Travelling or being treated back home: using your Spanish cover abroad

Terms used

• NIE — The NIE is the identity number for foreigners that you need for tax, work and contracts.
• Tarjeta sanitaria europea — The tarjeta sanitaria europea (TSE) is a free card proving your public health cover when you travel temporarily in Europe.
• INSS — The INSS is Spain's national social security institute, which issues the TSE and decides S2 requests.
• CAISS — The CAISS is an INSS care centre where you can handle social security matters in person.
• Cl@ve — Cl@ve is Spain's electronic identity system for logging in to public websites.

Key rules

• Who gets the card: Only people insured in the Spanish public health system can get a Spanish TSE.
• Cost: The card is free to request.
• Urgent trip: Ask for a provisional certificate if you leave before the card arrives.
• Planned treatment: Get S2 authorisation before you travel, or the Spanish system may not pay.

Short trips: get the Spanish health card

If you are insured in the Spanish public health system, you can get a Spanish European Health Insurance Card (tarjeta sanitaria europea, or TSE) from the INSS. Insured means you work, are self-employed, are a pensioner, or are a beneficiary of someone who is. The card covers temporary stays in the EU/EEA, Switzerland and the UK. It is not issued if you lack Spanish cover.

The card is for care that becomes necessary during a trip. It is not for travelling in order to get treatment. That is a separate route, explained below.

How to request the card

It is free. You can request it in three ways:

• Online on the Seguridad Social website, with a digital certificate, Cl@ve or the app.
• By phone.
• In person at an INSS care centre (CAISS), usually with an appointment.

You need your ID (DNI, NIE or passport) and your social security number.

Online requests are usually processed quickly. The card then arrives by post within a few weeks. If you travel soon, ask for a provisional certificate. It can often be issued at once for urgent trips.

Planned treatment abroad: you need approval first

If you want treatment abroad that you have arranged in advance, for example back in your home country, the TSE does not cover it. You need prior authorisation from the INSS, called the S2 form. Ask before you travel.

1. Ask your public-system doctor for a medical report.
2. Send the request to your INSS provincial office (Dirección Provincial). Include the report, the treatment details and the name of the foreign provider.

The INSS must approve the request if two things are true. The treatment must be covered by Spanish public cover. It also must not be available in Spain within a medically acceptable time.

If it is approved, the Spanish health system pays the cost at the tariffs of the country that treats you. If those tariffs are lower than what you are charged, you may have to cover the difference.

Going to the UK

The UK is covered by the card for temporary stays, and S2 can apply too. The rules depend on the current UK-EU arrangements, so check with the INSS before you go.

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

Documents you need

• Your ID: a DNI, NIE or passport, for the card application.

• Your social security number, for the card application.

• A medical report from your public-system doctor, for the S2 request for planned treatment abroad.

• The treatment details and the name of the foreign provider, for the S2 request to the INSS provincial office.

Checklist

• Confirm you are insured in the Spanish public health system.

• Request the card free of charge on the Seguridad Social website with a digital certificate, Cl@ve or the app, by phone, or at an INSS care centre (CAISS).

• Ask for a provisional certificate if you travel soon, because the card takes a few weeks by post.

• Ask your public-system doctor for a medical report if you plan treatment abroad.

• Send the S2 request to your INSS provincial office before you travel for planned treatment.

Frequently asked questions

Can I get a Spanish health card if I am not insured in Spain?

No, the Spanish European health card is only issued to people covered by Spanish social security. That means workers, self-employed people, pensioners and their dependants. If you lack Spanish cover, you have no Spanish card to request.

What can I do if I need a card for an urgent trip?

You can often get a provisional certificate straight away for an urgent trip. Ask for it when you apply in person at an INSS care centre (CAISS). The full card usually comes by post within a few weeks.

Who pays for planned treatment abroad with S2 authorisation?

The Spanish public health system pays, at the tariffs of the country where you are treated. This applies only if the treatment is covered in Spain and cannot be given in Spain within a medically acceptable time. Apply to the INSS provincial office before you travel.

Can I use the Spanish card to travel to the UK?

Yes, the Spanish card can be used in the UK for temporary stays if you are insured in Spain. For planned treatment in the UK, S2 use depends on the current UK-EU arrangements, so ask the INSS before you book.