will be provided free of charge but if the country's nationals are obliged to pay for specific treatment that charge would also apply to EHIC card holders.

[AgedCrone in reply to nomoreheels]

Sadly Hoppy7 is right ...you can't use the EHIC if you live/ work in Spain......you would have to pay for all your treatment & prescriptions.

[nomoreheels in reply to AgedCrone]

That's right, as I said above - it is only applicable to non residents for access to healthcare before your return home. Also, as in my reply below - if resident the EHIC card isn't applicable but can be used by holidaymakers or temporary residents (ie have a 2nd home but reside in the UK for most months in the year).

[AgedCrone in reply to nomoreheels]

It's also worth remembering the EHIC is complimentry to Travel Insurance not a replacement. I needed to use the Italian medical services last year & the first thing my Insco asked when I claimed was did I have an EHIC. I understand if you don't have one, unless you only use the overseas national health service they might not pay up for any private treatment you have received. It could prove very expensive if you mistakenly end up in a private hospital.....which overseas hotels often send you to.

[nomoreheels in reply to AgedCrone]

Of course, recommend we have both, particularly with pre-existing conditions such as ours. Much depends on which company you take your insurance out with & I would recommend anyone to check then double check what is covered. As a family we experienced that, the (expensive) insurance taken out by over 2 over '80's didn't cover the private hospitals, only became apparent when refused admission & redirected to a state hospital. That said we couldn't fault the care received, unlike the dreadful repatriation experience.

[AgedCrone in reply to nomoreheels]

Travel insurance can be a minefield as you get older, but there are good policies available. I have been with the same company for about 10 years & I originally chose the company through a broker who went through everything that would be covered. I probably paid a bit over the odds for the first year, but this year at 70+ I paid under £200 for world wide annual cover.

I had a car accident in USA & when I left hospital the Insco phoned every day to see if I needed anything, sent a car to meet me at the UK airport & the driver even stopped at the supermarket as I had been away for a month & had no fresh food in the house!

My broker said it does pay to stay with one company as they can see if you claim very often.

Having said all that I have only used the bbloomin' policy twice this year as my RA has really played up!

[nomoreheels]

Hiya FoggyFlo & welcome. How exciting! Will you be working for a Spanish company or will it a transfer from a UK company? Well, I may have some info I can share but I lived in Spain from 2002 until 2013 when we returned to the UK. Now, things may have changed & I may be out of touch so I wouldn't like to give info which could well be incorrect because I'm pretty sure things have changed re charges for meds. When we lived there whilst percentages were paid for prescriptions (Spain has a co-pay system) the percentage & so the cost depended on the meds prescribed, some were say 50% of the cost others as low as 10%. The UK Gov website gov.uk/guidance/healthcare-... seems to have the lastest info covered, click on the links also provided, they also give further info. This one has may be helpful too healthcareinspain.eu./ though it may duplicate info on the Gov site. Also this site explains in easy terms expatica.com/es/healthcare/..., be prepared though some links provided take you Spanish websites which are obviously written in Spanish. Both will explain the steps needed to obtain your Tarjeta Sanitaria or TS (Health Card).

I do know that presently if you intend to be resident in Spain the EHIC card will not apply, that's only applicable for those in temporary residence or holidaymakers.

I saw my Rheumatology Consultant every 3 months, the only time I had contact with the nurse was for her to demonstrate & for me to show I could inject MTX & to give me my MTX injection info. It's different to here where you see the nurse inbetween appointments for advice or help or it was at my hospital anyhow. I would guess everyone is given as I was a direct mobile number to their Consultant for any extraneous appointments or advice. Blood test request forms were given to me completed (30 odd different ones) at the end of each Consultant appointment & I attended the hospital for these to be taken a week to ten days before my next appointment so they were analysed in good time to discuss the results at my appointment.

My h worked full time so I don't know if it's any different for part time work, the links I've given should provide that info. I didn't work but I was entitled to health care being his wife, as are children/immediate family. The first 6 months my h chose not to work & we concentrated on finding somewhere permanent to live so took out private health insurance. As soon as he took his job & was given his Documento de Afiliación a la Seguridad (Social Security number) we applied for our TS cards (this is one part of the necessary documentation needed to apply for the TS card). When we received both of them we cancelled the private insurance.

I hope some of this helps but if there's anything specific you need help with I'll help where I can.

[FoggyFlo in reply to nomoreheels]

Thanks nomoreheels, that's really useful. I'll have a look at the links you've given me. I'm hoping to get a job teaching English in a primary school, have got lots of experience in that field. But I'm saving up first and also want to learn some Spanish. Which part of Spain did you live in?

[FoggyFlo in reply to FoggyFlo]

It looks like to would have to pay 40% of the cost of mtx injection prescriptions, that could be quite costly if they're expensive in Spain! I need to keep saving up then!

[nomoreheels in reply to FoggyFlo]

The guide does give a reasonable indication but of course it can depend on a few things, declared annual income, specific exclusions which may or may not have some implication (disability & such). Also in Spain things like car tax, liability & such can differ from one autonomous region to another, even an ITV (MOT) can be different from town to town so nothing's written in stone until you know in which community you're likely to be settling, do bear this in mind. Another link to help explain healthplanspain.com/blog/he...

I must just say that between us at the time we took about 10 meds & it wasn't by any means expensive. That said then there were different percentages paid for each med, more regularly generally prescribed ones were a fraction of the actual cost, a bottle of MTX tablets were 38 cents for 50, one 15mg MTX injection was 2.44€, I can't remember what I paid for HCQ but I have it written down in a notebook so if I find it I'll let you know. Of course it's probably different now from when we were there, the cost price of MTX injections may have come down in that time so the percentage to be paid may be less but again it wasn't as it is now with specific percentages being charged depending on which annual income bracket & social situation you will be in. 

[nomoreheels in reply to FoggyFlo]

Costa Blanca, in the mountains back from the coast near Alicante. We have a friend who's a Director & English teacher in a private school & lived in Spain since the late 70's who at one time taught in Murcia & more recently Valencia, now semi retired.

I hope your hopes are realised. If you're considering the same region & I can help at all you only need to ask. I would advise anyone to do as we did & do your homework though, there's no doubt it's a beautiful country but it's quite different living there & the change in culture is something to experience away from popular resorts!

[FoggyFlo in reply to nomoreheels]

Thanks, you're so kind! I think from Sunshinegal' s post above, the cost of mtx injections would be too high (40% of 29 euros a week) and I can't tolerate tablets. So I think I'll have to win the pools! I did have friends over there, they live near Murcia and I visited a lot in the past. Great area

UPDATE: I think mtx is in a special category, so you only pay 10% of the cost

[nomoreheels in reply to FoggyFlo]

That sounds even better! I hope that helps. I found the price for HCQ, I used to pay 1.14€ for a month's supply. I have others you may recognise or be prescribed, 20mg omeprazole for example was 1.44€. I got the MTX wrong, I paid 2.44€ for a 15mg prefilled syringe, the 27€ was list price not prescription price, sorry if I alarmed you, I should have realised because our monthly meds charge only came to about 20€ for 13 different meds for my h & myself.

[FoggyFlo in reply to nomoreheels]

Yes I'm on hcq and omeprazole too, also on tramadol and folic acid, so sounds like I should be okay :). Thanks! The Alicante area looks promising

[FoggyFlo]

Thanks for your help everyone, it's been invaluable.