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Convenio Especial - Buy into state health care

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Jim's Guide - Convenio Especial - Buy into state health care

INTRODUCTION

Residents who, mainly due to age, aren't eligible to receive an S1 from DWP at Newcastle, have to take out private health insurance in order to ensure they receive health treatment here, and to qualify for obtaining residency.

However, such residents who can’t access the state health system can, after being resident here for 12 months, buy into the Valencian Community health system, giving total access to all healthcare provisions, with no exclusions for pre-existing conditions, although it will be necessary to pay the full cost of any medication.

This guide is written for those resident in the Valencian Community, but similar schemes are available in the other communities.

For example, the details for the scheme operated by Murcia are here:

https://sede.carm.es/web/pagina?IDCONTENIDO=1581&IDTIPO=240&RASTRO=c$m40288

From some reports I've read about other communities, it appears that some will allow applications at TGSS social security offices or at town halls, but I don't know whether or not those reports are correct.

Although I've abbreviated the description to Convenio Especial, the full description is Convenio Especial de Prestación de Asistencia Sanitaria - Special Agreement for the Provision of Health Care.

If you are paying into the Convenio Especial in one community then, if you temporarily move to another community, you will still have the right to health treatment.

COST

Current costs are €60 per month up to the age of 65, and €157 per month thereafter. In many cases, especially with regard to pre-existing conditions, this may be much better than continuing to pay for private health insurance. These subscription costs are mandated by central government law, and are therefore applicable irrespective of the autonomous community in which you live. The only way the cost can be increased is if your community introduces additional benefits.

LEGISLATION

Real Decreto 576/2013 - this is the top level state law which created the Convenio Especial, and set the prices.

DECRETO 190/2013 - this is the Valencian law.

GUIDE

The following is the Valencian 'what's it all about, Alfie?' web page, with links to the forms:

http://www.gva.es/es/inicio/procedimientos?id_proc=17044&version=amp

If you're using Google Chrome as your browser, you can right-click anywhere on the page and select the option to translate it. It won't be a perfect translation, but should be reasonable enough to understand.

DOCUMENTS REQUIRED

If two of you are applying, I'd point out that each application has to be submitted individually, so you'd each need a copy of the padrón, direct debit, etc.

The documentation you need to provide in support of your application are:

1): Application form

You can complete this online before you download and print it; or you can download it and complete it on your computer. You need to complete all the application form, thus producing two copies:

http://www.gva.es/downloads/publicados/IN/19162_BI.pdf

2): Copy of NIE

It isn't necessary to provide this, as long as you agree that the authorities check via their computer systems. You give that consent by selecting the AUTORIZA box on the application form.

3: Copy of passport

Be aware that they're entitled to require a notarised copy of your passport, although I very much doubt that they'd insist on this, and none of those who have given me feedback were required to provide a notarised copy.

4): Copy of padrón

It isn't necessary to provide this, as long as you agree that the authorities check via their computer systems. You give consent by selecting the AUTORIZA box on the application form.

Although the norm for most bureaucratic procedures is to provide a padrón less than three months old, in this case, if you do provide a padrón, I suggest an original one showing you have been on the padrón for more than a year.

5): Direct debit form

You can download this here:

http://www.gva.es/downloads/publicados/IN/19163_BI.pdf

Like the application form, you can complete this online before you download and print it; or you can download it and complete it on your computer.

6): Proof of residency

You need to prove you have lived in Spain for a continuous period of at least one year immediately prior to submitting the application.

This requirement, in my opinion, needs a closer study. Everywhere I've looked on the web, writers seem to take this as meaning that you must submit a residency certificate. I disagree - both the legislation and the application form ask for proof of having been resident - they do not specify a residency certificate. In my opinion, therefore, you could provide a copy or copies of e.g. padrón with original issue date, resident income tax declarations or resident bank account statements.

My opinion is confirmed by a lady who kindly provided feedback to me of her experience (thanks, Juliette). Her residency certificate was less than a year old when she successfully applied.

If, however, you do have a residency certificate more than a year old, the authorities will be able to check this online, but it wouldn't do any harm to include a copy.

7): Other documentation that might help

This is optional, but the more information you provide, the less likely it is that you will be asked to provide additional information after you've submitted the application.

a): If your residency certificate is less than a year old then, as I said above, I suggest you provide a copy of a resident tax return, or resident bank statement(s) more than a year old.

b): You are only entitled to apply for the Convenio Especial if you don't already qualify to join the public health system.

Some of the autonomous communities are requiring people to provide proof of not being so entitled.

At one time, the UK (DWP, NHS, Overseas Health Team, etc) would provide a 'legislation letter' stating that a person wasn't entitled to health cover in Spain, but they stopped doing that, and then started again. Fortunately, this is what they now say:

If you need to provide proof you are not covered by the UK for healthcare you may only request this from the UK when you are applying to join a free healthcare scheme in Spain e.g. healthcare on the basis of residency. The document is called a legislation letter and can be obtained by calling the Overseas Healthcare Service on +44 191 218 1999.

I've had feedback (thanks, Jeff) that Valencia do require this legislation letter, and that it needs to be translated into Spanish - although it doesn't need the Hague Apostille. I have seen one report that the legislation letter can be issued in both English and Spanish, so ask the Overseas Healthcare Service for that when you ring them.

If for some reason they won't issue the legislation letter, ask them to provide you with an S1. They will obviously say you aren't entitled, at which point ask them to give you written confirmation of that (thanks again to Jeff for that tip).

APPLICATION

Once you've got the data pack together, you can submit it in person at either of:

Registro de la Dirección Territorial de Sanidad Universal y Salud Pública - Valencia
Gran Via Ferran El Catòlic, 74
46008
València

Registro de la Dirección Territorial de Sanidad Universal y Salud Pública - Alicante
C/ Girona, 26
03001
Alicante

I suggest that you first check with your town hall, as many of these are now accepting applications of various types. For example, I received useful feedback from a lady (thanks, Lana) who submitted her application at Rojales town hall. She was given a receipt and told that the town hall would fax the documents through to Alicante.

Alternatively, you can send it by post. In that case, leave the envelope open.

Put your full name and address on the back of the envelope. Remember that an envelope can only contain one application.

Correos will check it and put a stamp on the application form and copy, and put both in the envelope with the other documents. I suggest you send it by carta certificada - recorded delivery.

You'll be notified within 30 days if your application has been accepted. If you don't get a reply from them within 30 days of them receiving it, then your application is deemed to be accepted by default.

Another piece of information that Juliette provided is that, when she didn't get a response, she went in person to enquire, and found that she had to go to one of the Valencian government offices in Alicante - at Rambla Méndez Núñez, 41, above the old Tourist Information office, on the ninth floor. She went in and the lady she saw had Juliette's application on her desk.

Once you receive the acceptance, you must within three months ask to be taken on at a doctor's surgery and, if there are several doctors, ask for the one you prefer. A doctor is not obliged to take you on his list, but I've not yet heard of anyone being refused.

If you are under 65 when you take up the Convenio Especial, they will automatically adjust the direct debit amount on the first day of the month following that in which you become 65.

You can opt out of the agreement as soon as you qualify to receive an S1, or earlier if you wish.

 

Convenio Especial - Buy into state health care

Jim's Guide - Convenio Especial - Buy into state health care

INTRODUCTION

Residents who, mainly due to age, aren't eligible to receive an S1 from DWP at Newcastle, have to take out private health insurance in order to ensure they receive health treatment here, and to qualify for obtaining residency.

However, such residents who can’t access the state health system can, after being resident here for 12 months, buy into the Valencian Community health system, giving total access to all healthcare provisions, with no exclusions for pre-existing conditions, although it will be necessary to pay the full cost of any medication.

This guide is written for those resident in the Valencian Community, but similar schemes are available in the other communities.

For example, the details for the scheme operated by Murcia are here:

https://sede.carm.es/web/pagina?IDCONTENIDO=1581&IDTIPO=240&RASTRO=c$m40288

From some reports I've read about other communities, it appears that some will allow applications at TGSS social security offices or at town halls, but I don't know whether or not those reports are correct.

Although I've abbreviated the description to Convenio Especial, the full description is Convenio Especial de Prestación de Asistencia Sanitaria - Special Agreement for the Provision of Health Care.

If you are paying into the Convenio Especial in one community then, if you temporarily move to another community, you will still have the right to health treatment.

COST

Current costs are €60 per month up to the age of 65, and €157 per month thereafter. In many cases, especially with regard to pre-existing conditions, this may be much better than continuing to pay for private health insurance. These subscription costs are mandated by central government law, and are therefore applicable irrespective of the autonomous community in which you live. The only way the cost can be increased is if your community introduces additional benefits.

LEGISLATION

Real Decreto 576/2013 - this is the top level state law which created the Convenio Especial, and set the prices.

DECRETO 190/2013 - this is the Valencian law.

GUIDE

The following is the Valencian 'what's it all about, Alfie?' web page, with links to the forms:

http://www.gva.es/es/inicio/procedimientos?id_proc=17044&version=amp

If you're using Google Chrome as your browser, you can right-click anywhere on the page and select the option to translate it. It won't be a perfect translation, but should be reasonable enough to understand.

DOCUMENTS REQUIRED

If two of you are applying, I'd point out that each application has to be submitted individually, so you'd each need a copy of the padrón, direct debit, etc.

The documentation you need to provide in support of your application are:

1): Application form

You can complete this online before you download and print it; or you can download it and complete it on your computer. You need to complete all the application form, thus producing two copies:

http://www.gva.es/downloads/publicados/IN/19162_BI.pdf

2): Copy of NIE

It isn't necessary to provide this, as long as you agree that the authorities check via their computer systems. You give that consent by selecting the AUTORIZA box on the application form.

3: Copy of passport

Be aware that they're entitled to require a notarised copy of your passport, although I very much doubt that they'd insist on this, and none of those who have given me feedback were required to provide a notarised copy.

4): Copy of padrón

It isn't necessary to provide this, as long as you agree that the authorities check via their computer systems. You give consent by selecting the AUTORIZA box on the application form.

Although the norm for most bureaucratic procedures is to provide a padrón less than three months old, in this case, if you do provide a padrón, I suggest an original one showing you have been on the padrón for more than a year.

5): Direct debit form

You can download this here:

http://www.gva.es/downloads/publicados/IN/19163_BI.pdf

Like the application form, you can complete this online before you download and print it; or you can download it and complete it on your computer.

6): Proof of residency

You need to prove you have lived in Spain for a continuous period of at least one year immediately prior to submitting the application.

This requirement, in my opinion, needs a closer study. Everywhere I've looked on the web, writers seem to take this as meaning that you must submit a residency certificate. I disagree - both the legislation and the application form ask for proof of having been resident - they do not specify a residency certificate. In my opinion, therefore, you could provide a copy or copies of e.g. padrón with original issue date, resident income tax declarations or resident bank account statements.

My opinion is confirmed by a lady who kindly provided feedback to me of her experience (thanks, Juliette). Her residency certificate was less than a year old when she successfully applied.

If, however, you do have a residency certificate more than a year old, the authorities will be able to check this online, but it wouldn't do any harm to include a copy.

7): Other documentation that might help

This is optional, but the more information you provide, the less likely it is that you will be asked to provide additional information after you've submitted the application.

a): If your residency certificate is less than a year old then, as I said above, I suggest you provide a copy of a resident tax return, or resident bank statement(s) more than a year old.

b): You are only entitled to apply for the Convenio Especial if you don't already qualify to join the public health system.

Some of the autonomous communities are requiring people to provide proof of not being so entitled.

At one time, the UK (DWP, NHS, Overseas Health Team, etc) would provide a 'legislation letter' stating that a person wasn't entitled to health cover in Spain, but they stopped doing that, and then started again. Fortunately, this is what they now say:

If you need to provide proof you are not covered by the UK for healthcare you may only request this from the UK when you are applying to join a free healthcare scheme in Spain e.g. healthcare on the basis of residency. The document is called a legislation letter and can be obtained by calling the Overseas Healthcare Service on +44 191 218 1999.

I've had feedback (thanks, Jeff) that Valencia do require this legislation letter, and that it needs to be translated into Spanish - although it doesn't need the Hague Apostille. I have seen one report that the legislation letter can be issued in both English and Spanish, so ask the Overseas Healthcare Service for that when you ring them.

If for some reason they won't issue the legislation letter, ask them to provide you with an S1. They will obviously say you aren't entitled, at which point ask them to give you written confirmation of that (thanks again to Jeff for that tip).

APPLICATION

Once you've got the data pack together, you can submit it in person at either of:

Registro de la Dirección Territorial de Sanidad Universal y Salud Pública - Valencia
Gran Via Ferran El Catòlic, 74
46008
València

Registro de la Dirección Territorial de Sanidad Universal y Salud Pública - Alicante
C/ Girona, 26
03001
Alicante

I suggest that you first check with your town hall, as many of these are now accepting applications of various types. For example, I received useful feedback from a lady (thanks, Lana) who submitted her application at Rojales town hall. She was given a receipt and told that the town hall would fax the documents through to Alicante.

Alternatively, you can send it by post. In that case, leave the envelope open.

Put your full name and address on the back of the envelope. Remember that an envelope can only contain one application.

Correos will check it and put a stamp on the application form and copy, and put both in the envelope with the other documents. I suggest you send it by carta certificada - recorded delivery.

You'll be notified within 30 days if your application has been accepted. If you don't get a reply from them within 30 days of them receiving it, then your application is deemed to be accepted by default.

Another piece of information that Juliette provided is that, when she didn't get a response, she went in person to enquire, and found that she had to go to one of the Valencian government offices in Alicante - at Rambla Méndez Núñez, 41, above the old Tourist Information office, on the ninth floor. She went in and the lady she saw had Juliette's application on her desk.

Once you receive the acceptance, you must within three months ask to be taken on at a doctor's surgery and, if there are several doctors, ask for the one you prefer. A doctor is not obliged to take you on his list, but I've not yet heard of anyone being refused.

If you are under 65 when you take up the Convenio Especial, they will automatically adjust the direct debit amount on the first day of the month following that in which you become 65.

You can opt out of the agreement as soon as you qualify to receive an S1, or earlier if you wish.

 

Disclaimer

While we try to ensure the guides are accurate and up to date, things change and mistakes happen, so please consider this when using the guides.

Jim, the author of the guides, is based on Costa Blanca, and so the articles are biased to that region, although in most cases they are the same or very similar for other areas.

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