Getting contraception in Spain: methods, access and cost

Terms used

• Tarjeta sanitaria — The tarjeta sanitaria is the health card that gives you access to public healthcare in your region.
• Centro de salud — The centro de salud is your local public health centre, where you register and see a family doctor or midwife.
• Matrona — A matrona is a midwife, who can prescribe and advise on contraception in public primary care.
• Convenio especial — The convenio especial is a special agreement where you pay a monthly fee to use public healthcare if you do not qualify otherwise.
• Padrón — The padrón is the register of residents kept by your town hall.

Key rules

• Prescription: Pills, rings, patches, implants and IUDs need a prescription or a doctor's procedure.
• No prescription: Condoms and emergency contraception are sold in pharmacies without prescription, and emergency contraception has no age limit.
• Funded methods: The public system funds only some pills, copper and hormonal IUDs and the implant, while condoms, the ring and the patch are not funded.
• Region: What extra your region funds depends on where you live, so check your regional health portal.

The short answer

You can get contraception three ways: through the public system with a prescription, through a private doctor or clinic, or straight from a pharmacy for a few methods. Condoms and emergency contraception need no prescription. Pills, rings, patches, implants and IUDs do.

Public route: health card first

The public route needs a health card (tarjeta sanitaria). Register at your local centro de salud to get one. Then book an appointment with one of these:

• Your family doctor (médico de familia) at the centro de salud.
• A midwife (matrona) at the same centre.
• A family planning centre (planificación familiar, or centro de salud sexual y reproductiva). Most regions have them, and many take direct appointments.

The doctor or midwife prescribes pills. An IUD or implant is fitted by a gynaecologist, or by a trained midwife or doctor at a planning centre. Hospital gynaecology often needs a referral from your GP. Planning centres often do not.

What the public system pays for

Counselling is covered. With a prescription, the public system funds a limited set of methods:

• Some combined and progestogen-only pills, mostly older ones.
• The copper IUD and the hormonal IUD.
• The implant.

For pills you usually pay the normal patient share for medicines if you work. Pensioners pay nothing.

Condoms, the vaginal ring and the patch are not funded nationally. Emergency contraception is generally not funded nationally either, though some regional services give it out free.

The list of funded methods has been under review since 2025, and it varies by region. Ask your doctor or planning centre what is funded now.

Regional extras

Health is run by each region. Several regions fund more methods for young people or people on low incomes. Andalucía, for example, offers free emergency contraception and some methods through its centres. Other regions have run similar programmes. Groups and methods differ by region and change often. Search your region's health portal for "planificación familiar" or "salud sexual y reproductiva", or ask at your centro de salud.

Pharmacy

Without a prescription you can buy condoms (male and female), spermicides and emergency contraception. Emergency contraception has no age limit. Everything else needs a prescription or a doctor's procedure.

If you are not an EU citizen

If you are a registered resident without other coverage, you can usually get a health card after a period of residence, generally at least 90 days. Register at the centro de salud or the social security office. If you do not qualify, you can pay a monthly fee for a special agreement (convenio especial) that gives access. Emergency care, pregnancy and birth care, and care for minors are covered whatever your status. Some regions also allow access to sexual health services for people without papers who have a padrón registration. Rules differ by region, so check with your local health authority.

Going private

Prices depend on the brand, pharmacy and clinic. Pills are bought monthly. Rings and patches cost more than pills. The implant and IUDs are a one-off cost, and hormonal ones cost more than copper. Ask for the price of the device and the insertion fee separately, and remember that a private gynaecologist's consultation adds to the total.

Where to go for sexual and reproductive health, compared

The right door depends on what you need. For emergency contraception or condoms, go to a pharmacy. For a prescription or a coil, start at a planning centre or your GP. For STI tests, a sexual health clinic or an NGO testing point is usually quickest.

What each option is best for

GP or midwife. Midwives (matronas) handle routine reproductive health, contraception and cervical screening. They can prescribe pills, the ring and the patch. Coils and implants are fitted by gynaecologists, or by trained midwives or doctors in planning centres. Waits for hospital gynaecology range from weeks to several months, depending on the region.

Planning centre. This is often the fastest public route to a prescription or a coil or implant. Most regions have one, but not all. Ask at your centro de salud where the nearest is.

Private gynaecologist. This is the quickest way to see a specialist. Many insurance policies allow direct access to specialists in their network, often with little or no co-payment. Prices vary by city and clinic, so ask before you book.

Pharmacy. Without a prescription you can buy condoms (male and female), spermicides and emergency contraception. The combined pill, progestogen-only pill, ring, patch, implant, injection and coil all need a prescription or a doctor's procedure.

STI clinic or testing point. Public sexual health centres, primary care and planning centres offer testing. Some cities also have dedicated STI clinics. Community organisations offer free rapid HIV and syphilis tests. What is available differs by city and region, so check locally.

Timeline and deadlines

• Register as a resident in Spain: before you ask for a health card

• Apply for a special agreement (convenio especial) with a monthly payment if you do not qualify for a health card: if you are not eligible after the residence period

• Book your contraception appointment with a family doctor, midwife or planning centre: once you have your health card

Checklist

• Book an appointment with your family doctor, a midwife (matrona) or a family planning centre to get a prescription.

• Ask which methods are funded: some pills, copper and hormonal IUDs and the implant are, while condoms, the ring and the patch are not.

• Ask your regional health department whether your region funds extra methods for young people or low-income groups.

• Ask a family planning centre or gynaecologist to fit an IUD or implant, and check if you need a GP referral.

• Contact the local health authority about a health card or special agreement if you are a non-EU resident without coverage.

• Search your region's health portal for 'planificación familiar' or 'salud sexual y reproductiva' to find your nearest centre.

What if contraception fails or you miss a pill?

Act as soon as you notice

Time matters most. Emergency contraception works best the sooner you use it, so go to a pharmacy the same day if you can.

If a condom broke or you had unprotected sex

Emergency contraception is sold in pharmacies without prescription. There is no age limit, and minors do not need parental consent. You have three options:

• Levonorgestrel: works up to 72 hours after sex, and the sooner you take it, the better it works.
• Ulipristal: works up to 120 hours after sex.
• Copper IUD: a doctor can insert it up to 5 days after sex. It is the most effective option. It needs an appointment, so call a health centre or clinic early.

If you are not sure which pill suits you, ask the pharmacist. They can explain the difference when you are there.

If you missed a combined pill

Less than 12 hours late: take the missed pill now and carry on as normal. You need no extra protection.

More than 12 hours late (one or more pills missed):

1. Take the last missed pill at once, even if that means taking two in one day.
2. Keep taking the rest at your usual time.
3. Use condoms for 7 days.

What else to do depends on where you are in the pack:

• Week 1: if you had unprotected sex in the previous 7 days, consider emergency contraception.
• Week 2: you usually do not need emergency contraception if you took the previous 7 pills correctly.
• Week 3: finish the active pills in your pack, skip the pill-free break and start the next pack straight away.

If you missed a progestogen-only pill

• Traditional progestogen-only pill: if you are more than 3 hours late, take the pill at once and use condoms for 2 days.
• Desogestrel pill: the limit is 12 hours instead of 3.

If you are unsure

Missed pills, vomiting, or several mistakes in one pack can make the picture confusing. Ask a pharmacist or doctor, and do it before the time windows above run out.

Frequently asked questions

Can I buy the contraceptive pill in a Spanish pharmacy without a prescription?

No, the combined pill and the progestogen-only pill need a prescription in Spain. You can buy condoms, spermicides and emergency contraception over the counter. For the pill, see a family doctor, a midwife (matrona) or a family planning centre.

Do I need a GP referral to see someone about an IUD or implant?

Not always, because many family planning centres (centros de salud sexual y reproductiva) accept direct appointments. A referral from your GP is often needed for hospital gynaecology. You need a health card (tarjeta sanitaria) either way.

Can I use public family planning if I am not an EU citizen?

Yes, if you are a registered resident with no other coverage, usually after at least 90 days in Spain, you can get a health card and use public family planning.

Will the ring or patch be paid for by public health in Spain?

No, the vaginal ring and the patch are not funded nationally, and neither are condoms. Some regions run programmes that fund them for young people or low-income groups, so ask at your planning centre.