The first time I walked into a Spanish doctor’s office was intimidating—like walking into the first day of school in a new state.

Although I’d done a lot of reading and research about the private Spanish healthcare system, I had no idea how it worked in practice.

One of the best ways to soothe your fears is by knowing what happens when you walk in the door. That’s what I’m here for.

Booking an Appointment

From apps to WhatsApp, there are multiple ways to book an appointment with a private physician. If the doctor is at a hospital, it’s often as easy as booking through the hospital app. Occasionally, you’ll need to call, and large hospital systems will frequently offer customer service in English.

Standalone practices typically use website contact forms, email, phone calls, or WhatsApp as first-contact options. Personally, I prefer the WhatsApp method. I can send any relevant test results, information, or translate messages directly within the app.

So, how soon can you get an appointment?

In my experience, I can get an appointment anywhere from the same day to a few weeks out. There’s always the option to make the appointment as far out as you’d like (follow-ups, for instance), but if you need to be seen? You can see someone relatively quickly.

What to Bring

Bring the essentials you’d take to any doctor’s appointment.

• Identification (passport or TIE card)

• Insurance card (if you’re using private insurance)

• Test results, medical records, or imaging related to the issue you’re being seen for

• Any referrals required by insurance (Note: I’ve never needed a referral to see a doctor, but I have needed a referral for a particular test.)

Walking In

The provider’s office—or clinic, in a hospital setting—looks basically like every other medical office you’ve ever been into. You’ll see a reception desk, waiting areas, and—if you’re in a hospital setting—a kiosk where you can check in for your visit.

In the outpatient clinic, you’ll step up to the kiosk, type in your NIE or passport number, and receive a ticket with a number. In the waiting area, you’ll see a monitor filled with numbers. This is where you’ll look for your number, and you’ll hear it called as well. You’ll go to the reception desk, present your identification and insurance (if applicable), be offered another ticket with a number, and be sent to the appropriate waiting area.

A private clinic’s process is slightly different. There’s no kiosk, but there will be a reception desk. You’ll offer your identification and insurance card, and reception may give you some forms to fill out while you wait.

Being Called Back

At an outpatient clinic, listen for your number to be called or watch for it on the monitor. The monitor will tell you what room number to go to. Doctors are usually working with a nurse, who will call your name if they aren’t sure you heard or saw your number called. If no nurse is present, you can go directly to the room.

The exam room is small, with enough space for a doctor, nurse, and patient (plus perhaps one patient companion) to comfortably work together. You’ll see an exam table covered with clean paper, medical tools, chairs, and all the typical accoutrements you’d expect.

I’ve never had vitals taken at any standard doctor’s visit. You can request the doctor take them, but in my experience, it isn’t protocol unless they suspect the vitals would help make a diagnosis. (You can check your blood pressure at almost any farmacia.)

During the Visit

Every doctor’s visit I’ve had in Spain begins at the doctor’s desk in a room or section adjacent to the exam room. The doctor will consult their computer for any notes or records pertaining to your visit, and they’ll ask you what you’re there to see them for.

Don’t expect a lot of small talk, and unless you’ve specifically sought out a physician who speaks English, expect most—if not all—of the interaction to be in Spanish. (This is where Google Translate can come in handy if your grasp on the language is tenuous.)

The provider will pay attention to you—not their screen. And when you’re finished with intake, you’ll be invited to the exam table if needed. (Sometimes, it’s just a conversation at the desk if it’s a follow-up appointment.)

Most of the visit will be “strictly business,” especially if your provider isn’t a fluent English speaker and you need English. It can take time for the doctor to get to know you. Over time, as your relationship forms, you’ll probably notice that conversations become warmer and more personal and less, “Let’s get this done.”

Tests, Imaging, and Labs

If your physician orders any kind of testing, you’ll receive a prescription, either written or as an order in the hospital’s computer system. If you have private insurance, you can take it to any lab where your insurance is accepted.

In my experience, labs are typically scheduled separately, while some imaging like ultrasounds may be done the same day if there’s availability.

Visiting an outpatient clinic at a hospital can make any tests you need easy to obtain. They’re often in the same building or just down the street. And if you’ve opted for a private clinic, most testing you’ll need can be obtained at a hospital.

For labs, you’ll typically take your order to the lab during walk-in hours and check in at the kiosk or desk with your ID and insurance. Other testing or imaging typically requires an appointment, which you can schedule for a later date. The physician will likely want a follow-up appointment with you once testing is complete to review the results, which you can schedule before you leave the clinic.

Prescriptions

Receiving a prescription from your provider is pretty easy-peasy. They’ll hand you a printout with a stamp or handwritten prescription from a prescription pad, which you can take to your preferred farmacia to be filled. You can pay with cash or card. Prescription coverage varies by insurance policy. Our policy does not cover prescription medications, but in general, they’re more affordable than those in the U.S.

If your medication isn’t in stock at your farmacia, you can check others, but chances are good your pharmacist can have that prescription to you later that same day or no later than the next morning.

You’ll pay for your meds when you pick them up. Prices tend to be similar no matter which farmacia you use.

Note: If you use an online provider, they can email your prescription with a QR code, which your pharmacist will scan when you order it and again when you pick it up.

Checkout

When you leave your appointment, if you have insurance with no co-pay, you’re done. You can walk directly out the door without stopping by the reception desk. If you’re paying out of pocket, you’ll be asked for payment before you leave, and if you have a co-pay, you’ll be asked to pay that. Your doctor may provide instructions for you to follow at home, and those will be printed out or emailed to you. You’ll also receive an invoice for your visit.

I’ve never received a surprise bill later. Our insurance plan has no co-pay. Every visit to a doctor, lab, test, or treatment within that system has been covered in full.

Final Thoughts

The Spanish system felt a bit cold to me at first. It was efficient and thorough, but it felt brisk. Over time, as I’ve grown more accustomed to how healthcare operates here, I’ve come to see that the efficiency is part of the design.

Like anywhere, familiarity changes the tone. I’ve found the same to be true of doctors’ offices. When I first began showing up as a patient, the staff barely cracked a smile at me. Now they offer warm smiles, ask how I’m doing, and even indulge the small talk I appreciate when I’m nervous. (It distracts me. What can I say?)

If you’re walking into your first medical appointment in Spain, I hope this makes it feel just a little less unknown.

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I write here about building a life abroad—slowly, imperfectly, and with a lot of trial and error.

You can subscribe to receive new posts by email, or support this work with a paid subscription, one-time contribution, or just hit the ❤️ button below to help others find poco a poco.

If you’d like to reach out directly, you can find me at jen@jeninspain.com.

New here? These pieces will help orient you:

A few days ago, I read a post on Threads from someone who, five months after moving to Spain, was realizing it isn’t for everyone. He got various responses, from “I have no regrets“ to “I completely understand what you’re saying.”

But he tried. Even if he decides to leave and return home, he tried.

This man will never experience that wonder or regret.

That said, this lifestyle isn’t for everyone, and I’ll be the first one to point it out.

I recently ran across a Business Insider article by Sydney Baker, a woman who spent five years abroad in Canada and Europe and ultimately decided it was time to return to the U.S. In her words:

Sydney isn’t wrong. The perpetual visa hurdles can be exhausting. And in her case, because of the lack of job opportunities for non-EU residents, she was reliant on low-paying language assistant positions. And let’s be real: when you’re an educated professional who once had a good-paying, white-collar job, accepting a much lower salary to maintain your visa while leaving you little money for “fun” can be exhausting.

And then there’s this quote:

The bureaucracy is never-ending when you’re living abroad. In fact, I have an entire section of my site dedicated to it. And when we moved in 2024, I took a photo of the ridiculously full accordion folder we brought with us to Washington, D.C., to apply for our visas.

There are two ways to handle it.

1. You can hire someone to handle it, but you’ll still be legally responsible for gathering items like birth certificates, marriage certificates, pet health certificates, etc.

2. Grit your teeth and dive in.

For Sydney, the cognitive load eventually became too much, compounded by job challenges and building a community abroad. She also rightfully pointed out that what influencers tout on social media is often incredibly deceptive.

The above quote sums it all up succinctly. On social media, there’s been some pushback against the “life abroad is a fairytale” narrative. I’m seeing it on Instagram, Facebook, YouTube … anywhere you find a collection of people who live their lives abroad.

Frankly, I’m thrilled to see it.

While life abroad is a lot of fun, it is also a lot of effort through laughter, tears, and all the emotions in between. It can be lonely, terrifying, and enraging.

Do I still get a little thrill when walking down a centuries-old street in Valencia? Absolutely. Sometimes, I forget I live here and am not on vacation. And then I go home to a notification from the Spanish government, and it’s back to reality.

For now, this is where we still choose to be—despite the constant friction and occasional uncertainty.

📚 What I’m reading right now: The Housemaid by Freida McFadden. I’ve only read one other book by McFadden, but I remember flying through the pages. In an effort to end my reading funk, I’m trying another one. So far, so good.

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I write here about building a life abroad—slowly, imperfectly, and with a lot of trial and error.

You can subscribe to receive new posts by email, or support this work with a paid subscription, one-time contribution, or just hit the ❤️ button below to help others find poco a poco.

If you’d like to reach out directly, you can find me at jen@jeninspain.com.

More daily life in Spain:

That’s when I stumbled upon Frenadol, which is often described online as Spain’s version of DayQuil, NyQuil, or Theraflu.

If you talk to Americans living abroad, the common refrain when a winter cold strikes is that they miss NyQuil.

Me, too.

It’s a cure-all, managing fever, congestion, aches, pains, and sleep all in one glorious liquid (or tablet, but I prefer the liquid).

But if you come to Spain expecting to find something like NyQuil, you’re going to be sorely disappointed.

Instead, think of your pharmacist as the healthcare professional they are. You offer your symptoms; they offer potential solutions.

Upgrade

As I pointed out in “Sick in Spain,” your local grocery store doesn’t carry over-the-counter meds. That job is reserved for the pharmacy. In fact, you can’t buy Frenadol on Amazon.es. It has to be purchased through a pharmacy.

Most medications sold in Spain aren’t an all-in-one like you commonly find in the U.S. This is where that Spanish you’ve been practicing comes into play, and it’s time to get thee to thy farmacia on the corner.

Once there, explain your symptoms to the pharmacist (whip out Google Translate if needed), and the pharmacist will make some recommendations based on what’s giving you trouble.

Pharmacists in Spain are highly educated, trained healthcare professionals. They can act as a sort of triage, letting you know when it’s time to go to the doctor or if they can offer something over-the-counter to put you on the mend. They’re on practically every corner in every community, with that bright green cross above the doors acting as a welcome mat.

And let’s be real: The better your pharmacist knows you, the better they can help you.

My pharmacist knows I speak some Spanish, but I’m far from fluent, and she is incredibly patient when I need to break out Google Translate or switch to Spanglish. (She speaks some English.) But it took time for that relationship to form, and now, I can walk in, describe what’s going on with me, and she will offer some personalized solutions.

Pharmacies don’t always have the medication you need in stock, just like in the U.S., but the system is efficient. If a prescription isn’t in stock, the pharmacist can order it, and it will either appear later that same day or the next morning.

It’s intimidating—walking into a pharmacy in a new country, maybe not speaking the language, and not knowing how the system works. However, your local farmacia wants to help. Genuinely. Ask questions. Come prepared with a symptom list in Spanish if needed. Then watch as a little magic happens.

I write here about building a life abroad—slowly, imperfectly, and with a lot of trial and error.

You can subscribe to receive new posts by email, or support this work with a paid subscription, one-time contribution, or just hit the ❤️ button below to help others find poco a poco.

If you’d like to reach out directly, you can find me at jen@jeninspain.com.

For more on healthcare in Spain:

You can’t hit the ground running in a new country if you don’t have some clue where to start.

Speaking from a U.S. perspective, there were certain apps I couldn’t live without in daily life. Think: Google Maps, Spotify, Libby … Then there were the less-used but still useful ones, like store apps and streaming services.

Whether we like it or not, there’s an app for that.

It can be overwhelming, especially when you can’t differentiate between what you need and what’s just nice to have.

Before we get into the weeds, first things first: If you’re using a U.S.-based Apple App Store or Google Play account, to access Spanish apps, you’ll either need to change your account location or create a Spain-based account. Some apps are not available worldwide, meaning they’re only available in their country of origin.

Personally, I used a secondary email address I already had to create a Spain-based account in the App Store. I log in and out of both accounts as needed.

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The Non-Negotiables

For a country that loves its old-school paperwork procedures, Spain is surprisingly forward-thinking on the technology-meets-bureaucracy front.

• DEHú. Official immigration communications are sent through DEHú. Although you’ll still receive emails to your email of record, this is where you’ll find messages if something goes missing.

• AppValencia. This is the city of Valencia’s app. Enter your city name and find the app, if it exists. You’ll find important local information in this app, including weather alerts, community events, and service updates.

• Cita Previa. Using your digital certificate, Cita Previa allows you to request and manage immigration appointments.

• Certificado Digital. Once you’ve obtained your digital certificate, it lives inside this app on your phone, acting as official identification that lets you access websites and other official apps.

• Cl@ve. Cl@ve works hand-in-hand with Certificado Digital. Think of Certificado Digital as the keys to the car, and Cl@ve as the car.

• Public healthcare app for your region. In Spain, each region names its public healthcare app something different, so you’ll need to find out what yours is called. In Valencia, it’s GVA+Salut.

Don’t think of this as a comprehensive list. Rather, it’s a list to get you started as you learn what other apps you’ll need as you navigate a new life in Spain.

Daily Essentials

These apps make day-to-day life simpler. You don’t need them, per se, but you’ll find life a bit easier if you use them.

• Your health insurance app. We have private health insurance, and all of the big companies offer apps. Download it and get familiar with it. You’ll use it more than you think.

• Your favorite private healthcare system’s app. We frequently use Quirónsalud for doctor appointments. I find having their app on my phone convenient for making appointments, confirming them, and viewing medical records or lab results.

• Transit apps. In Valencia, I use EMTicket to ride the buses. There is no App Store app for the Metro, so I created a shortcut to the website on my phone that looks like an app. There’s also a city bicycle rental app called Valenbisi, which I occasionally use.

• Banking apps. We currently use Revolut as our Spanish bank, and I use it to keep on top of bill payments and some purchases, as well as to manage our kids’ monthly allowances. I also use the Wise app to move money from our U.S. bank account to our Revolut account.

• WhatsApp. Spain—and the EU—runs on WhatsApp. I use it to communicate with friends and family, participate in local groups, and contact businesses. Even doctors’ offices will communicate via WhatsApp. It took some getting used to, especially since WhatsApp doesn’t have the same presence in the U.S., but now that I am familiar with it, it’s become my preferred method of communication.

• Your Spanish phone service’s app. Check your bills. Make payments. View your usage. Contact customer service.

Nice-to-Haves

These are the apps that you’ll use—maybe not frequently—but they won’t be top of mind. Instead, you’ll just be glad you didn’t have to download them when you thought about using them.

• Mercadona. Okay, maybe this one won’t be your favorite, but I love it! Mercadona is my favorite grocery store here, and while I don’t use it for shopping, I do use it to check whether I can find a particular item at my local store. Figure out which grocery store you like best and download the app.

• Trainline. Renfe’s website can be notoriously tricky to use, and with iryo and Ouigo in the mix, Trainline acts as an aggregator, making it easy to compare prices and times.

• Freenow. Need a cab? Freenow is my favorite way to grab a ride around town. You can schedule a taxi, tip your driver, and follow the route while you ride.

• Food delivery apps. My preference is Uber Eats, but in Spain, you can also choose from Glovo or Just Eat. Not all restaurants that deliver are offered on each app, so you might want them all.

This isn’t a comprehensive list, but I hope it gives you a good starting block. Landing in a country and not knowing where to find the information you need straight up sucks. No way around it. I wish someone had handed me this list before we moved. Instead, I had to piecemeal it together, which took time, patience, and digging.

I write here about building a life abroad—slowly, imperfectly, and with a lot of trial and error.

You can subscribe to receive new posts by email, or support this work with a paid subscription, one-time contribution, or just hit the ❤️ button below to help others find poco a poco.

If you’d like to reach out directly, you can find me at jen@jeninspain.com.

For more reading on navigating Spain:

When you think of healthcare, your mind probably first goes to health insurance. And rightfully so. If you’re from the U.S., it is one of your largest monthly expenditures.

Recently, my son experienced an allergic reaction that, initially, seemed mild. By afternoon, we were concerned enough to take him to our nearest urgencia to get checked out.

We walked in, handed over his TIE and insurance cards, explained to the receptionist why we were there, and she quickly escorted my son and me back to pediatric triage. Within minutes, a pediatrician met with us to assess whether his reaction would need further care.

As it turned out, he did need further care, and the doctor kept him for a couple of hours after administering epinephrine.

A week later, we met with an allergist for allergy testing, bloodwork, and ultimately, she prescribed Anapen, the Spanish equivalent of an EpiPen.

Later, at the pharmacy, I expected to spend more than €100 for the Anapen. In the U.S., an EpiPen will cost more than $150 using a GoodRx coupon. If you’re lucky enough to have “good” health insurance, you’ll have a copay to offset the worst of the cost, but the copay is variable. Otherwise … blah, blah, blah. You know the American health insurance drill.

You can see how this all very quickly becomes expensive—and complicated.

I whipped out my credit card to pay for the Anapen, and the pharmacist said:

“€42.09.”

My mouth must’ve dropped open a bit in shock because she smiled as she took the payment and bid me a good day.

Having been in Spain for nearly a year and a half, I’m still caught off guard by how affordable prescriptions are—and the cost is fairly consistent from pharmacy to pharmacy.

Ninety days of propranolol? €2.00.

Testosterone injections? €10.00.

Estradiol gel? €17.00.

When you use private healthcare in Spain, unlike in the U.S., your prescriptions won’t typically be covered by insurance. Instead, you can expect to pick up your prescriptions at the pharmacy, pay out of pocket, and be pleasantly surprised by the cost in most cases.

So how is Spain able to do this?

Prescription costs are subsidized via taxes and negotiations with drug companies.

Without getting into the politics, there is a public healthcare system. The cost of prescriptions ties back to how that system as a whole works. As a relatively new Spanish resident, I don’t entirely understand it yet.

Outside of prescription drugs, I find that over-the-counter drug costs can vary. Some are less expensive than those in the U.S., others are more. But for the prescriptions you really need?

Spain does a remarkably good job of ensuring everyone has access to the healthcare they require.

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I write here about building a life abroad—slowly, imperfectly, and with a lot of trial and error.

You can subscribe to receive new posts by email, or support this work with a paid subscription, one-time contribution, or just hit the ❤️ button below to help others find poco a poco.

If you’d like to reach out directly, you can find me at jen@jeninspain.com.

More reading on healthcare in Spain:

Lately, I’ve been thinking and dreaming about what owning our own home here in Spain might look like. Mostly, it comes down to my current kitchen, which, if I’m honest, I loathe.

I have specific tastes — items I loved in the U.S. and want to find replacements for here. Most of them are kitchen-related — the space where I love cooking fo…

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One of the many challenges of living abroad is missing foods from your home country. While American fast food chains abound here in Valencia (looking at you, Five Guys and Wingstop), some things simply can’t be replicated in Spain — unless you’re willing to make it yourself.

For the past year, I’ve learned to live without some of my favorite foods. I’m healthier for it, but occasionally, nostalgia hits, and I just want something more familiar. That’s when my cravings for sausage gravy and biscuits, and my favorite coffee creamer hit, all of which aren’t a “thing” in Spain.

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Recently, I decided that if we’re going to be in Valencia for the long haul, I have to put on my proverbial apron and learn some new recipes. While you can buy a lot of American food items online or at Taste of America in person, the cost adds up fast. I’m willing to pony up for the basics — like brown sugar — because those ingredients aren’t readily available in Spanish grocery stores. But buying powdered Coffee Mate creamer at double or triple the cost of U.S. prices isn’t sustainable. (And I’m a sucker for a great coffee creamer.)

These days, café con leche is my go-to coffee beverage of choice — at home and out. Starbucks is a rare treat (there are way too many great cafés here to try!), and I dare you to try to find coffee creamer in a grocery store. But this week, tired of my regular, I wanted that coffee creamer flavor that takes regular espresso up a notch.

I’m a cook, not a chef, so experimenting in the kitchen isn’t usually my thing. But since some of you asked, I’m sharing the two coffee creamer recipes I tried my hand at this week, which turned out better than I expected.

Mocha (Double Chocolate) Coffee Creamer

Ingredients

• 2 cups oat milk (or your preferred milk)

• 2 tablespoons unsweetened cocoa powder

• 1 teaspoon instant espresso powder (optional, but deepens the flavor)

• 1 teaspoon vanilla extract

• 2–3 tablespoons sweetened condensed milk (add more for sweetness or thickness)

Instructions

1. Whisk cocoa powder and espresso powder with a few tablespoons of warm oat milk until smooth.

2. Add the remaining milk and the condensed milk.

3. Stir in vanilla.

4. Store in a sealed jar in the fridge for up to a week. Shake before using.

Tip: You can melt a few chocolate chips into the warm mixture for a little extra richness.

Crème Brûlée Coffee Creamer

Ingredients

• 2 cups oat milk (or whole milk if you prefer a creamier texture)

• 2 tablespoons caramelo líquido (or caramel sauce if you have it)

• 1 tablespoon sweetened condensed milk

• 1 teaspoon vanilla extract

• 1 teaspoon butter (optional, for a richer “burnt sugar” note)

Instructions

1. Warm the milk gently in a saucepan.

2. Whisk in caramelo líquido, condensed milk, vanilla, and butter until smooth.

3. Let cool, then refrigerate in a jar for up to a week. Shake before each use.

Tip: If you think the results are too thin, stir in an extra tablespoon of condensed milk into the chilled version.

I don’t know why I never considered making my own coffee creamers before. It was really easy, and I’ve had a taste of the familiar all week long after spending just a few minutes with some simple ingredients. It might feel a bit inconvenient at first, but after I’ve done it a few times, it’s going to become second nature. Living abroad doesn’t mean you have to do without your favorite things. You just might have to find a different method of getting them.

I write here about building a life abroad—slowly, imperfectly, and with a lot of trial and error.

You can subscribe to receive new posts by email, or support this work with a paid subscription, one-time contribution, or just hit the ❤️ button below to help others find poco a poco.

If you’d like to reach out directly, you can find me at jen@jeninspain.com.

More on adjusting to life in Spain:

Wherever they go, bookworms are gonna bookworm.

Some of my favorite childhood memories are those summers spent at the library. In rural Kentucky, our summer entertainment options were few. The library was one of the few places that held programs for kids, and my mom made sure we participated. (We also participated in that nostalgic Pizza Hut BOOK IT!® reading program to earn those Personal Pan Pizzas® during the school year.)

Every library I’ve ever been in has a similar sensation to the one back home in Kentucky — the scent of old books, cold air conditioning, wooden tables that make a slight creak as you shift in your seat, and — in those days, anyway — card catalogs outlining every single book in the building. It’s a feeling of “home” as much to me as the gentle karst landscape of southcentral Kentucky. I so looked forward to library days, carrying as many books out of that library as my little arms could hold. We’d play fun games, listen to a story on the carpet, and disappear into a magical world for just a few hours.

This particular rural library even had a bookmobile, making rounds around the county to ensure those who couldn’t get to the library in person still had access to books, magazines, and more. It often appeared at my grandmother’s house, and since we stayed with her quite a bit in the summers and after school, my sister and I had the pleasure of exploring its shelves. We’d carefully make our selections for the week, and the next week, we’d have a whole new set of books to choose from. (P.S. If you haven’t yet read The Book Woman of Troublesome Creek, it’s worth the time. It’s an early version of a bookmobile in Appalachia in the 1930s.)

If my mom encouraged my lifelong love of reading, time spent at the library cemented it.

It will come as no surprise to anyone, then, that maintaining access to libraries and books was of the utmost importance to me as we planned our move abroad. Since I was an early adopter of e-readers (my first was a Barnes & Noble Nook way back in 2011), of course, I had a Kindle that would make the trip with me. But what would happen to my library cards? The truth is, I rarely buy books. I borrow them.

I love audiobooks, so those are always in rotation via Libby, Hoopla, or Spotify.

The idea of purchasing every. single. book. hurt my budget-loving heart.

As I tend to do with everything, I dove headfirst into research. My kids still needed to be able to read in English, too, and Will also reads the occasional book. How could I ensure my family still had access to the materials we all enjoy?

Our library cards from our suburban Nashville town have to be re-verified every few years. That was a simple solution since we still own a house in that county. I receive a notification via email that I need to re-verify, I reply, and the cards are renewed for another few years.

I’ve had a Nashville Public Library card for many, many years — since our move to the area in 2008. At that time, when Nashville issued library cards, they issued them for 10 or 20 years. I don’t know if they still do that, but mine has an expiration date in the 2030s. 😮 Suffice it to say, I don’t need to worry about my Nashville card anytime soon. I use it without a VPN or any other issues here in Spain, but I nearly exclusively use the Libby app to read ebooks and audiobooks. If I had to purchase access to the Nashville library as a Middle Tennessee resident, the fee is relatively low — $10/year. (I can’t think of a better way to spend $10/year, can you?)

When we moved to Raleigh, North Carolina, for the summer in 2024, Will, the kids, and I went to the Wake County Public Library to get cards. While the selection isn’t nearly as good as my Tennessee library cards, they do occasionally have books that those libraries don’t have. The waits are also much shorter than at any other library in Middle Tennessee.

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One of the most beautiful parts of living in Spain is how active older people are.

When I was a kid, my grandparents rarely went anywhere except for the doctor, church, or cemetery. Part of that was the circumstances of their location – rural Kentucky, where a car was needed for nearly every activity awa…

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It sounds silly, but finding a hair stylist was one of the most challenging parts of moving to Spain.

Back in Tennessee, I’d had the same hair stylist for many years. She and I got along well, and she knew what I liked. When I felt I needed a change, we could talk through it. It was a …

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Surprisingly, cooking is one of my biggest challenges in Spain.

In theory, cooking isn’t all that different in Spain than in the U.S. Find a recipe (or not). Buy the ingredients. Cook the meal.

Except when you’re overwhelmed by the newness of everything in your environment, cooking becomes one more ch…

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Before leaving the U.S., we stocked up on pharmaceuticals like NyQuil, Tylenol, and Pepto-Bismol. We’d heard some things we use regularly can be hard to find, and if one of us got sick soon after arrival, we wanted to be prepared without the additional stress of locating the medications we might need in a new country. But we weren’t too worried. After all, we could go to the grocery store and pick up what we needed when the time came, right?

Wrong!

If you’re new here or trying to understand how everyday life actually works once you move to Spain, I’ve laid out the bigger picture here.

In Spain, over-the-counter medications work very differently.

Most common cold, pain, and flu medications are sold through pharmacies (farmacias), not grocery stores.

We made several trips to our local Mercadona before it dawned on us that we had never seen acetaminophen or ibuprofen there. We hadn’t spotted a single cough syrup or allergy medication, either. Where were all the usual medicines?

This was one of our first reminders that daily logistics here don’t work the way we expected. I talk more about those early adjustments here.

Following one of these supermercado visits, which left me a little befuddled, I used my ChatGPT app to ask, “Where can I buy OTC medications in Spain?”

I quickly learned that all medications–OTC and prescription–are more regulated in Spain and the European Union. In other words, you can only buy medications like Frenadol (a popular OTC cold and flu med) in a farmacia.

You explain your symptoms or needs to the pharmacist, and they can help direct you to the best medication for that ailment. It’s a bit old-fashioned, but it makes a lot of sense if you think about it.

The pharmacist can help you avoid mixing meds that shouldn’t be taken together and direct you to the one that works best for your symptoms rather than just guessing.

This system prioritizes pharmacist guidance over self-medication, which is fundamentally different from what many Americans are used to.

Our family spent nearly all of January 2025 recovering from a couple of different illnesses. Within a couple of weeks, we were out of liquid NyQuil and DayQuil and had started on the tablets.

Knowing those would go quickly, too, I began researching what sorts of medications have similar symptom relief. We are lucky enough to have a farmacia just around the corner from our apartment entrance, so we could go there, but I wondered … can you buy OTC meds online?

Yes, you can!

I did a little cheer when I found okfarma.es. Associated with a pharmacy in Ciudad Real near Madrid, they operate 24/7 and offer online purchases with delivery within 24-48 hours. Perfecto! We could have what we needed within a couple of days without having to venture out of the house and spread whatever nasty bug we were fighting.

The longer we’re here, the more I’m discovering there is almost nothing we have to do without. (For the record, Frenadol is terrific for treating cold and flu symptoms.) The items may look or be branded differently, but whatever we need is typically available somewhere–often without leaving the house.

I thought I would have to learn to do without in many ways, which I didn’t like, but I was willing to make the trade-off, and I still am if the situation calls for it. However, I am also learning that adapting and integrating into this new culture requires a willingness to pivot repeatedly; life becomes much less stressful if you can do that.

This experience ended up shaping how I approach a lot of the bigger systems here, especially the ones that initially feel intimidating. I wrote more about that here.

I write here about building a life abroad—slowly, imperfectly, and with a lot of trial and error.

You can subscribe to receive new posts by email, or support this work with a paid subscription, one-time contribution, or just hit the ❤️ button below to help others find poco a poco.

If you’d like to reach out directly, you can find me at jen@jeninspain.com.

Related reading:

Will and I have always visited grocery stores wherever we travel. First, it’s great for the budget. Secondly, it’s an opportunity to see the various types of food available in a new region or country. It feels more authentic than eating at a restaurant for every meal.

We spent a week in a hotel room with our kids when we landed in Valencia. It wasn’t planned, but it was a much-needed break from all the hustling we’d been doing to make the move. There was no pressure, no plans … just getting accustomed to our new environment. We knew that once we got into our apartment, the real on-the-ground living would begin–all the things everyone has to do in their day-to-day lives.

Our first visit to the grocery store was dizzying. You know how you go to your regular grocery store every week and know where everything is located? You can lay hands on the ketchup, milk, and cereal blindfolded. And you know precisely what snacks your kids like, so you buy those week after week?

We no longer had any of that.

The mental gymnastics we had to perform those first few grocery store trips still make me tired. Everything was in Spanish, and we had no idea what to buy for ourselves or our kids. That first trip was a complete guess. Our philosophy was that we could try different things; if we didn’t like something, we would know for future reference. I hate wasting food, so this bothered me a lot, but how else would we know?

(For the record, we’re still experimenting with food.)

Generally speaking, the Spanish go to the grocery every day or two. We were used to going far less often. In the United States, grocery shopping was something I rarely did in the store. Instead, when our kids were small, I had the habit of ordering online for pickup because, with two under two, going to the store was a huge chore. Typically, I went no more often than once a week–every two weeks if I could get away with it.

We still haven’t gotten in the habit of going to the market every day or every other day. Instead, we go two or three times a week, with one big haul on the weekends. I’m sure the cashiers roll their eyes when they see the Americans coming with an overloaded cart, filling up the conveyor belt, and throwing our groceries into our bags as fast as we can.

Looking from the outside in, it’s probably downright comical to watch us filling up our granny cart, filling up a plastic grocery bag or two, and then filling up a tote bag. And I’m sure the cashiers are getting a good giggle as the items fly down the belt at us, our hands grabbing as fast as they can to get out of the way.

After a while, like anything else, it becomes routine. You learn where the snacks you enjoy are. You can read labels that once looked impossible to decipher. And you figure out which stores are your favorites. (Mine are Mercadona and SuperCOR.) Poco a poco, as the Spanish say, it gets easier.

On my last trip to Mercadona, I didn’t have to use a single word of English at the cash register, and I even understood the total euros due without looking at the screen.

That’s what I call progress.

I write here about building a life abroad—slowly, imperfectly, and with a lot of trial and error.

You can subscribe to receive new posts by email, or support this work with a paid subscription, one-time contribution, or just hit the ❤️ button below to help others find poco a poco.

If you’d like to reach out directly, you can find me at jen@jeninspain.com.

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Growing up, I could have pointed to Spain on a map, but France was where I really wanted to go. I distinctly remember getting one of those Scholastic book flyers, spotting a French-English dictionary, and excitedly asking my mom to order it for me. The idea of France appealed to me–its far-flung locale, the beautiful sound of the spoken language, and, for a fourth-grader, the Eiffel Tower.

Years later, I studied French for all four years of high school and two more years in college. I wanted nothing more than to speak (be?) French.

People were surprised when they heard our family moved to Spain–but not as surprised as I had anticipated. “Spain? Really? I would’ve guessed France or Ireland.”

Someone on Instagram recently suggested I write a post about everything that has surprised me about Spain since we moved. Did I have any misconceptions about this place I’ve fallen in love with? It’s a great question, and it caused me to pause and think. So, in no particular order, here we go:

Friendliness

No matter where you are in Europe, you’re supposed to adhere to a certain level of politesse–an unspoken social contract. These are things like saying hello in that country’s language as you enter a store, wishing your neighbor a good day in the elevator as you part ways, and offering a “see you later” to the cashier who checks you out at the supermarket. Not offering these little gestures is seen as rude or uncouth, whereas in the United States, we often go out of our way to avoid interactions. (Self-checkouts, anyone?)

Believe it or not, I looked forward to these things as we settled into this new society. I appreciate this gentle connection with others several times a day.

Life by the sea

None of the four of us has ever lived by water, much less a sea. So much of the culture here in Valencia revolves around the water in the form of sports, food, and its laid-back attitude. This is also true in much of Spain, albeit in coastal areas. Madrid, for example, has a more cosmopolitan, New York-ish feel. It’s a city that never sleeps. And after spending so many years hustling and grinding to “make it” in the States, we are very much enjoying this chill vibe.

Truthfully, we are rarely at the beach, although we all love that it’s only a 20-minute tram ride away. And its influence seeps into every aspect of Valencia.

Grocery shopping

Except for a couple of years in Chicago, my entire life was spent in the Southern U.S. If you’re from the South, you are probably familiar with the Publix grocery chain. The stores are beautifully designed, featuring a bakery, deli, butcher, and more. They are probably the closest comparison to a Spanish supermarket, but there are differences.

Most people here visit the market every day. This is a cadence we’ve had to make grand adjustments to as Americans. Even now, five months in, we still can’t manage to get to the store more than a couple of times a week, and the haul we drag over to the cashier probably makes them sigh internally. And it’s probably comic gold watching the cashier chuck the items down the belt at us as we try to keep up with the pace, throwing items in our bags and cart as fast as we can to get out of the way.

Grocery stores are usually closed on Sunday, although the schedule changes depending on the time of year and whether the store is in a shopping mall. So, we’ve had to learn another lesson: Plan ahead, or you won’t have snacks for the kids come Monday morning.

Car culture (or the lack thereof)

Neither Will nor I have a Spanish driver’s license, and when we first got here, we assumed we wouldn’t pursue one. However, the longer we’ve been here, the more we realize a license will come in handy, so Will is studying to take the written and driving tests. I’m not yet sure if I will do the same.

A car isn’t a requirement to get around. Public transit in Valencia is a wonder to behold, with trams, buses, trains, and scooter and bike rentals at our disposal. But to get out into the more rural areas and explore, a car can get you there much faster.

Not every Spanish family has a car, but I’m finding that many do, and it does make life easier in some ways. It can cut a 45-minute public transit ride to one area of town down to 15 minutes. Still, I enjoy having public transit available and not sitting in traffic for hours on end. I felt like I spent half my life in the car in the States.

Language

Spanish is indeed hard to learn as an adult. The longer we’re here, the easier it gets because repetition and immersion are two of the best ways to learn. However, some things are so much harder when you don’t speak the language well. I cannot emphasize this enough. If you’ve ever contemplated moving to another country, spending too much time working on the language is not possible.

Sure, you’ll encounter many people who speak English, but it greatly limits your interactions. It’s also respectful as a guest in that country to attempt to communicate in their language. When we begin communicating with someone in Spanish, they often switch to English when they see that we are trying–even when they believe their English is bad. You cannot integrate into a new culture if you don’t try to learn the native language. Period. End of.

You’re not a tourist who can get by with a few polite words and phrases. You’ll have to communicate with doctors, pharmacists, bureaucrats, neighbors, grocery store workers, order at restaurants, and much more. The Spanish people are amazing and will make every effort to help (99% of the time) but don’t be that guy who can’t be bothered to put forth any effort.

We somewhat underestimated the importance of the language piece, but we quickly had our expectations reset–and rightfully so. In fairness to myself, though, I’d been working on my Spanish regularly with Duolingo as soon as we began considering moving here. It helped give me a vocabulary to work with but lacks in the speaking skills department.

Spain will continue to surprise and delight me. It has a beautiful culture and warm and inviting people. I am getting to know myself and them just a little bit better every day.

I write here about building a life abroad—slowly, imperfectly, and with a lot of trial and error.

You can subscribe to receive new posts by email, or support this work with a paid subscription, one-time contribution, or just hit the ❤️ button below to help others find poco a poco.

If you’d like to reach out directly, you can find me at jen@jeninspain.com.

More snippets from daily life in Spain:

One of the questions I often get about living abroad is about healthcare. After all, healthcare in the United States is anything but straightforward. As an adult, you have to learn how to navigate a maze of deductibles, copays, out-of-pocket maxes, denials, appeals, and much, much more.

I’ve had a pre-existing eye condition since I was in my 20s, requiring injections and frequent doctor visits. I’ve had fights with health insurance companies about coverage, been denied, and made appeals–the works. I feel like I’m fairly well informed on this topic, whether I want to be or not.

As a shiny new adult, my mom advised me to “always buy the best health insurance you can afford.”

So I did. Always. And year after year, it was painfully expensive, increasing in cost despite generous employer subsidies.

When I decided to become a stay-at-home mom for a while a year after our daughter was born, I became completely dependent on my husband’s employer coverage. This meant that if he ever lost his job, we’d be on the hook for thousands of dollars every month for COBRA or an ACA plan, which we did not have the extra funds for then.

In 2024, as we gathered our paperwork and prepped for the move to Valencia, Spain, part of our visa process included proof of an annual health insurance policy with no deductibles or copays. We shopped it around, hoping it wouldn’t be completely ridiculous. My research told me it wouldn’t, but you never know until it’s in your hands.

Ultimately, we landed on a policy covering everything except my eye injections. The injections are more expensive here, out-of-pocket, than I paid in the U.S. However, the policy itself for our family of four was about $3,000. We were used to paying $17,000/year, which sounds insane as I type it out now. I would need to receive a lot of treatments to cover that difference.

Walking into a doctor’s office in Spain is not much different from that in the U.S. There are waiting rooms, exam rooms, etc. The offices I’ve been to are very modern and up-to-date. If you aren’t going to a practice with its own building, you will likely go to a hospital, where the subspecialties are divided into their own spaces.

We have private insurance, which was required for our visas, and we cannot yet use public healthcare. Once we’ve been here for a year, we will have access to the public system if we choose. Because we are not Spanish or EU citizens paying taxes into that system, we will have to pay a monthly fee for each family member. I believe it’s around €60 each (if you’re under 65), and you pay €0 for most treatments. With private insurance, we also pay €0 for most treatments (unless it is excluded from coverage). Most people I talk to say it’s worth having options in both systems, and we may also opt for that.

Prescriptions are generally far more affordable here in Spain than in the U.S. For example, my husband takes a medication that was about $40 for a 90-day supply. Here in Spain, it’s €1.50 for the same prescription. The pharmacist laughed at him when he had to ask her to repeat the price because surely that couldn’t be correct! I won’t pretend to understand how this works, but I believe it has to do with the public healthcare system and how taxes subsidize public healthcare and prescription drugs.

Of course, a post on a giant topic like this could go on for days. But so far, we are incredibly happy with the quality and cost of healthcare in Spain. We haven’t had to wait months to be seen, and we haven’t been rushed out the door at every appointment. We are also provided with full explanations of care.

While there are flaws–no system is perfect, after all–healthcare here is as modern and efficient as it is in the U.S. without the tremendous price tag.

I write here about building a life abroad—slowly, imperfectly, and with a lot of trial and error.

You can subscribe to receive new posts by email, or support this work with a paid subscription, one-time contribution, or just hit the ❤️ button below to help others find poco a poco.

If you’d like to reach out directly, you can find me at jen@jeninspain.com.

Learn more about life in Spain: