Can cross-border workers living in Spain use the GHA or Spanish healthcare?

Question

Accepted Answer

Frontier workers who live in Spain and pay Gibraltar social insurance are entitled to healthcare on both sides of the border. They obtain an S1 form from the Contributions Unit in Gibraltar and register it with Spanish social security to access the Spanish public system for themselves and their dependants.
Insured in Gibraltar: a frontier worker employed in Gibraltar pays Gibraltar social insurance contributions through their employer and is an insured person under the Group Practice Medical Scheme, so can register with the GHA.
S1 form for Spain: to access the Spanish public health system (the Servicio Andaluz de Salud in Andalucía), request an S1 form (formerly E106) from the Contributions Unit of the Income Tax Office in Gibraltar. Register the S1 with the Spanish social security authorities (INSS) and then with your local centro de salud. The S1 also allows dependants living in Spain to register for Spanish healthcare.
What to bring for GHA registration: your employment contract, proof of up-to-date contributions (a Contributions Unit letter or your tax code) and identification.
Timing: register as a cross-border worker promptly after starting employment; guidance has referred to a six-month window.
Pensioners: Gibraltar pensioners living in Spain need the appropriate entitlement form to register in Spain.
Changing rules: cross-border arrangements are being affected by implementation of the UK-EU agreement on Gibraltar in 2026. Confirm your current position with the GHA, the Contributions Unit and the INSS before relying on either system.

Can cross-border workers living in Spain use the GHA or Spanish healthcare?

Short answer

Detailed answer

Entitlement in Gibraltar

Access in Spain: the S1 form

For GHA registration bring

Check current rules