Does your family get healthcare through you or need their own route?

Terms used

• Pareja de hecho — A pareja de hecho is an unmarried couple formally registered as partners in an official registry.
• Padrón — The padrón is the town hall record of where you live.
• INSS — The INSS is Spain's national Social Security institute, which assesses and recognises beneficiaries.
• Convenio especial — The convenio especial is a paid monthly scheme that gives access to public healthcare through the Social Security.

Key rules

• Basic condition: Every family member must live in Spain and have no other healthcare cover to be your beneficiary.
• Children: Children are covered until they turn 26, or at any age with a disability of at least 65 percent.
• Parents: A parent must live with you and depend on you financially, with income below the ceiling.
• Residence permit: Non-lucrative or family reunification permits normally need private insurance with no co-payments.

Who can be covered through you

Your family can get public healthcare as beneficiaries of you only if you are insured in Spain and they meet set conditions. If they do not, they need their own route. This covers your spouse or partner, your children and dependent parents or other ascendants.

In every case the family member must live in Spain and have no other healthcare cover of their own.

Spouse or registered partner

A spouse can be added if you are legally married. A partner can be added if you are registered as a pareja de hecho. The partnership must be recorded in an official registry or shown by a notarial document. You may also need to show you have lived together for at least five years, using padrón records. A partner from outside Spain needs legal residence in Spain.

The proof is the marriage or partnership certificate. Documents and cohabitation proof differ by region, so ask your regional health service before you apply.

Children

Children can be beneficiaries until they turn 26, or at any age with a disability of at least 65 percent. Stepchildren and adopted or fostered children count too.

From age 18, an income limit applies. The child's income must stay below a threshold linked to the minimum wage. It changes every year, so ask the INSS (the national Social Security institute) for the current figure.

Dependent parents and other ascendants

A parent or grandparent can be added if all of this is true:

• They live in Spain and live with you.
• They depend on you financially.
• They are not insured or entitled to care by another route.
• Their income is below the yearly ceiling.

The INSS provincial office decides each case and issues the recognition. A parent who lives elsewhere, or who has an income above the ceiling, cannot be added.

When your family needs their own route

Look at the other routes if any of these applies:

• A parent does not live with you or does not depend on you.
• A child is over 26 and their income is above the ceiling.
• A partner cannot prove the relationship.
• You are not insured in Spain yourself.

The options are:

• Universal health coverage: for residents with no other cover. Your family member must show they have no other cover. In practice, they may need three months of registration or residence. Regional health services apply this differently.
• Convenio especial: a paid monthly scheme with the Social Security.
• Private insurance: you can buy this at any time.

If the residence permit is a non-lucrative or family reunification one, it normally requires private insurance with no co-payments. That route needs private insurance, not public cover.

The decision block below helps you pick between these options. The document list shows what to bring to register beneficiaries.

Choosing between options

Does your family member get cover through you, or do they need their own route?

• Beneficiary through you: Your family member lives in Spain, has no other cover, and fits the relationship rules. A parent or grandparent must also live with you, depend on you financially and have income below the ceiling.

• Universal health coverage: Your family member is a resident with no other cover but cannot be your beneficiary, for example an adult child over the age limit with income above the ceiling. They must show they have no other cover and, in practice, three months of registration or residence.

• Convenio especial with the Social Security: Your family member cannot be a beneficiary and does not qualify for the universal route. It is a paid monthly scheme.

• Private insurance: Your family member has no other route, or their residence permit requires it.

If your family member meets every condition for their relationship, register them as a beneficiary. If one fails, such as no shared home or financial dependence for a parent, a partner with no proof of the relationship, or a holder who is not insured in Spain, use one of the other three routes.

Documents to register family members as beneficiaries

• For every family member: the beneficiary application form (solicitud de inclusión de beneficiarios), filed at your local Social Security (INSS) office or through its online procedure.

• For every family member: your ID, NIE or passport and theirs.

• For every family member: proof of where you live (padrón, the town hall residence record).

• For every family member: a declaration that the beneficiary has no other healthcare cover.

• For a spouse: the marriage certificate.

• For a partner: proof of registration in a partner registry, or proof that you live together.

• For a child: the family book (libro de familia) or the birth certificate.

• For a dependent parent or other ascendant: proof that you live together, proof of dependence, and proof of their income, such as a tax return or income declaration.

• For marriage or birth certificates issued abroad: legalise them, normally with the Hague apostille if the country is a member.

• For foreign documents not in Spanish: a sworn translation (traducción jurada) into Spanish. It is not needed if the office accepts the language or an international convention covers the document, such as EU multilingual standard forms, which are often exempt from legalisation too.

Frequently asked questions

Do I need to have lived with my partner for five years to add them?

If your partner is a pareja de hecho (registered partner), you may need to show five years of living together, using padrón records. The partnership must also be in an official registry or set out in a notarial document. Rules differ by region, so ask your INSS office before you apply.

Can my parent be added if they do not live with me?

No, a parent or grandparent must live with you and depend on you financially, and their income must be below the ceiling. If any of these fails, they need their own route to cover.

Does private insurance for my family member's residence permit have to cover everything?

Yes, for non-lucrative or family reunification permits the private insurance normally has to be one with no co-payments. Check the exact terms with the office that handles the permit before you buy a policy.