Continuing dialysis, kidney and transplant care in Spain

Terms used

• Padrón — The padrón is the register of residents kept by your town hall, used to prove where you live.
• Tarjeta sanitaria — The tarjeta sanitaria is the public health card that gives you access to a family doctor and hospital care.
• INSS — The INSS is the national Social Security institute, where you can apply for recognition of health entitlement.
• Convenio especial — The convenio especial is a paid special agreement that gives access to public health care to some residents without other cover.
• Centro concertado — A centro concertado is a private centre contracted by the public health system to provide care, such as dialysis.
• EHIC — The EHIC is the European Health Insurance Card, which covers medically necessary public care during a temporary stay.
• GHIC — The GHIC is the UK Global Health Insurance Card, which covers medically necessary public care during a temporary stay.

Key rules

• Entitlement first: You need recognised public health entitlement before a public dialysis place or transplant clinic can be arranged.
• Dialysis lead time: A dialysis place is often arranged within days to a few weeks, and sooner if it is clinically urgent.
• Visitors: With a valid EHIC or GHIC you are treated at no cost, but arrange the place with the unit in advance.
• Anti-rejection drugs: The hospital pharmacy dispenses them, so arrange your supply before you arrive.

Start with your health entitlement

Public dialysis and transplant care depend on one thing: recognised entitlement to the public health system. Without it, a place can be delayed.

If you are a legal resident, you can usually qualify. You qualify if you work and pay into Social Security, if you are a pensioner, or if you hold an S1 or another EU/EEA/UK arrangement. Other legal residents without other cover can often qualify through residence. In some regions they can qualify through a paid scheme or a special agreement (convenio especial).

Do it in this order:

1. Get a Social Security number.
2. Register on the padrón at your town hall.
3. Apply at your regional health service or an INSS office for recognition of your entitlement.
4. Your health centre then assigns a family doctor and nurse and issues your tarjeta sanitaria.

Each region runs its own card procedure, so confirm the requirements with your regional health service. The documents list below shows what to bring.

If you need dialysis

Your family doctor or a hospital nephrologist refers you to the nephrology service. The hospital assesses you and gives you a place in its own unit or in a contracted private centre (centro concertado). Contracted centres handle most outpatient haemodialysis.

A place is often arranged within days to a few weeks, and sooner if it is clinically urgent. Delays in getting your health card entitlement can postpone it, so start the entitlement steps first.

Ask your current unit for your dialysis prescription, access details, viral serology and schedule. Bring them with a recent clinical report.

If you are visiting

If you hold a valid EHIC or GHIC, you are treated in public units or contracted centres at no cost, on the same terms as locals. Arrange the place with the unit in advance rather than turning up.

If you are a non-EU visitor or have no cover, you pay privately or through insurance. Travel insurance often excludes pre-existing conditions. Private sessions typically cost a few hundred euros each and vary by centre, so ask the unit for a quote before you book travel.

If you have had a transplant

Register for public health care, then ask your family doctor for a referral to the transplant follow-up unit. This is usually the nephrology service of a hospital. Your first appointment is typically scheduled within weeks, depending on region and hospital.

Ask your foreign transplant centre for a full report. It should include:

• the transplant date and the organ
• your immunosuppression regimen and drug levels
• recent bloods, biopsies, serology and vaccinations
• your latest follow-up

Translations of the key summaries help.

The transplant unit prescribes your anti-rejection drugs (immunosuppressants). The hospital pharmacy dispenses them free, often monthly or every few months. Arrange continuity of supply with that pharmacy before you arrive, so you do not run out.

Check-ups are frequent in the first months, then every few months, and eventually every 6–12 months, with blood tests including drug levels. Your family doctor handles general care. If you are stable, follow-up may be shared with local nephrology.

If you are covered only by private insurance, this public route does not apply. Ask your insurer which hospitals and transplant units it covers.

Records to bring

Spanish teams usually accept English reports, but a Spanish or certified translation of key summaries speeds things up. Bring imaging on disc or as a link in standard DICOM format, with the written report. Keep the originals yourself. Individual hospitals may ask for specific formats.

The timeline, documents, checklist and questions below walk you through the steps.

Timeline and deadlines

• Get your health card: Social Security number, padrón registration, then entitlement recognition: before you need a place, as early as you can after arriving

• Ask your family doctor or a hospital nephrologist for a referral to the nephrology service: once you hold your health card

• Get your dialysis place in a hospital unit or contracted centre: days to a few weeks after referral, sooner if clinically urgent

• Arrange anti-rejection drug supply with the hospital pharmacy: before you arrive

• Attend your first transplant follow-up appointment: typically within weeks of referral

Documents you need

• Passport or NIE/residence card, to prove who you are when applying for your health card.

• Padrón certificate from your town hall, proving you are registered as a resident at your address.

• Social Security number, needed to apply for recognition of your health entitlement.

• S1 or other proof of entitlement, only if your health cover comes from an EU/EEA/UK arrangement.

• Recent clinical summary or discharge report from your treating specialist, covering diagnosis, history, complications and current treatment. A Spanish or certified translation speeds things up.

• Current medication list with generic drug names and doses.

• Recent lab results and reports, plus imaging on disc or as a link in standard DICOM format with the written report.

• Dialysis prescription, access details, viral serology and your dialysis schedule, if you are on dialysis.

• Full report from your foreign transplant centre, if you have had a transplant: transplant date, organ, immunosuppression regimen and levels, recent bloods, biopsies, serology, vaccinations and latest follow-up.

Checklist

• Get a Social Security number and register on the padrón at your town hall.

• Gather a recent clinical report, medication list, lab results and imaging, with translations of key summaries.

• Ask your foreign transplant centre for a full transplant report, including drug levels.

• Arrange your immunosuppressant supply with the hospital pharmacy before you arrive.

• If you are visiting, bring your EHIC or GHIC and arrange the place with the unit in advance.

• If you have no cover, ask the dialysis unit for a written quote per session.

Frequently asked questions

Can I have dialysis in Spain on a short visit with a European health card?

Yes, if you hold a valid EHIC or GHIC, you are treated in public units or contracted centres at no cost, on the same terms as locals. Arrange the place with the unit in advance rather than turning up. Without a card, ask the unit for a private quote.

How much does private dialysis cost in Spain?

Private haemodialysis typically costs a few hundred euros per session, and the price varies by centre. Travel or private insurance often excludes pre-existing conditions. Ask the unit for a written quote before you book.

How often will I have transplant check-ups in Spain?

Visits are frequent in the first months, then every few months, and eventually every 6-12 months. Each visit usually includes blood tests with drug levels. Stable patients may share follow-up with local nephrology.