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End of Reciprocal Healthcare Arrangements with Spain - 452/2022

June 28, 2022

On 31 December 2020, as a result of the UK and Gibraltar’s departure from the European Union, reciprocal healthcare arrangements with the EU came to an end.

As HMGoG has previously informed in its Technical Notices on this subject, and in its Guidance to Citizens issued earlier this year, the full effect of the above was tempered in so far as Spain was concerned through a bridging measure introduced pursuant to Spain’s Real Decreto Brexit and unilateral arrangements maintained in Gibraltar. Under Spain’s Real Decreto Brexit, reciprocal healthcare arrangements were extended to last until 30 June 2022.

HMGoG regrets to note that at yesterday’s meeting of the Spanish Council of Ministers, the Spanish Government has decided not to extend this measure. It would have been HMGoG’s preference for these arrangements, which deeply affect citizens on either side of the border on matters as essential as healthcare, to have been maintained. Indeed, HMGoG was prepared to continue with them.

However, because reciprocity is a key element to these arrangements which cannot work without coordination and provisions for reimbursement of costs etc., HMGoG is left with no option but to discontinue them also in so far as treatment in Gibraltar is concerned.

The effect of the above is as follows:

Emergency Healthcare Treatment.

Gibraltar residents insured under Gibraltar’s Group Practice Medical Scheme (the Scheme which provides free access to Gibraltar Health Authority services and which covers the vast majority of residents of Gibraltar) will, after 30 June 2022, no longer be able to access free emergency healthcare in Spain during a temporary stay in Spain.

Therefore, as from 1 July 2022, residents of Gibraltar should ensure that they have appropriate travel insurance with medical cover each time they go to Spain, irrespective of the duration of the stay and therefore irrespective of whether time spent is only for some hours (for example a shopping trip or going to Spain for a meal).

The consequence of not having this insurance would mean that persons would themselves need to pay for any access to Spanish healthcare – even if that access to healthcare is required in the event of an emergency or accident. Where medical attention is required the costs incurred may be considerable so you should ensure you have adequate insurance cover or alternatively the means to pay. HMGoG cannot make itself responsible for any claims arising from a failure to insure against these risks.

The public is once again reminded that this has been the position in all EU Member States, other than Spain, since 31 December 2020. It will, as from 1 July 2022, also be the position in Spain.

As a result, and in so far as treatment in Gibraltar is concerned, HMGoG is obliged to inform that, as from 1 July 2022, the Gibraltar Health Authority will no longer provide free healthcare treatment to visitors to Gibraltar covered by Spain’s social security system.

Other issues affecting healthcare.

HMGoG is also obliged to inform that, as a result of the Spanish Government’s decision not to extend these arrangements, the Income Tax Office will, as from 1 July 2022, stop issuing S1 Certificates to persons not covered by the EU-UK Withdrawal Agreement who are frontier workers contributing to Gibraltar’s social security system.

Frontier workers affected should check with the Spanish Authorities whether, without an S1 Certificate, they would still be able to register for access to state-provided Spanish healthcare.

Persons covered by the Withdrawal Agreement

This Technical Notice does not affect the position of persons who fall within the scope of the Withdrawal Agreement.

Further information.

This Notice is meant for guidance only.

If you have any further queries please send an email to: