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HEALTH

Reader question: Can I move into a Spanish care home as a foreigner?

Many people move to Spain to enjoy the retirement dream in the sun, but what happens if you become ill and can no longer live independently?

Spanish care home
What happens if you need to go into a care home in Spain? Photo: OSCAR DEL POZO / AFP

Reader question: What happens if someone moves to Spain and then needs to go into a care home because of old age or illness? Who pays? Does it make a difference if you worked in Spain and paid into the Spanish system, or if you moved here after retirement?

This is a common question for people who retired in Spain from abroad and those who worked here and want to retire in Spain too.

According to a new study from Money.co.uk, Spain is one of the world’s most searched for retirement destinations and is the world’s sixth most popular country to retire in.

Per the latest statistics from the Spanish authorities from 2019, 38.7 percent of foreign residents in Spain from the EU were of retirement age and 33.9 percent were from Europe, but not an EU country.

This means that as well as having to provide services for the elderly Spanish population it is necessary to provide them for the foreign population too.

According to real estate giant Knight Frank in its latest European care homes report, “By 2050, Spain will have the second-highest share of people over the age of 80 in the world, surpassed only by Japan”. 

So what happens when you can no longer take care of yourself – what rights do you have to access Spanish care homes and will you have to pay for it all?

The good news is that there are no specific rules preventing foreign nationals from living in a Spanish care home – provided they have the legal right to reside in Spain. This means being from an EU country, protected under the Withdrawal Agreement if you are British and moved before Brexit, or have the appropriate visa for third-country nationals. 

Traditionally, the care of the elderly in Spain has been taken over by family members who become full-time caregivers so Spain has a less developed care home market than other countries such as the UK.

According to Knight Frank’s European care homes report, Spain and Italy only spend 0.9 percent of GDP on long-term care provision. 

That being said, there are several different care home options in Spain, some of which even have specifically been set up by foreigners. For example, the Norwegian government has created several care homes in Spain for its citizens who have retired abroad.

There are several different types of care homes for the elderly in Spain, depending on the type of level of care that you need. These include: 

Residental care home – Residencia para personas mayors/ancianos

Nursing home – Residencia con servicos de asistencia médica

Hospice – Centro de cuidados paliativos

Retirement housing – Viviendas aptas para jubilados

Who pays?

According to Info Residencias, the website for geriatric assistance in Spain, if you need to enter a care home in Spain, you should go to the social services of your town hall (ayuntamiento).

They will consider your health, economic and social situation and will decide if you are eligible to be sent to a care home or if you should be provided with care at home instead.

If you are deemed eligible, they will assign you either a place in a public or private residence, depending on your financial situation.  

If you recently retired to Spain and have not worked or paid into the social security system however, it is unlikely that you will be placed in a public care home and will probably have to pay for a place in a private care home.  

Info Residencias says that “a private residence for the elderly in a large city ranges from approximately €1,400 to more than €2,500 per month. Outside of the big cities, the prices may be somewhat lower, but not much more”. 

While Knight Franks writes in its report that Spanish care home fees range from €1,800 to €2,200 a month, depending on the region and quality of accommodation.

How can you pay?

Pension

If your pension plan is enough to cover the cost of the care home fees, then they will usually be paid for that way.

There are however several other ways of paying for care homes suggested by the Spanish authorities. These include:

Reverse Mortgage

The Reverse Mortgage (hipotecas revertidas) is a loan for people over 65 who own a home in Spain. Financial entities or insurance companies will typically pay you a monthly income which is secured against your home. 

However, one downside to this is that if more costs and debts rack up, then you could lose your home and won’t be able to pass it on to your children.

Programa Pensium

Another way that your home can be used to help pay for a care home is through the Programa Pensium. If you sign up for the programme, your home will be rented out, and contributions made for you on top of that towards your care. The management of the rental of your property will also be taken care of so that your family doesn’t have to worry about this as well. 

This way you get to keep your home and your family can do with it what they want when you pass away. It also gives you flexibility, allowing to you cancel the program at any time. 

Britons

Certain benefits that cover care costs are not available to non-EU citizens who have never worked or paid social security in Spain.

The UK Government does not have any reciprocal arrangements to cover overseas residential or nursing care for Brits living in Spain, so you will not be able to rely on help from back home, but will be able to use your pension from the UK if you receive it in Spain. 

READ ALSO: How Americans can retire in Spain

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HEALTH

What are Spain’s abortion laws for foreign residents and visitors?

With news that millions of women across the United States could soon lose their right to an abortion, we look at what the abortion laws are in Spain and find out if women overseas can fly to Spain to have the procedure.

What are Spain's abortion laws for foreign residents and visitors?

What happens if you find yourself in a difficult situation and need to terminate your pregnancy because of health or psychological reasons or even personal circumstances? Is it possible to get an abortion in Spain?

Abortion has been legal in Spain since 1985.

The initial version of Organic Law 9/1985 law allowed abortion in three cases: in criminology or rape cases within the first 12 weeks, if the pregnancy posed a threat to the physical or mental wellbeing of the pregnant woman (without a limit) or if the fetus could be born with serious physical or psychological defects within the first 22 weeks of gestation.

Then in 2010, the Law on Sexual and Reproductive Health and the Voluntary Interruption of Pregnancy was approved, allowing any woman over the age of 18 to terminate a pregnancy of her own free will during the first 14 weeks of pregnancy.

Foreign visitors

Spanish abortion law also allows foreigners to travel to Spain and have the procedure done here. Of course, foreign patients must also abide by the law set out above – ie. voluntary abortions are not possible after 14 weeks of gestation, but they can take place up until 22 weeks if there is a serious risk to the health of the pregnant woman or if the fetus has serious abnormalities or an incurable disease.  

Be aware, however, that if you are under the age of 18, you will need your parents’ consent if you wish to terminate a pregnancy.

Foreigners who do not reside in Spain cannot get abortions through the Spanish public health system and will have to pay for it privately instead. This is because they are not registered with the health system and do not pay social security to be able to access it.

Abortion clinic

Is it possible for foreigners to get an abortion in Spain? The short answer is yes. Photo: Scott Olson/Getty Images/AFP

This means that you will have to go to a private clinic or hospital instead. 

There are many private abortion clinics across Spain that are willing to treat foreign visitors, particularly in the country’s big cities, where you’ll be able to find a doctor who can speak to you in English or maybe even your own native language.

According to the latest stats from the Spanish government, there are a total of 207 authorised private abortion clinics in Spain. 

It’s unlikely that your health insurance from your home country will cover for procedures abroad, but it’s best to check with them first. 

If not, you’ll have to pay yourself. Prices for an abortion at a private clinic in Spain start at €300. 

Foreign residents

If you’re a foreign resident in Spain who is legally registered as living here and paying into the social security system, then technically you will be able to receive an abortion for free through the national health service.

However, in reality, this is not always possible as many doctors across Spain refuse to perform abortions, calling themselves “conscientious objectors”.

FOCUS: How women in Spain face barriers despite abortion being legal

So many doctors deny the procedure across the country, that there are 11 provinces in Spain, where no public hospitals have carried out voluntary abortions since the law allowed it in 2010, according to data from the Health Ministry

Furthermore, eight of these provinces have not reported abortions in the past 30 years. 

This means that if you live in Huesca and Teruel in Aragón; Ávila, Palencia, Segovia, Soria or Zamora in Castilla y León; Cuenca, Guadalajara and Toledo in Castilla-La Mancha); and Cáceres in Extremadura, it could be almost impossible for you to get a termination through the public health system.

Across Spain as a whole only 6.20 percent of all abortions, according to the most recent data from the Ministry of Health, were performed in public hospitals. Another 8.12 percent were performed in specialised centres of the public network, while a huge majority (almost 86 percent) were performed in outpatient centres of private clinics.

If you go straight to a private clinic, it’s unlikely that your social security will cover the procedure, however if you go to your public health doctor or gynaecologist first, they may be able to refer you to a private clinic, meaning that social security may be able to cover it. Be aware though, the waiting times will be a lot longer if you do it the second way. 

READ ALSO: Where in Spain is primary healthcare most overburdened?

Last month, Spain announced that it had criminalised the harassment or intimidation of women going for an abortion under new legislation approved by the Senate.

This means anti-abortion activists who try and convince women not to terminate their pregnancies could face up to a year behind bars.

According to the latest Spanish government data, the number of voluntary abortions decreased in 2020 by 10.97 percent compared to the previous year, registering a total of 88,269. 

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