The full guide
Your three options
| Option | Who it’s for | Cost |
|---|---|---|
| S1 form | EU state pensioners, and UK state pensioners under the Withdrawal Agreement | Paid by your pension country |
| Convenio especial | Residents without other public cover, after 12 months on the padrón | €60 a month under 65; €157 at 65 and over (2026) |
| Private insurance | Everyone else, and anyone wanting faster access | Rises with age |
Using an S1
If you get a state pension from an EU country, or from the UK and you’re covered by the Withdrawal Agreement or eligible under the UK-EU arrangements, your pension country can issue an S1. Register it with Spain’s Social Security (INSS), then take the document to your health centre for your tarjeta sanitaria. You’ll be treated like a Spanish pensioner, including pensioner rates for prescriptions.
The convenio especial
The convenio especial lets legal residents without other public cover pay a monthly fee to join the public system. You must have been registered on the padrón for at least 12 months. The fee is set nationally: €60 a month under 65 and €157 a month at 65 and over (2026). Regional health services run the applications, and outpatient prescriptions are usually not included, so you pay full price at the pharmacy.
Private insurance
A non-lucrative visa needs private insurance with no co-payments. Premiums rise with age, and some insurers set an upper age for new policies. Ask whether the policy guarantees renewal, what’s excluded for existing conditions, and whether there are waiting periods. Many retirees keep a private policy alongside public cover for faster specialist appointments.
Prescriptions
In the public system, pensioners usually pay 10% of the price, with monthly caps for lower incomes: €8.23 a month under €18,000 a year since the 2026 reform. See prescriptions and pharmacies in Spain.
Planning for later life
Spain has a public dependency system for people who need help with daily life, assessed by your regional social services. Provision and waiting times vary by region. It’s worth understanding early, along with making a Spanish will and setting up powers of attorney.
Frequently asked questions
Can I use my S1 if I retire early?
S1 forms are usually for state pensioners and some benefit recipients. Early retirees often need private insurance or the convenio especial until their state pension starts.
Does my UK GHIC cover me as a resident?
No. A GHIC or EHIC is for temporary stays. Residents need an S1, public cover through work, the convenio especial or private insurance.
