Whilst this Circular is still active there have been a number of changes, although the entitlement is still there.
This is the wording of the Circular, which initially came to us from our Consulate, Alicante: -
Según la Circular 1/2002 de la Comunidad Autónoma Valenciana, los ciudadanos miembros de la Unión Europea residentes en las provincias de Alicante, Castellón y Valencia, quienes no son ni pensionistas ni trabajadores, tienen el derecho a la asistencia sanitaria.
Dichas personas deben de solicitar la tarjeta sanitaria en su Centro de Salud correspondiente, haciendo referencia a “la extensión de asistencia sanitaria a demanda según la Circular 1/2002”. Deberán rellenar un impreso de solicitud el cual deberá ser presentado junto con el pasaporte en vigor y un certificado de empadronamiento de fecha de emisión reciente.
En caso de que el personal del Centro de Salud no conoce la mencionada Circular 1/2002, y por tanto no pueden tramitar la emisión de la tarjeta sanitaria, se le debe pedir que contacte con el jefe del departamento que se detalla a continuación, quien podrá informarle del contenido de la misma:
Sección de Afiliación y Validación
Consellería de Sanidad
calle Gerona, 26
03001 Alicante
tels: 965 938022 y 965 938099
And all applicants are advised to 'Paste' and download the above, when making their application and to forward it, together with their application.
This translates as follows: -
According to Circular 1/2002 of the Comunidad Autónoma Valenciana, EU citizens resident in the provinces of Alicante, Castellón and Valencia, who are neither pensioners nor employed persons, are entitled to full health care under the Spanish State Social Security system.
They should apply, referring to “la extensión de asistencia sanitaria a demanda según la Circular 1/2002”, for a “tarjeta sanitaria” at their local medical centre, where they will be required to produce your passport and a recently-issued “padrón” certificate, and to complete an application form.
If the medical centre staff are unaware of this entitlement, they should be asked to contact the following department, whose head will be happy to confirm the facts. However many Health Centers are even refusing to do this - in addition to which, we have received many complaints of rudeness.
Sección de Afiliación y Validación : - Now a waste of time. A more reliable address follows below: -
Consellería de Sanidad
Calle Gerona, 26
03001 Alicante
Tels: 965 938022 y 965 938099
The history : -
From the very outset of this entitlement was that many health centers within the Valencia Community could not get their heads around the new rules. This meant many complaints to us from would-be applicants.
The first problem was self-inflicted by the Regional Government, since they issued S.I.P cards to applicants using the national card. This was, not only misleading to applicants, but was and still is wrong, since the health care afforded under the Circular is territorial to Valencia only. Therefore, there is no right to the issue of an EHIC, or treatment beyond the frontiers of Valencia.
The second problem was that, not only was the card issued open ended, but also no consideration was given to citizens who may still have residual cover in the U.K. Let me identify 'Residual Cover'. Certain U.K. citizen may be entitled to 'Residual cover' where they have contributed to social security through employment in the U.K. within the 2 years immediately prior to their departure from the U.K. This must not be confused with N.I. contributions, since they represent pension contributions. If they had made social security contributions, then they would be entitled to the Issue of E form 106, where the period of cover depends upon the period they had made such contributions within the 2 yeas immediately prior to their departure.
Had a citizen, say been in employment up to the date of their departure then they would be issued with E.106 with a validity of up to 30 months, although normally issued for 24 months? This form, is issued by the 'Overseas Benefits Dept.Newcastle and should immediately be registered with the INSS. (Spanish office of Social Security). And, like the old E111 presented with a copy, on each occasion a citizen seeks health care. When then, in our case Spain, would then claim back from the U.K. the cost of treatment given. The full instructions over the procedure to be followed are set out on this form. We were therefore at the situation where citizens were not bothering to apply for an E106, where entitled, and Spain lost out on proper reimbursement. Also citizens, when presenting a form E.106 were often wrongly issued with a S.I.P. card. This does not comply with the procedures as set out by the E.U. Regulations, so you can see the mess Valencia were getting themselves into.
Many citizens have also been wrongly advised that they are first required to obtain a social security number. This too is wrong since such persons may not, or have no intention of seeking employment in Spain and therefore are not required to obtain this registration.
Now a third problem encountered was that some citizens, having been issued with S.I.P. card, and then later becoming entitled to a U.K. State pension, were not bothering to apply for and register their E form 121. (An E. form issued by the competent State, where they have previously contributed to their State pension – NI. contributions). When so registered, Spain receives a payment £1,400 a year for each State pensioner and certain other classes of citizens, such as those in receipt of incapacity beneifit.
Once the Health Authority of Valencia realized their 'faux par' they then cancelled, over-night, all S.I.P. cards issued in accordance with the Circular, without warning those citizens in receipt of them, where they then only became aware, when they attended for treatment. Many expats were left 'high and dry', without any health cover, since they had cancelled their private health protection. Unfortunately where you have, or had developed some long term or ongoing illness, there is no way of going back for private insurance in respect of such conditions. This also affected those with such conditions prior to the cancellation of private medicine insurance cover. What a bloody mess!!
Valencia then demanded a letter from Newcastle declaring that a citizen had no health entitlement rights in the U.K. They also declared that this must be presented in the Spanish language. Of course Russell Thomson, former Consul at Alicante, offered to authenticate the letter, to save expats the cost of an 'Official' translation, at an exorbitant consular fee. The 'Court Jester' also offered to authenticate a document after it had come to you under the authority of the Secretary of State, when it had been translated in the U.K. into the Spanisgh language? This was completely unnecessary.
We took a different route and contacted Newcastle direct, requesting that the form, now known as the 'legislative letter', be issued by Newcastle with a ‘Spanish translation’. This they agreed immediately to do. Also Valencia decided that the S.I.P. card would have an expiry date of 12 months and citizens were also required to renew them annually, accompanied by a fresh ‘legislative letter’ from Newcastle. Even after applicants had adopted this procedure certain health centers were still wrongly informing applicants that they were not entitled to further health care protection in accordance with the Circular. This was absolute nonsense. There has been and continues to be a complete break-down in communication from the Central Health Authorities with their health centers.
It must be said that initially our Vice Consul, Elizabeth Bell, was very helpful in this matter, but later, as difficulties continued, when we attempted to enlist assistance from our Consular Staff at Alicante, our appeals fell upon deaf ears, since despite many promises of further assistance, eventually our e-mails went unanswered. So much for their help. Or lack of it! I have these e-mails archived, which clearly show their lack of assistance and failure to properly act in accordance with their remit.
The current suggested Procedure: -
All that should be necessary is (a) the production of ones passport. (b) A most recent extract from the 'Padron', since they only have a validity now of 3 months from date of issue and 1 month in respect of unemployment benefit claims. (c) A current copy from Newcastle of the 'legislative letter' in Spanish, declaring that the applicant has no entitlement to receive any health care in the U.K. and is not entitled to the issue of E. forms 106 or 121.
The address of the Overseas Benefits Department is: -
Tyneview Park,
Newcastle Upon Tyne,
Inglaterra NE 98 1BA
Please mark the envelope 'Legislative letter - SPAIN.
However, the previous instruction demanded the production of a 'Residents Card's, or proof of application for same, but although these have been abolished as of 28 March 2007, vide Spain's Real Decreto 240/2007, following the issue of E.U. Directive 2004/38/EC, we do not know how the Spanish will be able to get their heads around this. Particularly where they are in breach of article 34 of the E.U. Directive, where the Government here has failed to carry any awareness campaign. At this time we advise new arrivals to Spain to forward a copy of their registration certificate, issued in accordance with the new procedures, but we are reluctant to issue advice at this time, with regard to those currently holding abolished residence cards where such cards would otherwise have been valid.
Our latest advice is that applicants now direct their application for health care State cover to: -
El Jefe De La Sección,
Generalitat Valencia De Afiliación,
Conselleria Sanitat,
Direcció Territorial - Valencia
We have found that if the application is properly worded, in Spanish of course, with copies of all necessary documents, this should achieve success. This is our experience so far, but you will not have received this advice from our Consul.
We also ask all our members to first address their problems to Elizabeth Bell, Vice Consul, her email address is Elizabeth.Bell@fco.gov.uk
Since we are doing all their work, without any assistance whasoever from them, could you also b.c.c. us a copy * and keep us informed over any response/progress, since we wish to report on this matter.
Possible good news from Murcia
In February we understand that the Minister for Health for the regional government of Murcia announced that within a year all residents of the Community of Murcia, whether they had contributed to social security or not, namely early retirees, would also receive free State health care within that Community. This was shown on ITV's 'Tonight’ programme in February 2007, which was made here in Spain. We shall have to wait and see?
Finally, our advice to all expats where they have no entitlement to health care from the U.K. is to keep up with private insurance health cover, since we do not know, as to how long such limited protection will continue to be offered here, and further, cross the border of Valencia, as matters currently stand, even where you have acquired health care in accordance with the Valencia Circular, then you have no health care cover elsewhere.
Please heed our advice and warning.
* b.c.c. For those of you who do not know what this means - here is an explanation.
When you send an email it has a "to" address which is obviously used for the recipient address to whom you are sending your email. In addition to this, there is a c.c. facility which enables you to send a copy of your email to a third party (or more). With this type of copy the recipient knows, upon receipt of your email, that you have also sent a copy of this email to say fred@aol.com.
However there are times, such as above, when you may want to sent an email to an individual but also want to send a copy, to a third party, but wish that the recipient remains totally unaware of this "copied" email. That is where the use of a b.c.c. function comes into its own. You should easily find how to do this by referring to the Help section in Outlook Express.