Finding your public healthcare routeArticle 3 of 10 · 4 min read
Your employer has not registered you for social security: are you covered?
If your employer never registered you for social security, the law still treats you as covered for health care. This page explains what evidence helps, how to complain to the labour inspectorate, and what to do about urgent care. It is for employees working without a registration.
Terms used
- Alta de pleno derecho — Alta de pleno derecho means you are treated as registered with social security by law, even if your employer never registered you.
- Inspección de Trabajo y Seguridad Social — The Inspección de Trabajo y Seguridad Social is the labour inspectorate, which investigates employers who break work and social security rules.
- Alta de oficio — An alta de oficio is a registration made by the authorities without the employer's cooperation.
- Alta — The alta is your registration with social security as a worker.
- Régimen General — The Régimen General is the main social security scheme for employees.
- INSS — The INSS is the national social security institute, which records your health entitlement.
- Tarjeta sanitaria — The tarjeta sanitaria is the health card issued by your regional health service to access public care.
Key rules
- Urgent care: You can get emergency care whatever your registration status.
- Complaint: Filing a complaint with the labour inspectorate is free and can be anonymous.
- Evidence: Keep every proof of work: contracts, payments, messages, timesheets, photos and co-worker statements.
- Missing entitlement: If your entitlement does not show after an alta, ask the INSS for the document that recognises it.
Are you covered for health care?
Yes. A worker is in alta de pleno derecho for health assistance even if the employer failed to register them. The employer's failure is the employer's problem, not a reason to lose your entitlement.
In practice, though, the health system works from the registration. Without an alta, the system may not show your entitlement, so you will need to push things along with evidence and the labour inspectorate.
What to do if you need care now
Go to emergency services if you need urgent care. It is available whatever your registration status. You do not need to fix your paperwork first.
Build your evidence
Start collecting proof that you worked there, even if the employer gave you nothing in writing. Useful items are listed in the documents block below. The most helpful are:
- a contract or written job offer;
- payslips, bank transfers or receipts showing you were paid;
- messages and emails about the work;
- timesheets and photos of you at work;
- written statements from co-workers who saw you working.
Informal evidence alone rarely gets you registered. The labour inspectorate or a labour court usually has to establish that the job existed, so the evidence mainly serves to support that step.
Contact the labour inspectorate
The Inspección de Trabajo y Seguridad Social investigates unregistered work. It can register you without your employer's cooperation (an alta de oficio), demand the unpaid contributions and penalise the employer.
A complaint is free and can be anonymous. You can file it through the inspectorate's electronic office, in person at a provincial office, or by post. Name the employer and describe the work, your dates and the evidence you have.
Once an alta exists
An alta in the Régimen General (employees) gives you asegurado status by law, so you do not need a separate health application. The INSS normally records your entitlement automatically, and your regional health service then issues the tarjeta sanitaria.
If the entitlement does not show in the system, ask the INSS for the document that recognises it. Take that to your regional health service.
The checklist below puts these steps in order.
Documents you need
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A contract or written job offer from the employer.
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Payslips, if the employer gave you any.
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Bank transfers or receipts showing you were paid.
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Messages and emails with the employer about the work.
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Timesheets and photos showing you at work.
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Written statements from co-workers who saw you working.
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The INSS document that recognises your health entitlement, if the system does not show it after your alta.
Checklist
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Collect any evidence of your work: contract, payslips, transfers, messages, timesheets, photos.
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File a free complaint with the labour inspectorate, naming the employer and describing the work, dates and evidence.
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Check whether your health entitlement shows in the system once an alta exists.
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Ask your regional health service for the tarjeta sanitaria once the entitlement shows.
Frequently asked questions
Is a complaint to the labour inspectorate free and can it be anonymous?
Yes, filing a complaint with the labour inspectorate is free and can be anonymous.
What can the labour inspectorate do about my employer?
The inspectorate can register you without your employer's cooperation, which is called an alta de oficio. It can also demand the unpaid contributions and fine the employer.
What if my alta exists but my health entitlement does not show up?
You can ask the INSS, Spain's social security institute, for the document that recognises your entitlement. Once it shows, your regional health service issues the tarjeta sanitaria, the health card.
More in Finding your public healthcare route
- Which route gives you public healthcare in Spain?
- Public healthcare when you work or are self-employed (autónomo)
- Remote work for a foreign employer: how do you get healthcare?
- No job and no pension yet: how do you join Spanish healthcare?
- Visa required private insurance: can you also use public healthcare?
- Does your family get healthcare through you or need their own route?
- Studying in Spain: which health cover applies to you?
- Does Spain's 2026 healthcare decree change anything for you?
- Working for the Spanish state: how mutualidad healthcare differs
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