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Registering With a Doctor

My client Tony, a Brit who moved to Madrid over a year ago, has this to say about how you go about getting medical care in Madrid:

After the first flurry of becoming legal residents of Spain, la media naranja* and I talked about getting registered with a doctor at the local Health Centre. We are not often sick, but we thought it would be better to do the registration while we were well, rather than wait until one of us actually needed to see a doctor.

Needless to say, we did nothing about it, until a few days ago, when my half orange came down with some kind of chest infection. We went to the 'Centro de Salud' in our barrio (there's at least one in every barrio), and tried to register. We had gone with what we guessed might be the required documents - NIE, Social Security numbers and passport copies. It turns out we were wrong. Before you can see a doctor (for free) you need a Health Card (Tarjeta Sanitaria). Here's what they wanted before they could issue the card:

1) Empadronomiento - this is your registration with the statistics and census service. You'll have got this before registering for your NIE.

2) Asignación de Numero de Seguridad Social - a document from the Ministry of Social Security that states your Social Security number. You might think that presenting a payslip (if you are employed) that mentions your SS number, or if you are self-employed, any other document that has this number on it would be enough, but no, the Ministry of Health are very picky about this. They want this particular form. You can get it from any Social Security Administration Office. The two nearest us are at Calle de la Cruz, 7, near Puerta Del Sol, and Calle Zurbano, 73, near Gregorio Marañon Metro.

Unfortunately for me, after I'd hiked to the latter office through howling, bitterly cold wind and rain, they told me I had to get authorisation from half orange before they would produce the form. So I went back home, we completed the forms and the authorisation, and I went to the de la Cruz office. It's a fairly quick procedure - they want your original ID document (either your passport or your NIE) and a copy, and then they issue a letter that states your name and address, and your SS number.

3) Original NIE document. When I had gathered all of these bits of paper together, I went back to the Health Centre. No problem with mine, but better half was a problem because she could not find her original NIE document. So even though we know the number, and it's mentioned on her Employment Contract and several other documents that I showed them, the functionarios refused to issue a Health Card. They said she could see a doctor on payment of a €45 deposit. If she returned with her original NIE or an application form for a replacement, within five working days, the deposit would be refunded. This is hopelessly optimistic on the part of the Health people: the Police who look after these documents work on a glacial timescale, they can't even answer the phone within five days, never mind issue a document (my biased personal opinion, obviously).

I now have a letter from the Health Centre, and an assigned doctor - I can use this if I need to to access my right to free medical treatment in Spain (free, hah! As an autonomo I pay a fortune each month in Social Security payments). Poor other half, coughing and spluttering away, and desperately in need of medical attention, is denied it because of the idiotic documentation requirements of the Health (dis)Service.

I only hope that if and when we ever get to see a doctor, the 'service' is much less stressful and much more professional than what we've seen up until now. I'm not very hopeful.

*media naranja = half orange = other half.

Tags: Bureaucracy, healthcare

22/01/2009 | 4904 page views

How To Register As A Freelancer

Many of our clients are teachers, and of those, quite a large proportion work on a freelance basis. This is because some institutes do not want to get involved in the administration of tax and social security payments, or because the person has income from several sources, and so it makes more sense to be officially self-employed, or 'autonomo' in Spanish.

Registering as an autonomo can be a bit daunting. If you manage to find a reliable gestor (a quasi-lawyer/accountant), he/she can do all of the registration work for you. Alternatively, you can do it yourself. The easiest way to do it is to use a place called the VUE (Ventanilla Unica Empresarial - one-window thingie for setting up businesses). These exist in most major Spanish cities, and they are basically a collection of officials from the various Government Departments and Ministries that are involved in business registrations, tax registrations, social security, etc. You might have to spend two or three hours there filling in forms, but the staff are helpful, and will make sure that you do every bit of official stuff that is needed.

Autonomo registration is fairly straightforward. Basically, what you are doing is declaring yourself as an autonomous worker in whatever field(s). Then you fill in forms that tell the tax authorities (personal income tax and VAT) where you live. And the same for Social Security.

As an autonomo, you are required to make a monthly contribution for Social Security - currently it's about €235-255. In return for this you get ~~almost nothing~~ access to Government Health services, sick pay, and eventually a meagre pension.

When you submit an invoice to a Spanish client, they have to retain 18% of the amount as tax (you may be able to reclaim some of this against allowable expenses). You also have to add 16% to the total for IVA (VAT).

You have to submit a tax return every three months, and I strongly recommend that you use a gestor for this.

Your fiscal identity number and your IVA number will be the same as your NIE. Once you have filled in all the forms, you'll get your Social Security number through the post, and the tax office will send you a few sheets of barcoded stickers that have to be used on any correspondence with them.

Madrid's VUE is located at Calle Ribera del Loira, 56-58. The nearest Metro is Campo de las Naciones. The phone number is 915 383 799. Unlike the NIE office, you will usually get your appointment within a week.

Tags: Autonomo, freelance, bureaucracy, VUE

27/06/2008 | 6626 page views

Getting Your NIE

The vast majority of our customers come from outside Spain. They come to Madrid to work or study, and they all need to get an NIE (Numero de Identificación de Extranjero - Foreigner's Identity Number). This is the magic ticket that allows you to run up huge debts with banks and credit cards (although you can open a 'foreigner's' bank account without an NIE, but don't expect the bank to lend you any money), buy a car, pay tax, get a Social Security number, etc.

There are basically two ways to get your NIE. The first is to pay a gestor - a quasi-lawyer/accountant/gofer - to do it for you, and the second is to phone for an appointment. There used to be a third way, which was to queue outside the office from about 5am, but I believe that option has been stopped now.

To get your NIE you can phone for an appointment on these three numbers. They are usually engaged and there's no queueing system, so find out how the redial function on your phone works. The operators don't seem to speak English, so practice the Spanish phrases you might need!
913226919
913226835
913226876

The waiting time for the appointment varies according to how busy they are, but don't be surprised if you have to wait a couple of months.
This is the address of the office (unless you are Bulgarian or Romanian):
Plaza del Campillo del Mundo Nuevo nº 3
28005 - Madrid.
The nearest Metro is probably Puerta de Toledo.

There is a small fee (about €6.70) for the NIE - despite the fact that the EU has declared it illegal. You must pay this into their account before you can enter the building for your appointment; the heavily armed guards on the door will want to see your receipt for the payment before they will let you in. I advise you to visit the oficina some days before your appointment, get a payment form at the door, and pay at your leisure. The banks around the oficina will only accept payment until 10 or 11 in the morning, and possibly only when there's a q in the month, so save yourself a bit of stress and do it ahead of time.

Once you get to your appointment, you might have to wait a few minutes inside the oficina, but when you actually get to see the nice lady it takes less than ten minutes to squeeze your details into the computer, and your NIE is issued immediately. The NIE used to be a little plastic card, but now, for EU citizens at least, it's just a green A4 certificate.

Documentation requirements are the subject of urban myth, but as a minimum you need your passport and a copy, and the completed application form (which you can download from here). As with any government dealings anywhere, you would be well advised to take the original and a photocopy of any official document you've acquired since you were ten years old, plus about two hundred passport photos, but actually, as far as we know (and this information is offered without any guarantee or claim to accuracy, veracity or reality whatsoever, and anything that goes wrong is your fault), they only want the form and the passport.

Tags: NIE, Bureaucracy

15/06/2008 | 6619 page views

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