Setting up healthcare for your whole family, step by step

Terms used

• Padrón — The padrón is the municipal register of residents. Your town hall certifies that you live at your address.
• NIE — The NIE is the identification number Spain gives to foreigners.
• INSS — The INSS is the Social Security institute that confirms your right to public healthcare.
• Convenio especial — The convenio especial is a paid agreement that gives non-working residents access to public healthcare.
• Tarjeta sanitaria — The tarjeta sanitaria is the public health card that lets you use public doctors and hospitals.
• Centro de salud — The centro de salud is your local public health centre, where your family doctor, pediatrician and matrona work.
• Libro de familia — The libro de familia is the family book recording parents and children, used as proof of a child's parentage.
• Matrona — The matrona is a midwife who follows pregnancy and offers family planning advice in primary care.

Key rules

• Order: Get proof of entitlement before you apply for the tarjeta sanitaria.
• Your centro: Your padrón address decides which centro de salud and doctor you get.
• Children: Children are normally registered through a parent's entitlement.
• Region: Forms, referrals and pediatric age limits differ by region, so ask your centro.

The short version

Do it in this order: padrón, legal residence papers, proof of entitlement to public healthcare, then the tarjeta sanitaria, then your first appointment. Entitlement comes before the card. Without it, the centro de salud cannot issue the card.

Step 1: Register on the padrón

Go to your town hall and register every family member at your address. You get a padrón certificate for each person. Your address decides which centro de salud you are assigned to, so do this first.

Step 2: Have your legal residence papers ready

Each adult needs a NIE, a residence card or, for EU citizens, the EU registration certificate. Children need a passport or NIE.

Step 3: Get entitlement to public healthcare

Choose the route that fits you. The decision below helps you compare them.

• If you work, or depend on someone who does: you are covered through Social Security. Ask the Social Security office (INSS) for proof of your entitlement.
• If you do not work: you may need a convenio especial through the regional health service, or private insurance. Which one depends on your visa.
• For children: they are normally registered as beneficiaries of a parent's entitlement. Bring a birth certificate or libro de familia, plus the parent's details.

Step 4: Apply for the tarjeta sanitaria

Take the documents to your centro de salud, or apply through your regional health service. Do this for each family member. Ask whether your region also wants its own form or proof of residence, because procedures differ by region. The centro may give you a provisional document, and the card follows by post. The checklist and document list below cover what to bring.

Step 5: Your centro and doctor are assigned

You are assigned to the centro that serves your padrón address. The system also gives you a named family doctor (adults) or pediatrician (children), usually when the card is issued.

• Children: In most of Spain, public pediatricians see children up to age 14. After that a family doctor takes over. Some regions extend this, and where pediatricians are scarce, a younger child may be assigned a family doctor.
• Changing doctor or centro: Most regions let you ask for a change, online, by app or at the admissions desk. A request can be refused if the doctor's list is full.

Step 6: Book the first appointment

Adults need nothing beyond the card. Book by regional app, website, phone or at the centro's desk, using the card number (CIP). Some centros ask new patients to confirm their details at the desk.

For children, book a first visit with the pediatrician. Bring any vaccine records from abroad so the nurse can continue the series from your documented doses.

If someone is pregnant

Your first contact is the family doctor or the matrona at your centro, who confirms the pregnancy and opens the pregnancy record. Many regions let you go straight to the matrona. The first matrona visit is usually in the first trimester, around weeks 8 to 12, followed by the first hospital scan at about 12 weeks. Your region sets the exact schedule.

Family planning

Contraception advice and sexual health services are available through your family doctor, the matrona or a family planning centre, where your region has one. You need the card and an appointment. Some regions ask for a doctor's referral to see a gynaecologist, so ask at your centro.

Timing

The planner below lays out the first 90 days. Do the padrón and entitlement steps in your first days, because everything else waits on them.

Choosing between options

Which route should you use to get entitlement to public healthcare before applying for the health card?

• Through Social Security affiliation: You work in Spain, or you are a dependant of someone who does. Register your entitlement with the INSS and add your children as beneficiaries.

• Through the regional health service: You have a special agreement or a convenio especial (a paid scheme for residents not otherwise covered).

• Private insurance for now: You do not work and your visa requires private cover rather than public access.

Register on the padrón first, get your residence papers, then use whichever route covers you to request the tarjeta sanitaria. Your centro and named doctor or pediatrician are then assigned from your padrón address.

Plan your family's first 90 days of healthcare

Your first 90 days

• Get padrón certificates and gather IDs, entitlement proof and vaccine records: in your first week

• Apply for the tarjeta sanitaria for each family member at the centro de salud: as soon as your padrón is ready

• Collect a provisional document or printed card at the centro: same day or within days in many regions

• Receive the physical card by post: often within a few weeks; slower where entitlement must be verified first

• Book the first GP or pediatrician appointment: once the card works; waits run from a few days to a week or more

• Attend the first hospital scan if pregnant: at about 12 weeks

• Start vaccine catch-up doses at the first nursing or pediatric visit: commonly within a few weeks to a couple of months of registering

Card and appointment waiting times vary by region and area, so confirm current lead times with your regional health service.

Documents you need

• Padrón certificate: proof from your town hall that you are registered at your address. It decides which centro de salud you are assigned to.

• Legal residence papers: your NIE, residence card or, for EU citizens, the EU registration certificate.

• Proof of healthcare entitlement from the Social Security office (INSS) if you work or are a dependant, or your regional health service's agreement if you are covered by a convenio especial.

• For each child: birth certificate or libro de familia (family book), plus the parent's details, so the child is registered under the parent's entitlement.

Family healthcare setup checklist for your first weeks

Family healthcare setup checklist

• Bring each adult's passport, NIE or residence card (or DNI) to the centro de salud.

• Gather proof of healthcare entitlement for each adult: the Social Security healthcare entitlement certificate, your Social Security number, or your convenio especial document.

• Bring each child's passport or NIE, birth certificate or libro de familia (family book), and a parent's ID and entitlement proof.

• Ask the centro whether your region also wants its own application form or proof of residence.

• Collect each child's and adult's foreign vaccination records, showing dates and vaccine types, so valid doses count toward the Spanish schedule.

• Ask the nurse or pediatrician to continue the series from your documented doses; undocumented doses are generally treated as not given.

• Register each family member for the tarjeta sanitaria (public health card) at the centro de salud.

• If you are pregnant, ask the centro for a first matrona (midwife) visit once your card works.

Frequently asked questions

Can I choose my family doctor or change centro de salud?

Yes, you can ask to choose or change your doctor or centro, but the answer depends on your region and on space. You start at the centro serving your padrón address.

Do I need to register in person before my first GP appointment?

No, adults normally need nothing beyond the tarjeta sanitaria and an assigned centro and doctor. Book by regional app, website, phone or at the admissions desk, usually with your card number (CIP).

Can I go straight to a matrona when I am pregnant?

In many regions yes, you can go directly to the matrona (midwife) at your centro de salud once you have a tarjeta sanitaria. In others the family doctor is the first contact. Either one confirms the pregnancy and opens your pregnancy record.

How do I get contraception or family planning advice in public care?

You book an appointment at your centro de salud with your family doctor or matrona, using your health card. Some regions also have dedicated family planning centres, such as ASSIR in Catalonia, where you can often book directly. A GP referral is sometimes needed for gynaecology.