Key data
| Regulation | Resolution of June 23, 2026, from the Under-Secretariat, publishing the Agreement between the ISM and SASEMAR on medical evacuations at sea |
|---|---|
| BOE Publication | June 29, 2026 |
| Entry into force | May 26, 2026 (date of agreement signature) |
| Affected parties | Embarked workers of the Special Maritime Social Security Regime |
| Category | Public Sector |
| Maximum budget | €300,000 (VAT exempt), distributed between 2026 and 2030 |
| Agreement validity | 4 years from signature (until 2030) |
| Reference rates | Order FOM/1634/2013, revisable through ministerial orders |
| Official source | BOE-A-2026-14085 |
Embarked workers in the Special Maritime Regime have had, since May 26, 2026, a new legal framework that guarantees coverage of their medical evacuations at sea. The agreement between the Maritime Social Institute (ISM) and the Maritime Safety and Rescue Society (SASEMAR), published in the BOE on June 29, 2026 through the Under-Secretariat Resolution, replaces the previous agreement—which could not be extended—and sets the rules for the next four years.
The agreement does not generate new costs for shipowners or fishing companies: the ISM finances operations from its own budget. What does matter operationally is knowing the correct activation procedure, because a poorly managed evacuation can cause delays with serious consequences for the seafarer.
What does this regulation establish?
The agreement regulates the relationship between the ISM and SASEMAR for the execution and financing of maritime medical evacuations of seafarers. The previous agreement could not be extended, so it was essential to sign a new one to maintain operational coverage.
The key elements of the new agreement are as follows:
| Element | Detail |
|---|---|
| Executing body | SASEMAR (Maritime Safety and Rescue Society) |
| Financing body | ISM (Maritime Social Institute) |
| Medical coordination | Spanish Radio Medical Center (CRME) |
| Prior requirement in Spanish waters | CRME recommendation, except in immediate emergencies |
| Evacuations outside Spanish waters | Coordination with foreign MRCC centers |
| Applicable rates | Order FOM/1634/2013, revisable through ministerial orders |
| Maximum budget | €300,000 VAT exempt, distributed between 2026 and 2030 |
| Validity | 4 years from signature (May 26, 2026) |
The procedure distinguishes two scenarios: evacuations in areas of Spanish responsibility, where prior CRME recommendation is required unless urgency does not permit it, and evacuations outside Spanish waters, which are coordinated with the MRCC centers of the corresponding countries.
Economic and operational impact
The cost of maritime medical evacuations falls entirely on the ISM, which pays SASEMAR according to the rates set in the Order FOM/1634/2013. These rates may be updated through subsequent ministerial orders, so the unit cost per operation may vary throughout the agreement's validity.
The maximum committed budget is €300,000 VAT exempt for the period 2026-2030. This represents a theoretical average of €75,000 annually, although the actual distribution will depend on the number and complexity of evacuations that occur each year.
For shipping companies and sector workers, the direct economic impact is zero: no new contributions, fees, or payment obligations are generated. The value of the agreement is operational and coverage-related: it guarantees that SASEMAR can act with clear legal and financial backing when a seafarer needs to be evacuated.
Who does it affect?
- Embarked workers included in the Special Maritime Social Security Regime: they are the direct beneficiaries of evacuation coverage.
- Shipping and shipping companies with workers in the Special Maritime Regime: must understand the CRME activation procedure to avoid operational errors.
- Fleet managers and HR managers in fishing, maritime transport, or offshore services companies: need to have updated the medical emergency protocol on board.
- ISM and SASEMAR as signatory parties: assume respectively the financing and execution of operations.
- Labor and Social Security advisors managing maritime sector companies: must inform their clients of the new framework in force.
Practical example
A seafarer embarked on a fishing vessel operating in Spanish responsibility waters suffers a serious medical emergency 80 miles from the coast. The captain contacts the Spanish Radio Medical Center (CRME), which evaluates the situation and, if necessary, recommends evacuation. With that recommendation, SASEMAR is activated, which executes the transfer.
The cost of the operation—helicopter, vessel, or the means corresponding according to the rates of the Order FOM/1634/2013—is paid by the ISM directly to SASEMAR, without the seafarer or shipping company having to make any payment. If the emergency is immediate and there is no time to obtain the CRME recommendation, the evacuation can still be initiated without loss of coverage.
If the vessel operates outside Spanish waters, the procedure is coordinated with the MRCC center of the corresponding country, maintaining the same financial coverage by the ISM.
What should companies do now?
- Update the medical emergency protocol on board to reflect that the evacuation procedure in Spanish waters requires first contacting the CRME, except in immediate emergencies.
- Communicate to captains and crews the contact number of the Spanish Radio Medical Center (CRME) and the SASEMAR activation procedure, especially in fleets operating in areas far from the coast.
- Review protocols for operations outside Spanish waters: in those cases, coordination is carried out with foreign MRCC centers, and the ISM continues to cover the cost.
- Inform the HR department or labor advisory that the previous agreement has been replaced and that the new framework is in force from May 26, 2026 until 2030.
- Verify that workers are correctly classified in the Special Maritime Social Security Regime, as the agreement's coverage applies exclusively to this group.
Frequently asked questions
Who pays the cost of a seafarer's medical evacuation at sea?
The ISM (Maritime Social Institute) assumes the full cost of maritime medical evacuations of workers in the Special Maritime Regime. SASEMAR executes the operation and invoices the ISM according to the rates of Order FOM/1634/2013. Neither the seafarer nor the shipping company pays for the evacuation covered by this agreement.
How much money is allocated to the ISM-SASEMAR agreement for medical evacuations?
The maximum budget of the agreement is €300,000 VAT exempt, distributed between 2026 and 2030. The amount is distributed over the four years of validity depending on the actual number of evacuations carried out each year.
Is it mandatory to contact the CRME before requesting a maritime medical evacuation?
Yes, in areas of Spanish responsibility the procedure requires a prior recommendation from the Spanish Radio Medical Center (CRME) before activating SASEMAR. The only exception is immediate emergencies, in which evacuation can be initiated without waiting for such recommendation without losing coverage.
What happens if the vessel operates outside Spanish waters and needs a medical evacuation?
The agreement also covers evacuations outside Spanish waters. In that case, the operation is coordinated with the foreign MRCC centers of the corresponding country, and the ISM remains the body that finances the cost of the evacuation.
How long will the new ISM-SASEMAR agreement be in force?
The agreement has a validity of 4 years from its signature on May 26, 2026, so it will be in force until 2030. It replaces the previous agreement, which could not be extended. The applicable rates may be revised during this period through successive ministerial orders.
Official source
Consult complete regulation in official source (BOE-A-2026-14085)
Notice: This article is for informational purposes only and does not constitute legal advice. For specific decisions, consult a qualified professional. Source: https://www.boe.es/diario_boe/txt.php?id=BOE-A-2026-14085