Caregivers can now claim benefits simultaneously or alternatively for minors with serious illnesses

The Spanish Government has approved Royal Decree 957/2026, of November 4, which develops the legal regime for the economic benefit for the care of minors affected by cancer or other serious illnesses within the Social Security in Spain (Seguridad Social) system. This regulation, published in the BOE (BOE-A-2026-23176), represents a significant expansion of social protection, adapting to modern family structures and evolving medical knowledge regarding neurodevelopmental disorders and intensive outpatient treatments.

What changes

The new Royal Decree introduces three fundamental shifts in how the benefit is managed and who is entitled to receive it. First, the scope of protected medical conditions has been broadened. According to Annex I, the list of serious illnesses now explicitly includes Autism Spectrum Disorder and Poirier-Bienvenu neurodevelopmental syndrome, ensuring that families dealing with these conditions have access to the same level of financial support as those dealing with cancer.

Second, the regulation addresses the reality of modern households by allowing both caregivers to receive the benefit. Previously, the management was more restrictive; now, the law permits both parents or legal guardians to perceive the benefit either alternatively or simultaneously. This change is designed to promote shared responsibility in caregiving and to alleviate the economic burden on families where both caregivers may need to reduce their working hours.

Third, the criteria for medical accreditation have been modernized. Under the previous framework, hospital admission was often a de facto requirement for certain protections. The new Decree, through the introduction of Annex II, establishes a new medical declaration model. This model allows for the recognition of the benefit for treatments that, while not requiring hospital stay, possess an intensity equivalent to hospitalization. This ensures that children undergoing intensive outpatient therapies are not left unprotected.

Context

This Royal Decree is a consolidation and modernization effort. It serves to centralize the management of this benefit into a single regulatory text, providing greater legal certainty and administrative homogeneity across Spain. To achieve this, the new law expressly repeals two previous regulations: Order TMS/103/2019, of February 6, and Royal Decree 1148/2011, of July 29. By repealing these, the administration eliminates the fragmentation of rules that previously governed the list of diseases and the medical declaration models.

The regulation is developed in accordance with Articles 190 to 192 of the consolidated text of the General Law of the Social Security, approved by Royal Legislative Act 8/2015. It builds upon previous reforms, such as Royal Decree-Law 31/2026, which had already begun the process of extending benefits beyond the age of 26 for certain cases of disability, and seeks to harmonize the application of the law through a forthcoming technical guide for healthcare professionals and managing entities.

Who it affects and how

Individuals (Parents and Guardians)
The primary beneficiaries are parents, legal guardians for adoption purposes, or permanent foster parents. If you are a caregiver for a minor suffering from cancer or one of the newly included serious illnesses, you are entitled to claim this benefit to compensate for the loss of income resulting from the need to reduce your working hours. The impact is twofold: you gain access to benefits for neurodevelopmental conditions (like autism) and you gain the flexibility to share the benefit with another caregiver, which is crucial for maintaining household income.

Self-employed workers (Autónomos)
Self-employed individuals acting as parents or legal guardians are directly affected. Since the benefit is designed to compensate for reduced income, the ability to claim this while managing a business is vital. The new medical declaration model (Annex II) is particularly relevant for self-employed caregivers who may not be hospitalized but must provide intensive care at home, allowing them to justify their reduced professional activity through the new administrative channels.

Small and Medium Enterprises (PYMEs)
While the benefit is not paid to the company, SMEs are indirectly affected by the changes in labor dynamics. As caregivers (who are employees) exercise their right to reduce working hours or claim these benefits, companies must be aware of the updated legal framework regarding the leave and care requirements of their staff to ensure compliance with labor regulations and social security reporting.

What to do and when

The new regulatory framework will enter into force on January 5, 2027. Until that date, the existing regulations remain in effect. Once the new Decree is active, caregivers should take the following actions:

• For new claims involving intensive outpatient treatment: Ensure that the medical professional uses the specific model provided in Annex II of Royal Decree 957/2026. This model is specifically designed to reflect the intensity of treatments that do not require hospitalization but justify the benefit.
• For families with neurodevelopmental diagnoses: Review the updated list of illnesses in Annex I to confirm that conditions such as Autism Spectrum Disorder are now formally recognized for the purpose of this benefit.
• For dual-caregiver households: Evaluate whether it is more beneficial to claim the benefit simultaneously or alternatively, depending on the specific reduction in working hours required by each parent.

Because these matters involve complex interactions between labor law and Social Security in Spain (Seguridad Social), we recommend contacting the specialized area at BMC to evaluate your specific family and professional situation.