Getting your public health card in Spain

What it is

The public health card (tarjeta sanitaria individual, TSI) gives you access to your region's public health service: a GP (médico de cabecera), your local health centre (centro de salud) and public hospitals.

Healthcare is run by each autonomous community, so the card has a different name and look depending on where you live (for example tarjeta SIP in the Valencian Community). The steps are very similar everywhere.

Before you apply

You need two things in place first:

1. Registration on the padrón in the town where you live (see the empadronamiento guide).

2. Your right to public healthcare, recognised by the Social Security Institute (INSS). You usually have it if you:

   • work in Spain, or are registered as autónomo;
   • receive a Spanish pension, or a pension from another EU country registered with an S1 form;
   • are the registered family member (beneficiario) of someone who does.

   Ask the INSS for the document recognising your right to healthcare (reconocimiento del derecho a la asistencia sanitaria). Often it's done online, or your employer's registration is enough for the health centre to see it.

What to bring

• Your passport or TIE, and your NIE.
• Your padrón certificate.
• The INSS document showing your right to healthcare, or your Social Security number.

Steps

1. Find your health centre. It's assigned by your address; your region's health service website has a search.
2. Apply at the admissions desk (admisión) with your documents. In some regions you can start online, but a first card is usually requested in person.
3. Get a GP assigned at the same time.
4. Receive your card. Some regions give a provisional document on the day so you can see a doctor straight away. Many regions also have an app with a virtual card.

Cost

Free.

Common pitfalls

• Padrón and Social Security first. Without both, the health centre can't issue the card.
• Your residence required private insurance? With a non-lucrative or student permit, or an EU registration based on your own insurance, you usually don't qualify through the INSS. Keep your insurance.
• Not covered? After a year living in Spain and on the padrón, you can join the public system with a paid agreement (convenio especial) through your regional health service: €60 a month under 65, €157 from 65. Otherwise you'll need private health insurance.
• Moving to another region. You need a new card from the new region's health service.

When to ask a helper

If you're retired, between jobs, a student or on private insurance and unsure whether you qualify, ask someone in your region who's been through it.