Spain’s Council of Ministers approved a royal decree on Tuesday, March 10, 2026, guaranteeing access to public healthcare for undocumented migrants and simultaneously expanding co-payment systems for orthopaedic products like wheelchairs and prosthetics, benefiting over seven million people nationwide.
The decree, published on March 11, 2026, removes administrative barriers that previously prevented undocumented residents from receiving routine medical care, effectively universalizing Spain’s public healthcare system, according to officials. The move aligns with broader immigration reforms and a forthcoming mass-regularisation scheme and is intended to reduce reliance on costly emergency treatments.
Beyond extending healthcare access to those without legal residency, the royal decree also restructures co-payment systems for prosthetics, wheelchairs, and other support devices. These payments will now align with existing pharmaceutical and medicinal co-payment systems, meaning millions will be eligible for reduced costs or complete exemption from payment. Individuals already exempt from pharmaceutical co-payments – including low-income pensioners, people with disabilities, and beneficiaries of certain social benefits – will automatically be exempt from paying for these devices.
The co-payment structure will be income-based. Individuals earning €100,000 or more will contribute 60 percent of the product’s cost. Those with incomes between €18,000 and €100,000 will pay 50 percent, while those earning less will contribute 40 percent. Pensioners will face a 10 percent co-payment, with some exceptions for higher income brackets. A maximum limit on user payments will be established by ministerial order.
The government, led by Socialist Prime Minister Pedro Sánchez, utilized a royal decree to bypass parliamentary debate, as the ruling coalition currently lacks a workable majority. The decree establishes a procedure for recognizing the right to healthcare and publicly funded treatment for foreign nationals without legal residency. Applicants will be required to submit a responsible declaration certifying they do not have existing health coverage.
To prove residency, applicants can present a municipal registration certificate or alternative documentation such as school enrollment records, utility bills, or reports from social services. Upon application, migrants will receive a provisional document granting immediate access to medical services, eliminating months-long waiting periods. If authorities fail to respond within three months, access to healthcare is automatically granted.
Minister of Inclusion, Social Security, and Migration, Elma Saiz, emphasized the regulation’s aim to unify criteria across the country and ensure access to healthcare regardless of legal or economic status. The move is also intended to provide greater certainty for employers and mobile workers, according to a government press release.
