A Snapshot of Healthcare in Spain

There’s no escaping the hot topic of healthcare these days. Whether you’re all for Bernie Sander’s universal healthcare, or happy sticking to private insurance, healthcare is definitely a concern for many people, especially us in the USA. When we moved to Spain, we were required under the terms of our visas to apply for travel health insurance. Matt obtained his through OSU, while I obtained mine through a private company. But both of our plans required a minimum of $30,000 of coverage, $0 deductible and coverage for all emergency scenarios. And like all humans do from time to time, we needed to see various doctors while living in Spain. Here are our stories:

Doctor’s Visit and Minor Surgery:

It wasn’t the plan to visit the doctors within the first few weeks of arriving in Spain. I had noticed a bump on my arm that was getting red, painful and larger by the day. So, after about a week of waiting to see if the irritation went down, I decided to see a doctor. I found a physician through my insurance network whose entire office spoke English! I asked for an appointment and received one for the next day. During my visit, the doctor said that I had an infection that would most likely need to be drained (gross). I was scared, but happy that I could easily communicate with my doctor. I actually felt quite safe with this man that I had only known for about 20 minutes, and could tell that he would take good care of me. He got me ready for this minor surgical procedure, and was very gentle the entire time. He gave me directions for how to care for it at home, and scheduled 2 more appointments for me to come back over the next 4 days, to check on how the infection was clearing up.

This physician was included in my insurance network, but did not do direct billing. Which means, I had to pay out of pocket for my services and then submit the claim to insurance. The total for this incident including 3 appointments and the minor surgical procedure came to around $500. While it took a while to get processed, I eventually was reimbursed $425 for my visit, therefore costing me $75.

Sick Visit at Doctor’s Office:

Being a teacher, I used to get sick A LOT. So, it didn’t take long to figure out that something was off when my lungs started to bother me. I again scheduled an appointment with my English-speaking physician and was given an appointment that same day. I was able to see the same doctor as I had before, and he was again so kind and gentle with me. I felt that he did a thorough exam, much more than I get in the US, to make sure he knew what was going on. It was nice to feel that he wasn’t rushing or hurrying to get me on my way. I genuinely felt like he wanted to make me feel better without doing too much or too little. He sent me off with a few prescriptions and gave me his email and phone number to call him if I had any further concerns or if things didn’t start getting better. I know that in the USA, many chains of doctors have online portals where you can contact you doctor, but this seem to have a nice, personal touch.

Again, I paid $151 upfront for these services, but was reimbursed in full through my insurance.

Vaccinations:

Matt and I were planning a lot of trips while we were here in Spain, and the main one was a safari in Africa! We were both super excited, but also needed to get some vaccines for the trip. I wasn’t exactly sure where it was best to get these vaccines, as I was sure they wouldn’t be covered in my health insurance. After a bit of digging, I discovered that Madrid had government-run vaccination centers throughout the city. Services were available to citizens, residents and travelers, some without any cost to the patient! I booked an appointment 2 months out from our trip, even though I could have chosen dates that were the next day! When I arrived, I was seen by a doctor who asked about my travel itinerary, past vaccinations and gave me her recommendations for necessary vaccines. She had recommended 2 vaccines and also gave me a prescription for an oral Typhoid vaccine and Malaria prevention. I received my vaccines with a nurse who was one of the nicest I’d ever met! She spoke pretty good English, was kind and happy, and really sweet about my fainting issue with needles. Honestly, she got the vaccines done before I even knew she started! “That’s what will happen when you work at a vaccine center for 19 years!” was her response. Last it came time to pay, and this is where I was really nervous… In the US, I’ve paid $100 for just 1 vaccine, not including the doctor’s visit! I held my breath and waited for the damage…

39 euros…I’m sorry, WHAT?!? I thought maybe I misunderstood, or she left a 0 off the end. But then she showed me a sign that said all vaccines cost 19.80 euro each for travelers or residents who don’t pay into the Spanish healthcare system. For citizens, it’s free! No cost to see the doctors, no cost for administering the vaccines. I had never been so happy to pay for vaccines before. I even thought about getting a few more (even though I absolutely hate shots!) just because the price was so cheap! For example, I was told to get the Japanese Encephalitis vaccine before leaving on our 2016 trip, but didn’t want to pay $360+ for the shot. So, I went without, against the recommendation from my doctor. But the SAME vaccine here – 19.80 euro. It was the craziest thing I’ve seen in healthcare differences so far!

Hospital visit:

My wonderful husband, Matt, is hardly ever sick; a fact he contributes to all the germ exposure we survived in Asia. He is also quite stubborn about going to the doctors. But I knew that if my husband was waking me up at 3:00 am, in so much pain he decided to go to the hospital, it must be bad. We arrived at the Emergency room of a private hospital at 3:30 am. This particular hospital had a department for international patients and a translator was available for us right away. Matt waited about 20 mins before being seen by the doctor. Given the location of Matt’s pain, the obvious signs of infection and the swelling in his face, they decided to admit him into the hospital. Neither I or Matt have ever been admitted, so it seemed quite severe and of course we were both nervous. By 4:30, we were escorted upstairs to a private room where Matt was given IV antibiotics and some pain medicine. I was given linens so that I could spend the rest of the night there with him until the doctors could come back during normal hours. Matt stayed in the hospital for 5 days, continuing to get IV antibiotics and seeing specialists due to the placement of his infection. He was seen by maxofacial doctors, plastic surgeons, and dermatology. Each doctor was accompanied by an English translator, and while they were a bit lacking in information to share with us, we were able to ask questions and get information translated for our comprehension. I would say that the worst part of his experience was the food, as he was placed on an all liquid diet, and obviously didn’t like the cream of fish soup served at dinner. The nurses were about as attentive as they are in the US (at least what we’ve experienced in outpatient procedures or with family members), and sometimes had to be rung to get IV’s taken out or more medicine. When he got discharged, he left with a prescription for oral antibiotics and a check up appointment in 10 days.

The total cost to us – $0.

Matt ended up going back for the same issue about 2 weeks later when the infection moved to a more serious location, and was admitted again for 1 night with IV antibiotics. The infection was tested, and medicines adjusted to better heal his serious infection. Again, $0.

Something we heard from other travelers and a doctor friend in Spain is that private hospitals are known to admit for mild issues and keep people longer, because they know that means more money from insurance. And when a study-abroad student comes, they can be almost certain they are on private insurance. Our doctor friend claimed that public hospitals that are run by the government are far better than the private hospitals, providing great care to their patients which is covered under their universal healthcare system. While we cannot comment on how good public hospitals are, we would be curious to see how much better they could be for such a cheap price! Overall, we were glad that Matt got the care he needed at the private hospital, and it didn’t cost us a dime!

What’s that going to cost?

Let’s look at those numbers again, shall we? For all the medical services that we needed for our time in Spain, we spent:

  • Minor surgery – $75
  • 4 doctor’s office visits – $0
  • 2 vaccines – $42
  • 2 hospital stays – $0

TOTAL: $117

Now, I know what you’re thinking – what about the insurance premiums you paid for this amazing health insurance? Matt and I both paid around the same amount for our private travel health insurance plans at $310 each for 9 months of coverage. Not per month, but for the whole 9 months we were in Spain! Thus, totaling up all of the money we spent on healthcare in 9 months was $737 for 2 people. Now, granted, getting claims submitted has been an absolute pain in the a**, but it still has been exponentially cheaper than any healthcare we would receive in the USA. Heck, I’ve paid more than that in 1 month for an employer-provided insurance plan! Not only was the cost of care cheaper, but the quality of care was superior. The doctors, nurses and staff we encountered in Spain took very good care of us, and were so accommodating to our needs, linguistically and otherwise. We felt heard by medical professions, we never felt rushed, and we knew that they were doing the best they could to take care of us. In the end, I was so thankful for all that they did.

Matthew & Stephanie

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