Asylum seekers and temporary protection: how healthcare access works

Terms used

• Resguardo — The resguardo is the receipt proving you have applied for international protection.
• Tarjeta roja — The tarjeta roja is the red identity card for asylum applicants. It shows your NIE.
• NIE — The NIE is the identification number Spain gives to foreigners.
• Empadronamiento — Empadronamiento is your registration at the town hall of the place where you live.
• Tarjeta sanitaria — The tarjeta sanitaria is the individual health card that gives access to public healthcare in your region.
• Centro de salud — A centro de salud is your local public primary-care health centre.

Key rules

• Entitlement: Asylum applicants and temporary-protection beneficiaries have the right to public healthcare on the same terms as Spanish nationals.
• Before formalisation: Emergency care, care for pregnant women and care for minors are guaranteed even before your application is formalised.
• Regional rules: Each regional health service sets its own document requirements, so confirm them with your health centre.
• After rejection: A final rejection usually cancels the health card, but emergency care stays available and a route for people without papers may apply.

The short answer

If you have applied for international protection, or you hold temporary protection, you are entitled to public healthcare on the same terms as Spanish nationals. The document that proves your status unlocks the health card. Which document, and where you show it, depends on your region.

When access starts

Full access usually starts when your asylum application is formalised. Your proof is the resguardo. Some regions accept the appointment document for formalising the application, so ask your health service.

Before that, you still get:

• emergency care
• care for pregnant women
• care for minors
• an initial medical screening through the reception system

Asylum applicants: getting the health card

You apply for the tarjeta sanitaria at your regional health service office or your health centre (centro de salud). Regions generally accept:

• your resguardo, or the appointment document
• the tarjeta roja, your identity document as an applicant, which shows your NIE
• your passport or ID
• an empadronamiento certificate, which most regions ask for

Practice varies. Some regions issue the card on the basis of the appointment or a referral from an NGO or reception centre. Others want the resguardo or tarjeta roja plus the registration certificate. Confirm what your health centre asks for before you go.

Temporary protection: getting the health card

Once you have protection and a NIE, register at your town hall, then apply for the tarjeta sanitaria. Bring:

• the resolution granting protection from the Ministry of the Interior, or the residence card showing your NIE
• your passport or ID
• your empadronamiento certificate

A primary-care doctor is then assigned to you. Some regions let you apply online or by phone. Temporary protection has been extended in stages, so check the current end date.

Help from the reception system

If you are in the state reception system, your centre helps you book the asylum appointment, get the resguardo and tarjeta roja, register at the town hall and apply for the health card. It also refers you to the public health service. It covers some extra medical costs that the public service does not include. It also provides psychological care and special care for vulnerable people.

If you are outside the system, you handle these steps yourself, or with help from an NGO.

If your claim is rejected

A final rejection ends your status, and the health card is usually cancelled when the tarjeta roja expires or the decision becomes final. While an appeal or reexamination is pending with suspensive effect, the card often continues. Do not stop care during an appeal without checking with your health centre.

After a final rejection you may still get public care through the route for people without papers. It gives access on equal terms with Spaniards, if you are registered in the region and can show you have no other entitlement. Ask your health centre how it works locally. Emergency care is always available.

Where to look next

The documents list, checklist, timeline and warnings below set out the steps in order.

Timeline and deadlines

• Get emergency care, care for pregnant women and care for minors, plus the reception system's initial medical screening: before your application is formalised

• Apply for the health card with your resguardo: once your asylum application is formalised

• Keep using your health card while an appeal with suspensive effect is pending: during an appeal or reexamination

• Expect your health card to be cancelled: when the red card expires or the rejection becomes final

• Apply for public care through the route for people without papers: after a final rejection

Documents you need

• Proof of asylum application (resguardo), or the appointment document for formalising it, issued through the asylum process. Asylum applicants use this to unlock the health card.

• Red card (tarjeta roja), the identity document for asylum applicants, which shows your NIE. Some regions ask for it instead of the resguardo.

• Passport or ID.

• Empadronamiento certificate, your registration at the town hall. Most regions ask for it.

• For temporary protection: the resolution granting protection from the Ministry of the Interior, or the residence card showing your NIE.

Checklist

• Register at your town hall to get your empadronamiento certificate.

• Gather your resguardo or red card, plus your passport or ID.

• If you have temporary protection, bring the resolution granting protection and your NIE card.

• Go to your regional health service office or health centre and apply for the health card (tarjeta sanitaria).

• Ask your reception centre for help with each step if you are in the reception system.

• If your claim is rejected, ask the health centre how to keep access through the route for people without papers.

What to watch out for

• Your health card can end after a final rejection: A final rejection ends your asylum status and the health entitlement tied to it. The card is usually cancelled when the red card expires or the decision becomes final. Before the card ends, ask your health centre how to register for public care as a person without papers. You will need to be registered in the region and show you have no other entitlement.

• Do not stop care during an appeal without checking: The card often continues while an appeal or reexamination with suspensive effect is pending, but this is not automatic everywhere. Show proof of your appeal at the health centre and ask them to confirm your card stays active.

• Emergency care is always available: You will not be refused emergency care even if your card has ended. Go to the nearest emergency service and explain your situation.

Frequently asked questions

Can I get a health card before my asylum application is formalised?

Not usually, because most regions start full access from formalisation, shown by your resguardo (proof of application). Before then, emergency care and care for pregnant women and minors are guaranteed, and the reception system does an initial medical screening.

Which documents does a Ukrainian temporary-protection beneficiary show for a health card?

You show the resolution granting protection or your NIE card, plus your passport or ID and your empadronamiento (town hall registration) certificate.

What happens to my health card if my asylum claim is finally rejected?

Your card is usually cancelled once the red card expires or the decision becomes final. While an appeal with suspensive effect is pending it often continues, and afterwards you may apply through the route for people without papers, which gives access on equal terms with Spaniards.