The short answer
If you receive a UK State Pension and live in Spain, you can usually access Spanish public healthcare through an S1 certificate, with the UK covering the cost. Apply through NHS Overseas Healthcare Services, then register your S1 with Spain's National Social Security Institute (INSS).
Once approved, you can obtain your regional health card and use public healthcare services on the same basis as Spanish residents. Eligibility depends on your circumstances, particularly if you also receive a pension from another country.
Updated 24 October 2026
The S1 certificate allows eligible UK State Pension recipients living in Spain to access the Spanish public healthcare system, with the UK responsible for funding their care.
These reciprocal healthcare arrangements continue after Brexit and remain available to eligible pensioners moving to Spain.
Who qualifies for an S1?
You may qualify if you're receiving a UK State Pension and are legally resident in Spain, or preparing to move there.
If you also receive a state pension from Spain or another European country, the rules determining which country pays for your healthcare can be more complicated. NHS Overseas Healthcare Services can confirm your eligibility.
How do you apply?
You can apply through NHS Overseas Healthcare Services:
- Telephone: +44 (0)191 218 1999
- Email: s1applications@nhsbsa.nhs.uk
- Online: Through the NHS Business Services Authority website.
You'll generally need your National Insurance number, personal details, pension information and address in Spain. You can begin arranging your application before moving, although entitlement depends on meeting the eligibility requirements.
Registering your S1 in Spain
Once your S1 has been issued, you must register it with Spain's National Social Security Institute (*Instituto Nacional de la Seguridad Social*, or INSS).
Registration can be completed through an INSS office or its online portal. You'll generally need your S1, passport, NIE, proof of Spanish residence and a completed healthcare application form.
After INSS recognises your entitlement, you can register with your local health centre and obtain your regional health card. In the Valencian Community, this is known as the SIP card (*Sistema de Información Poblacional*).
What healthcare does the S1 cover?
Your S1 provides access to Spanish public healthcare on the same basis as someone insured under the Spanish system. This generally includes GP appointments, specialist consultations, hospital treatment and emergency care.
Not every service is completely free. Prescription charges and certain other patient contributions may apply.
Eligible dependants, including a spouse or partner, may also be covered, although their entitlement must be assessed and registered separately where required.
Once your S1 is registered, you may also qualify for a UK-issued GHIC or EHIC for medically necessary state healthcare during temporary visits to other eligible European countries.
What doesn't the S1 cover?
An S1 does not provide private medical insurance or automatic access to private hospitals and clinics. You'll need separate insurance or pay privately if you want those services.
It also doesn't replace the need to establish legal residence in Spain.
What should you do next?
Contact NHS Overseas Healthcare Services to confirm your eligibility and apply for your S1. Once issued, register it with INSS and arrange your regional health card.
Start the process as early as possible to avoid gaps in healthcare arrangements when relocating.
People also ask
›Do I need private health insurance if I have an S1?
No, the S1 gives you full access to Spanish public healthcare, so you don't need private insurance for routine care. Some people still take out private policies for faster access or extra services, but it's not required.
›How long does it take to get the S1 form?
The NHS Overseas Healthcare Services usually processes applications within a few weeks, but it can vary. It's best to apply as soon as you know your moving date.
›Can I use the S1 for treatment in the UK?
Yes, S1 holders are entitled to primary care, emergency treatment, and hospital care when visiting the UK. You'll need to show your S1 certificate.