🇪🇸 Spain

If you work and contribute, you are in the public system. If you are economically inactive — a retiree, someone living on savings, most nomad-visa holders — the route in is the convenio especial: a paid opt-in to the SNS that gets you a tarjeta sanitaria individual. It covers you in your autonomous community, on trips to other communities, and across the EU/EEA/UK/Switzerland via the CPS certificate from the INSS. The catch people hit: you must show at least one continuous year of prior residence in Spain, the EU/EEA, Switzerland or the UK, plus proof your home country does not already export health cover to you. So it is not available the week you land.

Typical cost: Convenio especial premium ~$65/mo under 65 and ~$170/mo at 65+ (EUR 60 / EUR 157, excludes subsidised prescriptions); private insurance commonly ~$50-150/mo; private GP visit ~$50-90.

Tip: pair with travel-medical + medical-evacuation cover.

Taxed. Residents pay IRPF on worldwide income.

You are tax resident if you spend more than 183 days of the calendar year in Spain — and sporadic absences still count toward that total unless you can prove tax residency somewhere else. There is a second trigger people miss: you are also resident if the main base of your economic activities or interests sits in Spain, however many days you spent here. Residents pay IRPF on worldwide income.

Not tax advice — confirm with a local professional.

English is common in tourist areas, international firms and among younger urban professionals in Madrid/Barcelona, but limited in public offices and everyday services.