The COVID-19 pandemic and the vaccination to fight against it has been on our minds for more than a year now. The amount of information in the media surrounding the pandemic is staggering, but for many of us the most important question has still gone unanswered: when can I get vaccinated? And for those whose access to healthcare in Spain is via private health insurance, there is almost no information at all. But is there something you can do if you only have private health cover?

Vaccination plan in Spain

In September 2020, the Inter-Territorial Council of the National Health System decided on a single vaccination strategy to be carried out in Spain. Their official website is a useful source of information where you can follow the latest updates on the vaccination progress and be notified on other important news regarding the pandemic.

Spain´s vaccination plan is divided into three stages, and from January until March 2021 they plan to carry out the first phase by providing vaccines to the following groups listed in order of priority:

1. Care home residents and health and social personnel that work with them
2. Health workers on the frontline
3. Other health and social personnel
4. People considered highly dependent

On January 21st, Spanish authorities announced a fifth group to be introduced in the second phase which consists of residents over the age of 80, approximately 6% of the Spanish population. The other groups will be announced gradually.

Residents who only have private insurance

The current vaccination strategy will only be carried out within the public health system; the private sector is not entitled to supply vaccines. Although most of the population has access to public health care in Spain, there is at least one group that hasn’t yet been taken into consideration: legal residents holding private medical insurance who are required by the Immigration authorities to obtain or renew their non-lucrative residence permits and are therefore not eligible for free access to public health care (Real Decreto – ley 7/2018 de 27 de julio de 2018, BOE 30 de julio de 2018 – Art.3-2c). Currently this group is not on the public health care system’s radar because they are not registered with Social Security and do not hold a SIP card, so are easily overlooked when vaccination lists are made.

The former health minister, Salvador Illa, announced that Spain will get 140 million doses, that there will be vaccines for everyone, and there will be more than enough. The Spanish authorities keep insisting that vaccination is universal and anyone living in Spain will have access to it. We are confident that everyone eventually will, but we are also aware that many people in the previously mentioned group are senior residents over 65, some with pre-existing conditions and in higher risk groups, and who should therefore be vaccinated on an equal footing with the rest of the population – not any later and not as the last ones in line.

We understand the frustration and concerns that this uncertainty can bring and have already teamed up with private insurers to take further action and report the situation to the official authorities. At the moment, there is no clear information on plans for the private sector to take part in the vaccination programme, but we believe that it will likely happen once the vaccine becomes more widely available.

What can I do now?

Apart from being patient while the vaccination strategy progresses, there is not very much that you can do right now.

There is one thing that you probably shouldn´t do though. Lately there have been several rumours circulating on social media and within expat communities of a vaccine waiting list, or the possibility of registering online for a temporary SIP so as to be potentially included in the list for vaccination.

There is an online form for people who have COVID-19 symptoms and do not have SIP cards, which registers them on the system so that they can receive the appropriate medical attention. We reached out to that particular office to clarify this matter and they confirmed it is only for people with COVID-19 symptoms. The massive amount of inappropriate registration on this site overwhelms their workload and may eventually affect people’s access to health care who truly need medical assistance.

What is the SIP card, and should I get one?

Probably everyone by now has heard the term ‘SIP card’ but may not be familiar with its meaning.

The Valencian Health authorities have provided on their website a fairly clear definition of the “SIP card”:

The Health Card is the valid document for the identification of each citizen and for the accreditation of the type of services and health benefits that are legally and individually recognized in the Valencian Community. The information contained therein is extracted from data collected by the Population Information System of the Conselleria de Sanitat.

The Health Card certifies the level of public health benefits that each citizen legally has with regards to the National Health System by virtue of the insurance regulations in force at all times.
Being in possession of the SIP Health Card does not imply the right to public health benefits.

The Individual Health Cards issued by the Ministry of Health, will not alter, if applicable, the obligation of their holders or third parties to assume the cost of health care provided by the public health system of the Valencian Community.

Can I get public health care?

Although Spain has declared that access to public health services is universal, as previously mentioned some resident groups are not eligible for public coverage (at least for the first five years until they become permanent residents and qualify for free access to public health care). The ones who depend only on private health insurance, have the option to pay a monthly fee to access state-run healthcare (the so called pay-in scheme – in Spanish, Convenio especial de prestación de asistencia sanitaria) after having lived for 12 months in Spain. Currently, the fee is 60 euros a month for residents under 65, and 157 euros a month for those over 65.

If a person decides to join the public system by signing the “Convenio Especial”, the SIP card will be issued on the spot. But paying-in doesn’t fit everyone’s budget or situation; the public system is known for longer waiting times, little to no choice of doctor (which can be quite frustrating as many specialists barely speak English) and no direct access to specialists, etc.

Of course, public health care can be a very important backup for more severe conditions and diseases, with access to cancer treatment, transplantation surgeries etc., so the decision is very personal and depends on each person´s specific circumstances. Needless to say, someone can be covered by both systems simultaneously and pick which one to turn to, private or public, depending on their needs.

How can I get the “tarjeta SIP de pago”?

If you happen to find yourself in a situation with no public health care coverage and you cannot or do not wish to join the pay-in scheme, and regardless of any other circumstances, you can still obtain the SIP card (tarjeta SIP de pago) at your nearest public health centre. This card will allow the health centre to identify you within the public healthcare system if needed and will allow you to use public health services for a price (the card itself will be issued free of charge). Please note that holding a SIP card does not guarantee you access to the vaccine, but it will at least include you in the system and make you more visible to the health administration.

To obtain the SIP de pago card you need to go in person to your closest public healthcare centre. Due to COVID-19 restrictions, certain centres may require an appointment. The front desk usually attends to these inquiries in the morning. Here, you can search for the medical centre closest to your home address.

At the health centre, you should provide the following documentation:

1. Your passport (bring a copy just in case) and residence card.
2. “Certificado de empadronamiento” (registration with the Town Hall) which is no older than three months. If you live in Valencia city, you can request an updated copy of your certificate online and it will be sent to your email address.
3. In the case of minors, you should bring their documents and birth certificates as well. Children do not need to be present.

As we have mentioned earlier, there are several types of SIP cards, so ask specifically for the “tarjeta SIP de pago”, otherwise the health centre may redirect you to the Social Security office to get a document of your coverage (as mentioned earlier, some groups for residents will not qualify so you can end up going in circles). The card will be issued on the spot.

We hope you find this information useful and we will keep you posted!

Health Insurance in Spain for Expats