The people entitled to use this card are those who are in Spain temporarily (on holiday or staying at a second home for some months of the year). This assumes you consider that you still live mainly in the UK. Then, if you are a UK student, in Spain, studying as part of a UK course – then a UK EHIC is the correct way to gain health cover during your stay in Spain.
On the other hand, if you live mainly in Spain, or are planning to do so, you have to register for state healthcare in another way and this will be explained later. If you are a UK state pensioner/insured person who is registered for state healthcare in Spain, the UK EHIC is only for use outside of Spain, while on holiday perhaps, but within the European Union.
If your entitlement to use a UK EHIC is without any doubt, the card will cover you for all medically necessary treatment for the duration of your temporary stay in Spain. Medically necessary treatment is defined as treatment decided by a doctor and will be given on the same basis as an insured resident in Spain. It can include routine or specialist treatment and the monitoring of existing conditions, as long as the treatment cannot wait until you get home to the UK.
The card cannot be used to see a private doctor and is only recognized in state hospitals and health centers. If you want to travel to Spain just to get health treatment, then the EHIC cannot be used. Instead, you need to obtain form S2 from your local health authority in the UK. The same S2 form is needed if you are pregnant and want to give birth in Spain, as once again, the EHIC will not cover you.
It’s important to emphasize that an EHIC is not an alternative to travel insurance. It does not give you access to private healthcare or cover costs such as a return flight to your home country, and it most certainly does not cover the cost of lost or stolen property
As mentioned earlier, if your main residence is in Spain or are about to retire there, then healthcare is obtained in a different way. Assuming you do not work or pay social security contributions in Spain, and assuming too you do not receive Spanish state pension or benefit, and have never received Spanish unemployment benefit – then you need to acquire form S1 from the International Pension Centre or your local INSS in the UK.
This needs to be presented to your local Department of Social Security in Spain, where they will provide a certificate that confirms your status. This certificate is needed when you apply for your health card (TSI – Tarjeta Sanitara Individual). This card will give you the same cover as enjoyed by Spanish nationals. Once you have this TSI card, you take it to your local medical centre, to register with a doctor, and they will allocate a SIP card. You have to carry this with you at all times and present it whenever you need to visit your doctor, or collect prescribed medication from the chemist.
Finally, it’s important to say that, if you live in Spain and regularly visit relatives in the UK, you need to acquire and carry a Spanish issued EHIC card, to obtain free UK treatment.