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Free medical treatment for pilgrims?

Margaret Butterworth

Active Member
Time of past OR future Camino
2013 (Pamplona to Burgos)
2014 (Burgos to Villafranca del Bierzo)
2015 (Villafranca to Santiago)
2016 (Le Puy to Conques; SJPP To Pamplona)
I've read posts in the past which suggested that pilgrims receive free medical treatment for Camino-related problems. A few anecdotes related their experiences in this regard. Others spoke about having to pay up front. Recently I visited new public clinic in Astorga for a consultation about my painful knee. The doctor didn't examine me and simply prescribed Ibuprofen 600, which is readily OTC in Spain. (I was really hoping for a cortisone injection, but was told there were no facilities for this in that clinic). Back home, I have just received a bill by registered post for €74 from the Council of Castile and Leon. I would have paid at the time, if they'd asked me, though on reflection this was expensive for the treatment received.

Can anyone please clarify what pilgrims can expect in the way of free treatment on the Camino?
 
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I've read posts in the past which suggested that pilgrims receive free medical treatment for Camino-related problems. A few anecdotes related their experiences in this regard. Others spoke about having to pay up front. Recently I visited new public clinic in Astorga for a consultation about my painful knee. The doctor didn't examine me and simply prescribed Ibuprofen 600, which is readily OTC in Spain. (I was really hoping for a cortisone injection, but was told there were no facilities for this in that clinic). Back home, I have just received a bill by registered post for €74 from the Council of Castile and Leon. I would have paid at the time, if they'd asked me, though on reflection this was expensive for the treatment received.

Can anyone please clarify what pilgrims can expect in the way of free treatment on the Camino?

I would say that a pilgrim on Camino should expect no free treatment simply because one is a pilgrim.

I have read about gratis treatment for small issues at local clinics, and became acquainted with a pilgrim on Camino who had a blister treated and was told to 'never mind' when he offered payment. At the same time, I know of folks who have had to pay for the care they receive. Like you, they typically receive a billing statement in the mail.
 
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There have been frequent threads about paying medical bills on the camino, and the advice is almost always to pay it at the time, if possible.

EU citizens with health cards are covered, but the rest of us are not. There are cases where the clinic cannot be bothered to do the paperwork necessary, and they might give the treatment free. But we shouldn't expect that!
 
Aside from treatment in an emergency department or equivalent, I would expect only those with an EHIC to be treated 'for free'. The rest of can expect to pay, and it is a bonus otherwise.

As for the cost, when my wife was treated at Burgos Hospital in 2016, the cost for what was essentially a long consultation was about 100 Euro.

We also insisted on paying at the time, which was not simple but worth it to avoid the circumstance the OP is now facing.
 
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I think that there may be problems associated with the delays that I have heard of from when the treatment was given and when the bill for the treatment was received at home. I was so intimidated by the procedure that I was asked to go through before seeing a doctor in Spain that I tore up the paper given to me, which I was supposed to use to open an account at a particular bank and then give some sort of access to the account to the clinic. The letter was all in legalese Spanish and quite incomprehensible to me. I then resorted to self-treatment, which worked perfectly but probably is not to be recommended.
If I receive a bill long after a medical service, and with no exact written report of what treatment was done and why, I do not think that I could get my medical insurer to pay it. And I do not know how I can contact the insurer before the treatment, as I have tried to make overseas calls on a Spanish sim card, with little success. I buy insurance for major emergencies, but would certainly pay whatever the bill might be for minor problems, if I could get some sort of statement at the time. I believe that this can rarely be done.
 
I've read posts in the past which suggested that pilgrims receive free medical treatment for Camino-related problems. A few anecdotes related their experiences in this regard. Others spoke about having to pay up front.
From what I can tell, following threads here and reading up a bit, stories of free treatment because you are a (foreign) pilgrim are stories of the past; occasionally, an individual doctor may still waive fees because of the administrative hurdle to bill you; doctors and clinics are often not set up for immediate billing but increasingly so; medical staff may not even be aware of payment procedures (there was a recent thread where someone was told by medical staff that treatment at a university clinic was free and then she received an electronic bill the next day in her mailbox). Expect to pay unless you are from an EU/EEA country and have your EHIC card with you. Some clinics or doctors - this may depend on the region (Galicia, Navarra, etc) - have two tariffs, which may explain differences in what foreign pilgrims are charged as you may be charged as a privately insured patient and you will be charged a high fee.

BTW, there is no such thing as free health care anywhere in the EU, not even in the UK. It has to be paid. The health care system is just not set up everywhere in a way where those who are covered see, or are directly involved, in the money flow.
 
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In the UK we go to see a doctor or the accident department of a hospital and money or cost does not even cross our minds, it is all free for us at the point of delivery - though we do pay a small fee for prescriptions - (it isn't actually free of course, everyone pays 11% National Insurance tax on their income which pays for health and pension) and some of us can have that mindset when travelling, though when travelling in the EU we carry our EHIC card which gives us similar rights.

Nevertheless, I don't think that any pilgrim should expect free treatment but should always have good travel insurance, and if UK carry their EHIC card. That said, when I took a pilgrim to the hospital in Ponferrada one night they told me that pilgrims were treated free. I also took a pilgrim to the doctor's surgery in Los Arcos - a Swedish woman with absolutely no insurance whatsoever :eek: - and they gave her free treatment, as well another woman (another swede too!) to a doctor's surgery in Fromista who did the same - but I think that these are rare Acts of Good and should not be relied upon nor even asked for.

Margaret, re the bill - pretty cheap. If you are UK then take it/send it to your local Health & Social Security office and they will refund you.
 
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there is no such thing as free health care anywhere in the EU, not even in the UK. It has to be paid.
Here in the UK most health treatment is free at the point of use. Yes, we pay for it, but in general taxation, the same way we pay for education, defence, roads etc. A contribution is paid towards the cost of prescription medicine, but only by those, aged 18-60, in employment. My daughter has just given birth by caesarian section to a beautiful baby girl. A health problem meant that her pregnancy required regular monitoring. It cost her nothing, (and prescriptions are free if you're pregnant.)
"Breaking Bad" could not have been made in the UK! We regard the NHS as our jewel in the crown.
 
Margaret, re the bill - pretty cheap. If you are UK then take it/send it to your local Health & Social Security office and they will refund you.
I wouldn’t call it pretty cheap 😊 but rather not unusual by (my) EU standards. I’m used to paying €30 for a consultation with a GP and €90 for a consultation with a doctor in a small clinic where not much more is done than handing out a prescription. So €74 for a prescription in a Spanish clinic doesn’t strike me as unusually high.
 
Here in the UK most health treatment is free at the point of use
For those covered by the NHS 😊. I think I was just trying to point out to readers from further away ☺ that there are costs involved even when patients don’t see them. Many if not most „free“ health care systems in Europe struggle with costs and how hospitals are financed and how staff is adequately renumerated. As far as I can tell the NHS is no exception and also as far as I can tell they all have been making increased efforts in recent years to get payments from those who don’t live in the country but are just on a visit. Spain is no exception.
 
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There are several countries worldwide (all EU-countries obviously) that have some sort of Social Security Treaties with the EU or separate countries of the EU. For medical support you need some sort of a proof of insurance.

I called my Health Insurance yesterday, they told me, that all of the medical treatment, that is necessary and covered by the spain medical insurance system will be covered via my insurance-card. No need to pay anything. Only evacuation or special treatment will be covered by my travel health insurance that was offered while booking my flight.

Buen Camino!
Roland

25days until my flight to Bayonne!
 
I can tell the NHS is no exception and also as far as I can tell they all have been making increased efforts in recent years to get payments from those who don’t live in the country but are just on a visit. Spain is no exception.
i don’t want to clog up this thread with discussions about health care systems but I think the following remark is relevant for what I think are changing times for pilgrims and other tourists in European countries: years ago, I once needed treatment in the UK and at another time in Ireland. In both cases, I didn’t have to pay. I didn’t even need to show an EHIC card or its predecessor, the E111 form. I even got a pair of crutches for free in Dublin. I am only vaguely aware of the changes in the UK and know nothing about Ireland but I have little doubt that these days are gone. As are the days of free treatment for pilgrims in Spain. You need to show proof that you are entitled to treatment without having to pay yourself and if not you are likely to receive a bill.
 
This thread has now dispelled the myth about free medical treatment for pilgrims on the Camino! I must admit I had previously (naively and mistakenly) believed in the myth - not because I expected something for nothing, but because of the universal kindness shown to pilgrims by the Spanish. I thought that perhaps there really was an unofficial or even official policy to assist pilgrims arrive at their destination. I now understand categorically that this is not the case.
 
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This thread has now dispelled the myth about free medical treatment for pilgrims on the Camino! I must admit I had previously (naively and mistakenly) believed in the myth - not because I expected something for nothing, but because of the universal kindness shown to pilgrims by the Spanish. I thought that perhaps there really was an unofficial or even official policy to assist pilgrims arrive at their destination. I now understand categorically that this is not the case.

I appreciate your starting this thread, Margaret. It definitely covers a topic that every foreign pilgrim to Spain needs to be aware of. It is important, as a part of travel planning, to consider what we need to do in order to cover the expense of unexpected and emergency medical care.
 
UK citizens with EHIC cards usually won't pay at a hospital in France but later will receive a bill for part of the treatment cost, the rest is claimed by the hospital who claim directly from UK set up. If you visit a G.P. in France you pay there and then. Also in pharmacies you pay for the prescriptions. You can claim some of this back when you return to the UK but not all costs will be refunded.
EHIC card won't cover repatriation costs, you will need travel insurance for that.

That's my experience, I've not needed to use the Spanish health system, thankfully.
 
Last August after I had to cut my Camino short because of shin and foot pain I went to the hospital in Santiago to make sure that I didn't have anything like a stress fracture. They aren't set up to take payments at the time of service, but took my name and address.
After a brief examination I was given two acetaminophen.
I received a bill from the hospital two months later for 361€, which oukd only be paid by bank transfer, which cost me an additional $30. So it was quite a large expense.
I was able to submit the bill to my health insurance company, who reimbursed me about half.
I had gone to the hospital on the suggestion of the receptionist at my hotel, but I think that the cost may have been much lower if I had gone to a Centro de Salud.
 
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In Spain the Health competency is decentralized among the 17 Comunidades Autónomas (Galicia, Madrid, C.León, etc).
Last year I fell down doing the C. Portugues and had some scratches in my face and arms that finally only needed antiseptic.
So I visited the Centro de Salud in O Milladoiro (10 kms before Santiago) where I had to spend more than 3 hours because a visit to a doctor was required and at the office didn't know how to charge all of this to my C.A. (Madrid). Fortunately they found the way.
 
Expect to pay. Especially for service from hospitals and clinics; they have the capability of setting up a billing service. From what I have read people have been treated in small towns when a health service doctor happens to be making a weekly visit or something. In that case it is not easy to do a billing and, since the treatment is usually simple, the doctor takes the easy way out and just ignores the billing. Pilgrims who have been treated this way then pass on the story of how the Spanish health system is free.

We got caught in this halfway knowing that hospitals cost but thinking clinic visits were free. On our second clinic visit we knew better and passed on insurance information. Months later we got two bills in the mail which we used to get reimbursed by the insurance company but we had to pay the bills ourselves. Credit cards were not acceptable. Payment was to be done in person or with a certified check or a bank transfer. The last two would have cost us $40 for each payment. Using their website to message them I got them to combine the bills. Setting up a Western Union account to get the bank transfer fee down to $10 did not help as I needed the name of a person getting the funds to pass US government anti-money laundring regulations. Finally I ended up getting someone else in Spain to pay the bill and reimbursed him.

Taking the time to pay the bill while there is worth the trouble.
 
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Fergal Keane wrote an amusing account of some emergency dental treatment that he received during a public holiday. I seem to recall that he was rather humbled that the dentist refused to charge him anything for the treatment. It's in his excellent book "Letters Home."
 
Get a spanish phone number with Airalo. eSim, so no physical SIM card. Easy to use app to add more funds if needed.
I would say that a pilgrim on Camino should expect no free treatment simply because one is a pilgrim.

I have read about gratis treatment for small issues at local clinics, and became acquainted with a pilgrim on Camino who had a blister treated and was told to 'never mind' when he offered payment. At the same time, I know of folks who have had to pay for the care they receive. Like you, they typically receive a billing statement in the mail.
I personally spent several hours in a emergency room complete with anbulance ride. surgury on chin from a fall and multiple xrays.
Total charge €126. wow.
 
Something to be aware of is that in Spain there are the national clinics and hospitals, but there are also private clinics. Try to ascertain which you are visiting before you proceed because the costs can vary considerably, and the EHIC card may not cover private hospital costs. Pharmacies are usually a very good place to seek initial advice and those on the Camino are well accustomed to the more common problems that pilgrims suffer from.

I always have travel insurance wherever I go to cover those costs that an EHIC card may not, but mostly to cover repatriation if that is necessary.

It's also worth noting that Spain has a very good reputation for medical standards so you don't need to fear in that respect.
 
I've read posts in the past which suggested that pilgrims receive free medical treatment for Camino-related problems. A few anecdotes related their experiences in this regard. Others spoke about having to pay up front. Recently I visited new public clinic in Astorga for a consultation about my painful knee. The doctor didn't examine me and simply prescribed Ibuprofen 600, which is readily OTC in Spain. (I was really hoping for a cortisone injection, but was told there were no facilities for this in that clinic). Back home, I have just received a bill by registered post for €74 from the Council of Castile and Leon. I would have paid at the time, if they'd asked me, though on reflection this was expensive for the treatment received.

Can anyone please clarify what pilgrims can expect in the way of free treatment on the Camino?

We went to the hospital in Leon and was charged upfront €120 - they told me this before treatment for blisters. They also asked about travel insurance which we have and they actually called the insurance company for me. The other clinic was on Carrion de los condes and that was €74. This was mid may this year :)
 
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My takeaway from this thread, and something all non-EU pilgrims should understand, is that if you need health care while on Camino you should expect to pay for all but the most minor treatment.

Also, pilgrims coming from outside the EU can prepare for this by purchasing travel insurance from Allianz or one of the other providers of travelers health insurance. Just Google "travel medical insurance."

Personally, I always buy travelers insurance from the airline when I buy the air ticket. This would provide for medical evacuation back home as well as cover for serious illness. Viewed against the cost of your Camino, this is pocket change, and money very well spent IMHO.

However, and because I traveled internationally for my entire 30-year professional career, I took pains while employed, to obtain primary (now secondary) health insurance that could be used out of the US. I hold Blue Cross - Blue Shield (BC/BS) medical insurance obtained in a group arrangement originally through my employer, and now continued in retirement. It is not cheap. But it IS comprehensive.

This coverage became secondary to my US mandated Medicare medical insurance cover for 'senior' citizens. When I turned 65 last year, I was mandatorily placed into this government health insurance program for 'seniors' program. My previously primary insurance cover (BC-BS) became the secondary provider.

The good news is that, with stacked coverages like this, I never see a bill or co-pay. One or the other provider pays for everything. Of course, this is not cheap. But, as one ages, costs and frequencies do increase. So, this is a wise investment IMHO. I regard health insurance as one of my monthly mandatory costs, just like my mortgage and utility payments. Maintaining ME is my primary directive...

The bad news is that Medicare is not available, even by reimbursement for medical services received, outside the US. The good news is that my BC /BS secondary cover is usable and reverts to being primary coverage when I am out of the US.

Through their international partnerships, BC /BS have a website one can go to to find a hospital or medical professional that 'accepts' this foreign coverage. By way of example, at Santiago, the University Medical Center is listed as the 'go to' hospital.

There is a saying among women of a certain generation that goes, "...one can never be too thin or too rich..." I add to that... "or have too much health insurance coverage..."

Hope this helps the dialog.
 
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We went to the hospital in Leon and was charged upfront €120 - they told me this before treatment for blisters. They also asked about travel insurance which we have and they actually called the insurance company for me. The other clinic was on Carrion de los condes and that was €74. This was mid may this year :)
A bit similar here. I went to hospital in Leòn, suffering "shin splints". They did a preliminary "charge" of about 200€ to my credit card, phoned my Australian travel insurance provider, did the xrays and MRI etc while awaiting a reply, and eventually I paid nothing because the insurer gave them the go ahead.
If you can't afford travel insurance, you can't afford to travel.
 
I personally spent several hours in a emergency room complete with anbulance ride. surgury on chin from a fall and multiple xrays.
Total charge €126. wow.
I presume that the real cost of treatment was higher. From what I read on a reliable Spanish website (although I couldn’t establish whether the information was up to date or outdated) it seems that state hospitals will or would wave most or all of the charges to the patient or insurer when it’s a real emergency requiring immediate treatment of a foreign visitor (anyone, not just pilgrims).

However, nobody should count on it. As someone said in this thread: If you can afford to travel to Spain, you can afford to buy adequate travel (sickness) insurance.
 
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Although I’ve lived and worked my whole life in EU countries, I’m not covered by a universal health care insurance system. Due to the nature of my last employer and the pension system I belong to, I’m one of hundred thousands of Europeans who don’t get an EHIC card. I’m what‘s called a private patient and have to pay medical bills myself first, whether in Spain or in other EU countries including country of residence. In my experience, a delay of a week to two or three months between treatment and arrival of the invoice from a day clinic or for lab work is not unusual.

It seems that anything between a day and a few months between consultation/treatment and issuing of the invoice is also the usual time span when you received treatment in Spain?
 
For traveling I strongly recommend travel health insurance. Mine would cover all cost that would shortfall from my regular health insurance, repatriation costs ambulance flights and if necessary funeral costs.
Why would you expect free treatment. That would mean that all the paying health insurance takers would be paying for pilgrims. That does not seem fair to me. Travel health insurance is affordable and should be a normal part of your gear.
If you are considered a self paying private patient expect to be billed more than a normal patient with insurance card.
Inquire beforehand what would be covered and what would you need.
I have seen patients that did not take precautions and when serious sick they had no way to go back home. A nightmare for their loved ones and for them.

When I told my husband that my funeral cost would be covered and my wishes for my ashes to be spread into the ocean and he would have no costs and as an extra bonus being on a pilgrimage I would go straight to the pearly gates, he gave me a sideways glance and said you DO intent to come back, right?
 
One the issue of travel insurance, make sure the policy covers over 30 days on a single visit. This is particularly important if walking from SJPP to Santiago, following the usual stages, with a few days at the end and perhaps on to Muxia or Fisterra.

This is particularly worth checking if buying "annual" travel insurance. There WILL BE a time limit on any one visit.

Insurers may offer 45 day cover at time of purchase for a small extra fee.
 
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I've read posts in the past which suggested that pilgrims receive free medical treatment for Camino-related problems. A few anecdotes related their experiences in this regard. Others spoke about having to pay up front. Recently I visited new public clinic in Astorga for a consultation about my painful knee. The doctor didn't examine me and simply prescribed Ibuprofen 600, which is readily OTC in Spain. (I was really hoping for a cortisone injection, but was told there were no facilities for this in that clinic). Back home, I have just received a bill by registered post for €74 from the Council of Castile and Leon. I would have paid at the time, if they'd asked me, though on reflection this was expensive for the treatment received.

Can anyone please clarify what pilgrims can expect in the way of free treatment on the Camino?

I had travel insurance just in case so that was not the problem. My problem was being charged 75 eu up front to have a doctor look at my badly swolen ankle that I could barely walk on, then have her shrug her shoulders with an "I don't have a clue" look. No X-ray or anything... just that shrug and a rx for antibiotics.
 
My daughter in 2002 had bad blisters and was treated in the hospital at Burgos - for free as she was a Pilgrim.
 
state hospitals will or would wave most or all of the charges to the patient or insurer when it’s a real emergency requiring immediate treatment of a foreign visitor (anyone, not just pilgrims).
I think it is "normal" in most civilized places to give real emergency (i.e. life-saving) treatment to patients who need it, and then ask questions about their nationality or health insurance later.
 
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I think it is "normal" in most civilized places to give real emergency (i.e. life-saving) treatment to patients who need it, and then ask questions about their nationality or health insurance later.
As I understand it, from what I read, non-residents without automatic right to coverage under the public health system in Spain, such as non-EU tourists, may be exempt from costs of treatment in case of an emergency of the type of accident or serious (acute?) illness - and that means no invoice after emergency treatment is completed. I offered this bit of knowledge that I had gleaned as a possible explanation for the apparently low cost of treatment in a public hospital that someone cited in their case after a fall.

In any case, the laws have changed in view of the huge increase of healthcare cost to the national and local governments during recent years, as well as abuse of the kind called health tourism, and what was free years ago is no longer free today.
 
As I understand it, from what I read, non-residents without automatic right to coverage under the public health system in Spain, such as non-EU tourists, may be exempt from costs of treatment in case of an emergency of the type of accident or serious (acute?) illness - and that means no invoice after emergency treatment is completed. I offered this bit of knowledge that I had gleaned as a possible explanation for the apparently low cost of treatment in a public hospital that someone cited in their case after a fall.

In any case, the laws have changed in view of the huge increase of healthcare cost to the national and local governments during recent years, as well as abuse of the kind called health tourism, and what was free years ago is no longer free today.

Although all of this thread is focused on Spain my recent experience in France may be of interest. I was on the voie de Vézelay, final destination SDG. On my day 30 my wife joined me and 9 days ago, on her day 18, just south of Orthez she slipped awkwardly on a tricky section, broke her ankle. It was immediately obvious. No phone signal or companions, cool and light rain. I Stabilised her and took off up the hill to find help, which came in the form of a pilgrim (angel) coming in the other direction, French and with a phone. Marie-Helene I think. Only the second returning pilgrim I’d encountered in 48 days. She got hold of the emergency rescue and with my maps.me app coordinates we were able to give them the exact location. That probably saved an hour as we were not close to any named roads. Remarkably another pilgrim who was behind us caught up and wouldn’t you know it, he is a doctor. Helped a great deal. I regret very much not getting his name and contact details but things were a bit hectic and emotional. The pompiers arrived very quickly, prepared and in numbers, and we had her in Orthez hospital within about 3 hours. Within another couple of hours she was Xrayed, off site surgeon had given his instructions for a caste and plan made to operate on the Monday. Operation was fairly routine and she was in the Clinique overnight and discharged the following day. In a lot of pain though, heavily sedated and almost totally immobile. I found a single level apartment in Salies-de-Béarn and after 10 days here, we leave tomorrow to fly back to NewZealand, business class lie flat. The treatment has been very competent and the people absolutely lovely. The rescue has not cost us anything, the cost of the day in emergency was €89 (X-ray and drugs) and the operation and Hospital cost is I think about €2800, which is handled directly between our insurer and the hospital. It includes the follow up appointment with surgeon 2 days ago. The other costs are crutches and moon boot (€97) and prescription for a month of painkillers etc (€230) which I paid in cash and will recover under the insurance policy. Extra accom, expenses and all related flight costs all covered.
My wife Barb should fully recover we believe. A disastrous accident for us but an extraordinary experience in terms of how effective all the various parts worked and the value delivered. Thankfully our insurance was comprehensive!
That leaves some unfinished business in Spain which I will attend to next year hehe!
Sorry this is so long. I hope it’s helpful.
By the way the accident was on a very rough patch about 2 kms past l’hôpital d’orion.
Joe
 
My daughter in 2002 had bad blisters and was treated in the hospital at Burgos - for free as she was a Pilgrim.
Smiles, kisses and hugs can be free but health care isn't. Somebody paid for that treatment. In your case it was Spanish/EU tax-payers if your daughter didn't have EHIC or travel insurance.
 
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I’ve read this now repeatedly so it seems to be the case that emergency medical assistance may be free of charge in specific cases (for anyone, not pilgrim specific), even when you are not a beneficiary of Spanish social security or a mutually recognised social security system, for example that of another EU country and of a limited number of other countries such as Brazil or Morocco. I just mention this because the reports of whether pilgrims were billed or not in recent years seem confusing or contradictory at first sight. See for example:

Este artículo contempla la asistencia sanitaria:
• De urgencia por enfermedad grave o accidente, cualquiera que sea la causa, hasta la situación de alta médica. Esta asistencia será prestada en los servicios de urgencia (PAC, hospitales,,). No tienen derecho a recetas médicas oficiales.
• De asistencia al embarazo, parto y postparto. Conlleva la emisión de recetas médicas oficiales (40%).
• Extranjeros menores de 18 años. Conlleva la emisión de recetas médicas oficiales (40%).
En estos casos no se genera ningún tipo de facturación del importe de la asistencia sanitaria al usuario.
Si bien cualquier ciudadano podrá ser atendido en el Sistema Público Gallego de Salud, la atención sanitaria solo podrá ser gratuita en caso de personas aseguradas, beneficiarias o que se encuentren en las situaciones especiales antes citadas.
 
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I’ve read this now repeatedly so it seems to be the case that emergency medical assistance may be free of charge in specific cases (for anyone, not pilgrim specific), even when you are not a beneficiary of Spanish social security or a mutually recognised social security system, for example that of another EU country and of a limited number of other countries such as Brazil or Morocco. I just mention this because the reports of whether pilgrims were billed or not in recent years seem confusing or contradictory at first sight. See for example:

Este artículo contempla la asistencia sanitaria:
• De urgencia por enfermedad grave o accidente, cualquiera que sea la causa, hasta la situación de alta médica. Esta asistencia será prestada en los servicios de urgencia (PAC, hospitales,,). No tienen derecho a recetas médicas oficiales.
• De asistencia al embarazo, parto y postparto. Conlleva la emisión de recetas médicas oficiales (40%).
• Extranjeros menores de 18 años. Conlleva la emisión de recetas médicas oficiales (40%).
En estos casos no se genera ningún tipo de facturación del importe de la asistencia sanitaria al usuario.
Si bien cualquier ciudadano podrá ser atendido en el Sistema Público Gallego de Salud, la atención sanitaria solo podrá ser gratuita en caso de personas aseguradas, beneficiarias o que se encuentren en las situaciones especiales antes citadas.
I recently went to a Spanish hospital for emergency treatment and it was stated in big letters in reception that no-one would be admitted unless they had a European Health Insurance card.
 
I’ve read this now repeatedly so it seems to be the case that emergency medical assistance may be free of charge in specific cases (for anyone, not pilgrim specific), even when you are not a beneficiary of Spanish social security or a mutually recognised social security system, for example that of another EU country and of a limited number of other countries such as Brazil or Morocco. I just mention this because the reports of whether pilgrims were billed or not in recent years seem confusing or contradictory at first sight.
Thank you for researching this. It seems to me that similar principles apply elsewhere in Spain and around Europe.

Re-reading this, I don't think the other issue that occurs from time to time here in Australia has been mentioned, and that is the distinction between acute and chronic conditions. It seems emergency departments here are attended by people who have chronic conditions, which in general would require on-going management rather than urgent medical intervention. I have experience of this with my mother, who did need urgent treatment and got it on one occasion, but when she went back to the emergency department a couple of weeks later, was upset that after the triage and initial diagnosis, they wouldn't admit her. She was told she needed to see her own GP to manage her condition.

I suspect that this might be part of the decision made by the doctor or hospital about whether one does or does not pay. When my wife went to emergency at the Burgos hospital, she was diagnosed with an allergy to wheat pollen, which would be seen as a chronic condition needing ongoing management. We were required to pay for the treatment, and purchase the prescribed medication.

Some years earlier, in Britain, when she had fallen and wrenched her knee badly, she was treated for free in the emergency department at the closest hospital. Clearly her condition in this case was acute.

I know these might be isolated incidents in different countries and at different times, but I do think they illustrate another layer of the complexity that medical practitioners, etc face when deciding whether a patient will or won't be billed for their treatment.
 
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I can't imagine anyone travelling outside of the area of their own healthcare coverage without obtaining travel insurance or being prepared to pay the fees for whatever care they might require. I am constantly astonished at the idiots from my own country (I am Canadian) who do so and then expect someone else to pick up the cost when they have an accident. Having said that, in 2015 I was bitten by a dog in Bidueda on the Frances route and had to visit the hospital in Sarria for treatment. I offered my travel insurance upon arrival and again before leaving and they would not take it. They did have my information and a police report was filed but much to my astonishmentI was never billed for anything. While I appreciate it, I feel bad that the Spanish people covered the cost of my medical care.
 
€2,-/day will present your project to thousands of visitors each day. All interested in the Camino de Santiago.
I can't imagine anyone travelling outside of the area of their own healthcare coverage without obtaining travel insurance or being prepared to pay the fees for whatever care they might require. I am constantly astonished at the idiots from my own country (I am Canadian) who do so and then expect someone else to pick up the cost when they have an accident.
Health care coverage in Canada is more complex than in many other countries, since it depends upon one's province of residence and a Canadian is generally covered for medical care to the dollar amount of what would be paid in his or her province of residence. In his last years, my father traveled back and forth from his original province of residence, Ontario, to stay for months at a time in Alberta. His Ontario coverage was not sufficient to pay his medical bills and had to be supplemented out of his own pocket. Nor could he have simply repeatedly transferred his coverage, since there is generally a three month delay. And of course, there are all sorts of complications associated with paying for medical coverage for travel. which I once attempted to do for him when on a cruise with my father. This is not to suggest that travelers should not purchase such coverage, just to say that it is complicated to do so and, in the end, the patient is subject to receiving back from the insurer whatever it chooses to pay.
 
Health care coverage in Canada is more complex than in many other countries, since it depends upon one's province of residence and a Canadian is generally covered for medical care to the dollar amount of what would be paid in his or her province of residence. In his last years, my father traveled back and forth from his original province of residence, Ontario, to stay for months at a time in Alberta. His Ontario coverage was not sufficient to pay his medical bills and had to be supplemented out of his own pocket. Nor could he have simply repeatedly transferred his coverage, since there is generally a three month delay. And of course, there are all sorts of complications associated with paying for medical coverage for travel. which I once attempted to do for him when on a cruise with my father. This is not to suggest that travelers should not purchase such coverage, just to say that it is complicated to do so and, in the end, the patient is subject to receiving back from the insurer whatever it chooses to pay.
Most certainly true! My husband was diagnosed with Atrial Fibrillation just a couple of months prior to our first Camino. I expected that we would have to pay a hefty premium when we walked into BCAA to obtain insurance. We were completely honest about the situation and were shocked when they said they wouldn't insure him at all. He was 51 at the time. We then went to the company that handles our home insurance, again being completely honest, and obtained insurance along with an email as proof that he would be covered. Surprisingly it wasn't even that expensive. However he was quite prepared to travel without it had it come to that. I said "If that's the case, I see three possible scenarios. Best case: nothing happens, second best case: you die, because the third case is that you have a stroke and if you think I am losing everything we have to drag you home because you insisted on travelling you can think again!" (Compassion is my middle name. ;) )
 
I needed hospital treatment of about 6 hours in Vigo on the way to Santiago. I gave Ausyralian travel insurance details on admission and was not required to pay anything on discharge. The treatment was excellent. I advised the insurance company of the treatment and hospital details the same day. Several months later the invoice arrived in the post - around €400 from memory. I contacted the insurance company to remind them of my earlier email and forwarded the account. All settled without delay. So yes, there is a charge and I could not fault the care I received. As an aside it was interesting that almost all staff: consultants, doctors, technicians, orderlies were predominantly women. I might have seen one male. It was the university teaching hospital in Vigo and might be atypical but evident enough to stick in my mind. Travel insurance is not a luxury.
 
A selection of Camino Jewellery
I've read posts in the past which suggested that pilgrims receive free medical treatment for Camino-related problems. A few anecdotes related their experiences in this regard. Others spoke about having to pay up front. Recently I visited new public clinic in Astorga for a consultation about my painful knee. The doctor didn't examine me and simply prescribed Ibuprofen 600, which is readily OTC in Spain. (I was really hoping for a cortisone injection, but was told there were no facilities for this in that clinic). Back home, I have just received a bill by registered post for €74 from the Council of Castile and Leon. I would have paid at the time, if they'd asked me, though on reflection this was expensive for the treatment received.

Can anyone please clarify what pilgrims can expect in the way of free treatment on the Camino?
 
Buy travel insurance before you leave the USA. Either it will work as primary coverage on the spot or you’ll be reimbursed when you get home. The hospital in Leon was familiar with our TravelEx and there were no delays getting treatment.

 
I've read posts in the past which suggested that pilgrims receive free medical treatment for Camino-related problems. A few anecdotes related their experiences in this regard. Others spoke about having to pay up front. Recently I visited new public clinic in Astorga for a consultation about my painful knee. The doctor didn't examine me and simply prescribed Ibuprofen 600, which is readily OTC in Spain. (I was really hoping for a cortisone injection, but was told there were no facilities for this in that clinic). Back home, I have just received a bill by registered post for €74 from the Council of Castile and Leon. I would have paid at the time, if they'd asked me, though on reflection this was expensive for the treatment received.

Can anyone please clarify what pilgrims can expect in the way of free treatment on the Camino?
[/QUOTE]
It really varies from place to place. In the past I travelled to Spain every year with students and there were occasions when I had to take a student to the doctor. I visited several clinics and hospitals over the years and we never were charged a penny and always received great care.

In 2013 I met a young lady along the Camino del Norte who ended up needing medical care in Laredo. I went with her to a clinic where they examined her, took x-rays of her leg and found she had a stress fracture on her tibia. She was told to rest and was given crutches for moving about. At the end of the consultation she didn't have to pay anything and she never received a bill either.

In 2016 on Camino Sanabrés my friend needed to see a doctor in Ourense because her knee was swollen. She had an x-ray taken and the doctor gave her a cortisone shot to help soothe the pain. There was no charge.

This year along Camino Portugués I ended up going to see a private doctor in Caldas das Reis. The doctor did a thorough examination and gave me a cortisone shot along with 2 prescriptions for my pes anserinus tendinitis. I paid 30€ for the consultation and the shot, and then went to the pharmacy and spent 4€ to fill out the prescriptions.

I think it depends on what type of medical facility you visit:)

Ultreïa!
 
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I should add that in Leon we were told that without travel insurance, the doctor visit would be €129 and that it would be an additional €125 if an x-ray were required.
 
I should add that in Leon we were told that without travel insurance, the doctor visit would be €129 and that it would be an additional €125 if an x-ray were required.
That sounds exorbitant and out of the ordinary! In all of my experiences with medical facilities in different parts of Spain I have never had that happen to me, my students or my friends. Also, I never have purchased travel insurance or been asked if I have it when at the doctor there!
 
That sounds exorbitant and out of the ordinary! In all of my experiences with medical facilities in different parts of Spain I have never had that happen to me, my students or my friends. Also, I never have purchased travel insurance or been asked if I have it when at the doctor there!
That was our experience last week. Sounds like you haven’t needed care in a big city. The purpose of this forum is to help pilgrims prepare for their trek. Interestingly, it was passport not credit card info that was documented. We were seen after giving travel insurance policy information.
 
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That was our experience last week. Sounds like you haven’t needed care in a big city. The purpose of this forum is to help pilgrims prepare for their trek. Interestingly, it was passport not credit card info that was documented. We were seen after giving travel insurance policy information.
That was our experience last week. Sounds like you haven’t needed care in a big city. The purpose of this forum is to help pilgrims prepare for their trek. Interestingly, it was passport not credit card info that was documented. We were seen after giving travel insurance policy information.
You are right when you say that passport information is requested. That, I have had to do every time whether for myself, students or friends. I've had medical emergencies in Madrid, Barcelona, Valencia and San Sebastián, so yes, some have been in bigger cities, always without a charge or a minimal one (30€) but a always a good experience:)
 
I've read posts in the past which suggested that pilgrims receive free medical treatment for Camino-related problems. A few anecdotes related their experiences in this regard. Others spoke about having to pay up front. Recently I visited new public clinic in Astorga for a consultation about my painful knee. The doctor didn't examine me and simply prescribed Ibuprofen 600, which is readily OTC in Spain. (I was really hoping for a cortisone injection, but was told there were no facilities for this in that clinic). Back home, I have just received a bill by registered post for €74 from the Council of Castile and Leon. I would have paid at the time, if they'd asked me, though on reflection this was expensive for the treatment received.

Can anyone please clarify what pilgrims can expect in the way of free treatment on the Camino?
I personally carry a federal government provided insurance and it covers overseas medical expenses. In fact the government insurance has list of facilities that they are affiliated with/MOU etc. What about privately insured people?
 
Join our full-service guided tour and let us convert you into a Pampered Pilgrim!
I've read posts in the past which suggested that pilgrims receive free medical treatment for Camino-related problems. A few anecdotes related their experiences in this regard. Others spoke about having to pay up front. Recently I visited new public clinic in Astorga for a consultation about my painful knee. The doctor didn't examine me and simply prescribed Ibuprofen 600, which is readily OTC in Spain. (I was really hoping for a cortisone injection, but was told there were no facilities for this in that clinic). Back home, I have just received a bill by registered post for €74 from the Council of Castile and Leon. I would have paid at the time, if they'd asked me, though on reflection this was expensive for the treatment received.

Can anyone please clarify what pilgrims can expect in the way of free treatment on the Camino?

Hi Margaret

Hospital services are free. I went to the hospital in Burgos three weeks ago with a back problem and it was suggested I receive physiotherapy. It cost me for the physiotherapist. Hospitals don’t charge.

However, I had a similar injury as you described, three years ago in Estrella. My knee had been in pain since the Pyrenees mountains, so I went to the clinic in Estrella. They asked me for my medical insurance info and treated me. They fax the information to the insurance company and gave me the fax confirmation and said good bye. Several months later, I received a bill. My insurance company hadn’t paid. In the end, it all worked out as my insurance company paid approximately 150 Euro, $225 CDN for a ten minute consultation. It was suggested IBPROFIN 600 mgs and a tension band which ended up costing 5 Euro.

I’m in Portugal now. I should ask some questions as it appears I’m addicted to this area of the world and I should how it all works.
 
There are age limits for traveling insurance. Should you be able to obtain a membership with your road side assistances provider I intentionally do not mention the name you may be eligible for a very reasonable health insurance for traveling and they insured my 65 plus mother.
Reading about option you have a stroke and we carry you. The cost to repatriate a stroke patient from Central Europe to the States costs US$ 120 000. To be paid then and there. I saw it happen over and over again. Having lived closed to a river cruise destination and being called in to assist with the language issues. And that is only a part of the costs, consider the intensive care , helicopter transportation, ambulances, emergencies doctors and so on.
St. James may look after the pilgrims but god has no other hands to help but ours.
 
€2,-/day will present your project to thousands of visitors each day. All interested in the Camino de Santiago.
I would like to hear from anyone from Alberta Canada that bought AMA travel medical insurance and had to use it in Spain. Did you find it a good experience? Did they pay for treatment directly? I always bought their insurance because others here have told me good things but none used it in Spain.
 
I would like to hear from anyone from Alberta Canada that bought AMA travel medical insurance and had to use it in Spain. Did you find it a good experience? Did they pay for treatment directly? I always bought their insurance because others here have told me good things but none used it in Spain.
Rosemary,
I buy AMA travel medical insurance but I have not had to use it in Spain. However, I did have to use it for a minor medical condition in New Zealand. I made sure to get the doctor to give me a record of his results and diagnosis. The insurance paid for the cost of the doctor, $100 NZ plus the cost of the medication prescribed, in total, about one half of what I had paid for the insurance. I continue to buy AMA insurance because I trust the insurer to pay up promptly. They paid me, because I had to pay for the care at the time. The situation is different in Spain, as they often send a bill later, so you would have to inquire with them if you receive such a bill whether to submit it to them or to pay it and submit the receipt.
 
I've read posts in the past which suggested that pilgrims receive free medical treatment for Camino-related problems. A few anecdotes related their experiences in this regard. Others spoke about having to pay up front. Recently I visited new public clinic in Astorga for a consultation about my painful knee. The doctor didn't examine me and simply prescribed Ibuprofen 600, which is readily OTC in Spain. (I was really hoping for a cortisone injection, but was told there were no facilities for this in that clinic). Back home, I have just received a bill by registered post for €74 from the Council of Castile and Leon. I would have paid at the time, if they'd asked me, though on reflection this was expensive for the treatment received.

Can anyone please clarify what pilgrims can expect in the way of free treatment on the Camino?
Why would anyone expect free medical treatment?
 
The focus is on reducing the risk of failure through being well prepared. 2nd ed.
Why would anyone expect free medical treatment?
I suppose it depends on what free means and where you're from. I have always had all medical treatments todate paid for by my provincial health care (Canada) and I buy medical travel insurance for what may not be covered by my provincial plan when I travel. I don't want any person etc, in Spain to absorb costs on my behalf but I do have an expectation to be covered without incurring costs myself. I don't pay a fee for my provincial plan, except for a prescription fulfillment free which is very little. So it could be described as free medical care. I don't have any expectation that I will have to pay and if I do I have the expectation that I will be reimbursed. That's why I add additional coverage. That's not free but that's what free means to me.
 
The focus is on reducing the risk of failure through being well prepared. 2nd ed.
I ended up in the hospital last year with suspected DVT - I was on a drip, had blood tests and a full ultrasound of my leg to check for DVT. It ended up being an infection and I was prescribed antibiotics and strong ibuprofen. I had my EHIC card and the only thing I had to pay for was the antibiotics and ibuprofen - about 14 euros.
 
Those who have received free treatments and no bills following them have indeed been lucky. Please don't forget though that many European health services are severely stretched and their staff and facilities do have to be funded somehow.
 
The one from Galicia (the round) and the one from Castilla & Leon. Individually numbered and made by the same people that make the ones you see on your walk.
CW86
If you presented your EHIC then the hospital would in due course have claimed the costs back from the country that issued your EHIC card. That happened to me at a French hospital, I still had a bill later for €200 which I was able to reclaim. It's complicated but that's how it works for now. After Brexit this agreement may no longer exist.
 
I recently went to a Spanish hospital for emergency treatment and it was stated in big letters in reception that no-one would be admitted unless they had a European Health Insurance card.
And make sure that EHIC is up to date. A UK citizen I know had a fall in the Pyrenees (don't know which side) And broke his shoulder. When taken to the hospital it was discovered his card had expired. He needed emergency surgery, but chose to discharge himself from the hospital and fly home for the surgery.
 
If something happens while I'm there next month, I expect to pay.

As an aside, the costs in this thread shock me. Of my 3 dozen (plus) surgeries, most were $350,000 each plus $150,000 each for hospital. That's with insurance. Regular doctor visits run me $400. Is it any wonder I'll be sleeping outside on the CF? 🙄
 
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As the writer of the OP, I'd like to add an update. Of course, I had medical insurance for my trip, purchased in Australia. However, this is not the end of the story. I was able to claim for the bills for treatment at the clinics in Astorga and Ponferrada. There was a refusal to reimburse for expenses involved in curtailment of my holiday (i.e. the fee to Emirates for changing my flight). This was because the Doctor did not specifically say in writing that I had to return home. He simply wrote "take rest and no undue effort". I argued to the insurance company that this clearly meant I couldn't continue with the Camino as I had planned, but they would not accept this, even when the claim went for review. Moral of the story: make sure the Doctor you see is specific on the medical document. Another thing: insurers insist you provide an authorised translation of documents, costing about $80 or more; Google Translate is not acceptable!
 
A selection of Camino Jewellery
TravelEx did not require translations for our submitted medical expenses.
 
Another issue, which I did not see discussed above: if someone has paid for private insurance, sometimes the insurer will require that the patient get in touch with the insurer before undergoing any major treatment, except in the case of an emergency. This may be because the insurer has made arrangements to refer persons who need medical care to a particular private facility convenient to wherever the insured person is travelling. This was so with the insurance that I paid for before my trip to Mexico last winter. As I had paid in person at the AMA office, the staff were able to advise me as to where I should go for medical care, if needed. Canadians who pay medical expenses out of pocket may claim the amounts paid to reduce their income tax payments in Canada, and this includes payment for travel medical insurance. As a low income person, I do not have enough income to pay taxes, but there may still be advantages to paying costs up front in other countries, without even buying insurance. Senior's provincial coverage for some expenses (dental, eye glasses etc.) is not enough to cover what the services cost at home, but costs incurred abroad can be claimed back from the provincial health care system and will be reimbursed to the payer, up to the limit set by the provincial health care. This is without any paid travel insurance, but simply as part of the provincial system. So my brother gets inexpensive dental care in Mexico and gets it paid for in Alberta, up to the usual maximum. If he got it done at home, the amount covered by the government might run out long before he could pay a Calgary dentist for needed services. This is a peculiarity of the Canadian health care system which may lead to medical tourism for services such as dentistry, but at no cost to the host country, as it is paid for privately. Personally, I prefer to get my dental work done by my own dentist at home, regardless of the cost. But the cost of major dental work kept me from going on camino last year, so I can understand why someone might prefer to get dental work done at less cost, and save the cash for the next camino. Where there is any public health care, it varies greatly from country to country, in Canada, also from province to province. The traveler is responsible for arranging private coverage to provide for her/his needs.
 
The focus is on reducing the risk of failure through being well prepared. 2nd ed.
... and another thing: making a claim on medical insurance is incredibly frustrating. There are so many issues that you can get wrong. It's as if you are being set up to fail. If you arrange your insurance online, it means you have to make the claim at a distance and send everything by registered post. There is no office where you can go to seek advice. My claim was not a large one, but it appeared that the company was determined to find a way NOT to pay. Reading the small print is all very well, but there are pages and pages of it!
 
CW86
If you presented your EHIC then the hospital would in due course have claimed the costs back from the country that issued your EHIC card. That happened to me at a French hospital, I still had a bill later for €200 which I was able to reclaim. It's complicated but that's how it works for now. After Brexit this agreement may no longer exist.
Hmmm. Went to A & E in Astorga and a clinic in Pamplona. After much photocopying and taking of details I was not charged in either place. Won't expect that after Brexit though.
But in SJPP a visit to one of the doctors on the list in the pilgrim office cost nothing at all, they didn't even want to see my EHIC card.
 
I would like to clarify a little this issue:
  • There are some hospitals where they treat pilgrims for free (for example, the Hospital de la Reina in Ponferrada)
  • Except for these hospitals mentioned above, you have to pay. For EU citizens, the payment is already included in the taxes that we pay... therefore, we do not pay in the hospital and we have the right to be treated without any direct payment.
  • For citizens who do not belong to the EU: the coverage of the system is universal ... This means that the hospitals have an obligation to treat you (if they consider that you have a type of illness that can not wait until you return to your country) but they will try to bill you for the treatment they gave you.
  • In many cases, billing can be problematic and, especially if the treatment is not so important, they can simply decide not to charge you, but they have every right to do so.
  • Hospitals have the right to request your documents to decide if they will charge you or not and you are obliged to give them the documents.
  • You can say that you do not have any documents. They are still obliged to help you, but you would be placing yourself in the position of illegal immigrant (being in the country without any document) ... and I think this is beyond the scope of this forum.
 
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I live in the US. and whenever possible, I purchase my travel medical insurance from a person, an insurance agent, and not online. Just as important as having an insurance policy which includes all the benefits you need, it is just as critical to have live support to help you in an emergency. There’s nothing I dislike more than finding out I haven't been able to utilize the insurance to its full potential. I recommend purchasing your next policy from an agent who is experienced and can provide instruction on how to receive assistance when traveling abroad. Stay away from purchasing a policy from a website without speaking to a person first. Happy Travels!!!
 
I've read posts in the past which suggested that pilgrims receive free medical treatment for Camino-related problems. A few anecdotes related their experiences in this regard. Others spoke about having to pay up front. Recently I visited new public clinic in Astorga for a consultation about my painful knee. The doctor didn't examine me and simply prescribed Ibuprofen 600, which is readily OTC in Spain. (I was really hoping for a cortisone injection, but was told there were no facilities for this in that clinic). Back home, I have just received a bill by registered post for €74 from the Council of Castile and Leon. I would have paid at the time, if they'd asked me, though on reflection this was expensive for the treatment received.

Can anyone please clarify what pilgrims can expect in the way of free treatment on the Camino?
I carried private insurance on two caminos. The easiest insurance recognized was Europassistance. Even with private insurance covering « everything » I still had $400 out of pocket because receipts are difficult to get in Spain. Don’t travel without health and evacuation insurance.
 
The focus is on reducing the risk of failure through being well prepared. 2nd ed.
I had to attend the Pilgrim's hour in Ponferrada's Hospital de la Reina in Jula 2019 for a treatment of a small blister.
It was free at all, they didn't want to see my european insurance card.
As long as I am informed, that is true for 2021.

BC
Roland
 
I had to attend the Pilgrim's hour in Ponferrada's Hospital de la Reina in Jula 2019 for a treatment of a small blister.
It was free at all, they didn't want to see my european insurance card.
As long as I am informed, that is true for 2021.
What happens when you have to go to the Hospital de la Reina outside of the Pilgrim's Hour? And does this cover all ailments or only podology? As @Lirsy mentions in an earlier post in this thread, their free treatment offered to pilgrims is the exception and not the rule, and I see on their website that they are a "hospital privado".
 
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What happens when you have to go to the Hospital de la Reina outside of the Pilgrim's Hour? And does this cover all ailments or only podology? As @Lirsy says above their free treatment offered to pilgrims is the exception and not the rule, and I see on their website that they are a "hospital privado".
As far as I understand the rules in that specific hospital your are bound to the pilgrim's hour (noon-1pm) for a free treatment as a pilgrim. And there is no limitation in treatment, the other pilgrim that used this service broke one of his fingers as he stumbled and fell on his hands. That was treated equally for free.

BC
Roland
 
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I think that we have to take any free treatment as a gift, unexpected, a kindness.

Surely anyone who can afford to leave their home for weeks, fly on aeroplanes, buy kit, have funds for every day .. surely that person would also take out comprehensive travel insurance and then Camino without any expectations that a foreign country will provide them with free treatment as a matter of course?

It is common for an invoice to be sent to the home address so that it can be passed on to the insurance company.
 
Get the travel and medical insurance. Full stop.

I had to go to Spain and stay for weeks while my husband was in hospital with broken bones, and his care, operation and tickets home - in a wheelchair - including private ambulance to our front door, was covered by his EHIC and the insurance. We paid £500 ourselves, out of who knows how many thousands. It's not just for lost property along the way, in fact that is the least of your worries if you end up in hospital!
So - get the insurance. Call them and ask what it covers if you're not sure. Tell them what you are doing so you know you are covered for it - some will only insure a walking holiday in an organised group. Or below a certain height above sea level. Declare your conditions to make sure they can't turn down your claim.
And if you live in the UK, please remember that your EHIC is being replaced by a GHIC, so familiarise yourself with the rules and what it does(n't) cover.

In fact, now is a good time to look for insurance for your next adventures!
 
I had to attend the Pilgrim's hour in Ponferrada's Hospital de la Reina in Jula 2019 for a treatment of a small blister.
It was free at all, they didn't want to see my european insurance card.
As long as I am informed, that is true for 2021.

BC
Roland
I also went to the free Pilgrim clinic at Ponferrada's Hospital de la Reina in June 2019. I arrived at 9am and they refused to see me until 3pm.

I was feeling very unwell and unknown to me at the time, I had contracted Legionnaire disease.

When I finally got to see a doctor, he refused to examine my chest, take my temperature or make any other examination except for my legs or feet.

Desperately needing a rest day I got him to examine an old leg injury and provide me with a medical certificate so that I could spend a second day in Albergue de Peregrinos San Nicolás de Flue.

The next day, feeling better and refreshed, I walked on and continued walking until I eventually collapsed just after O Cebreiro.

Moral of the story, don't rely on the free Pilgrim clinic for anything other than simple issues and make sure that you have comprehensive insurance.

I did have comprehensive insurance and that paid for my ambulance ride to Lugo, critical hospital treatment and the week I spent in hospital recovering.
 
The 2024 Camino guides will be coming out little by little. Here is a collection of the ones that are out so far.
The assumption seems to be universal above that if you want travel medical insurance, are healthy, and are willing and able to pay for it you will be able to get it. I have been discovering, by submitting tentative applications to a couple of medical insurance providers, one of which I used for all four of my previous caminos, that I currently do not qualify. Insurers are unwilling to insure me because I had knee surgery last October. By their policies, they will not consider me for at least a year. Four months ago, my surgeon examined my knee and announced that I can do whatever I want. Three months from now, I shall be about to leave for a very long walk in Spain (the Levante), with or withouut insurance. Like most of you, I missed walking last year. Like many of you, those who are retired and can take time for a long walk, I have few years ahead of me when I am likely to be able to do so. Extreme caution is probably not the primary characteristic of solitary long-distance walkers. If I meet any of you on the trail, you are welcome to walk with me for a while, if you can keep up. (This last is a joke. I am a tortoise, rather than a hare. I take very few bar breaks and I get where I am going by the end of the day. I hope to see some of you in Santiago around the 20th of November).
 
The assumption seems to be universal above that if you want travel medical insurance, are healthy, and are willing and able to pay for it you will be able to get it. I have been discovering, by submitting tentative applications to a couple of medical insurance providers, one of which I used for all four of my previous caminos, that I currently do not qualify. Insurers are unwilling to insure me because I had knee surgery last October. By their policies, they will not consider me for at least a year. Four months ago, my surgeon examined my knee and announced that I can do whatever I want. Three months from now, I shall be about to leave for a very long walk in Spain (the Levante), with or withouut insurance. Like most of you, I missed walking last year. Like many of you, those who are retired and can take time for a long walk, I have few years ahead of me when I am likely to be able to do so. Extreme caution is probably not the primary characteristic of solitary long-distance walkers. If I meet any of you on the trail, you are welcome to walk with me for a while, if you can keep up. (This last is a joke. I am a tortoise, rather than a hare. I take very few bar breaks and I get where I am going by the end of the day. I hope to see some of you in Santiago around the 20th of November).
Surely the insurers would just exclude any knee related claims but cover you for most other things?
 
From what I can tell, following threads here and reading up a bit, stories of free treatment because you are a (foreign) pilgrim are stories of the past; occasionally, an individual doctor may still waive fees because of the administrative hurdle to bill you; doctors and clinics are often not set up for immediate billing but increasingly so; medical staff may not even be aware of payment procedures (there was a recent thread where someone was told by medical staff that treatment at a university clinic was free and then she received an electronic bill the next day in her mailbox). Expect to pay unless you are from an EU/EEA country and have your EHIC card with you. Some clinics or doctors - this may depend on the region (Galicia, Navarra, etc) - have two tariffs, which may explain differences in what foreign pilgrims are charged as you may be charged as a privately insured patient and you will be charged a high fee.

BTW, there is no such thing as free health care anywhere in the EU, not even in the UK. It has to be paid. The health care system is just not set up everywhere in a way where those who are covered see, or are directly involved, in the money flow.
Sad to hear. About 10 years ago I returned to Exeter, England, where I had done post grad work, and lost the hearing in my right ear. On the High Street, they had started a free clinic, staffed by Nurse Practitioners. I was seen there and referred to a hospital ENT. Wasn't charged for any of it.
 
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Surely the insurers would just exclude any knee related claims but cover you for most other things?

They seem to just ask travellers to fill in a questionnaire then reject or accept them as customers on the basis of the answers. However, I shall go in person to the local office of the company that has insured me for five previous journeys (to New Zealand plus four caminos). If they reject my application, I shall discuss with them if the knee surgery is the critical issue whether they would consider insuring me with this one exclusion. I know that their medical insurance for travellers is sold by them, but for another company, which is the official insurer. This might make it more difficult for them to change any aspect of the policy.
 
Ontarians may not have noticed that last year the provincial government decided that it would not cover out-of-Canada medical costs. Before then, they would pay up to the OHIP max for a specific treatment and you or your insurer would cover the rest. However, on account of the paperwork costs (as the computers prefer a number for each treatment rather than a description), this has been ended. You are now responsible for all of your out-of-Canada costs, so travel with insurance.

The myth of free medical care has been something I have been very careful to contradict when doing pilgrim training workshop, although I did not go as far as a colleague who had the room chant "Insure Insure Insure!"
 
I’d like to confirm that I did have medical and travel insurance from Australia. However - and this is important - in order to claim for changing my flight to return home early because of my knee issue, it was necessary for me to have documentation from the Spanish doctor that this “evacuation” was necessary. Because I had already told the doctor that it was my intention to return home, he had no need to offer this advice in writing. So, the insurance company refused to pay. The moral of the story is this: insurance companies always look for a loophole, so make sure you don’t offer them one!
 
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