From entitled to seeing a doctor: getting your health card (tarjeta sanitaria)

Key rules

• Who issues the card: Your region's health service issues the card, so the office, appointment system and online option depend on where you live.
• Health centre: Your health centre and GP are assigned by your home address on the padrón.
• Changing GP: You can usually ask to change GP or centre, but it can be refused if the doctor's list is full.
• Provisional document: Many regions give a provisional document at registration, so keep it until the card arrives.

Your regional health service issues the card, not a national office. You apply with your ID, padrón certificate and proof of Social Security cover. The region then records you, assigns a GP and a health centre, and sends the card. Applying has no fee, and no modelo is paid.

If your permit rests on private health insurance, you have no public card until you are covered through Social Security or the paid convenio especial (details).

If you are a UK citizen with Withdrawal Agreement rights, you apply in the same regional way once you are registered, using your Withdrawal Agreement residence document as ID; other UK citizens follow the non-EU rules. If you are a non-EU citizen, you use your NIE and passport or residence card as ID, and you need INSS recognition or Social Security affiliation first.

Before you apply

Do the earlier steps first, in this order: town hall registration, Social Security number, then entitlement from the INSS if you are not covered through work. The card comes after those.

Step 1: Find your regional service

Each autonomous community has its own body and its own way to apply:

• Andalucía: the Servicio Andaluz de Salud. Apply at the admissions desk of your health centre, or online through Salud Responde or the ClicSalud+ app and website.
• Cataluña: CatSalut issues the Tarjeta Sanitaria Individual. Apply at the CAP (primary care centre) of your area, or online through La Meva Salut.
• Madrid: the Servicio Madrileño de Salud issues the Tarjeta Sanitaria Individual. Apply at your health centre or on its online site, usually with a prior appointment.
• Valencia: the Conselleria de Sanitat issues the SIP card. Request it at your health centre or a SIP office. A prior appointment is sometimes bookable online.
• Other regions: each issues the card through its own regional health service: Osakidetza in the Basque Country, SERGAS in Galicia, SESCAM in Castilla-La Mancha, SACYL in Castilla y León, SES in Extremadura, the Servicio Murciano de Salud, the Servicio Canario de la Salud, IB-Salut in the Balearic Islands, Salud in Aragón, SESPA in Asturias, the Servicio Cántabro de Salud, SERIS in La Rioja and Osasunbidea in Navarra. In Ceuta and Melilla the card comes from INGESA.

Step 2: Apply

Go in person to your health centre or regional office, or apply online if your region allows it. Hand over your documents. Staff enter you in the region's population database.

Step 3: Get your GP and health centre

Children up to 14 get a paediatrician instead of a GP. You can generally ask to change GP or centre. Many regions let you choose freely within your area, and some across the whole region. Limits apply: some regions set a minimum time between changes.

Step 4: Receive the card

The card usually comes by post to your registered home address. In some regions you collect it at the health centre. Some regions offer a digital card on a mobile app. Delivery takes two to four weeks.

If your application is refused, ask the health service for the reason, bring the missing document, such as the INSS resolution or padrón certificate, and reapply.

What to watch for

• Your address on the padrón decides your health centre. If you move, update your padrón first.
• If your region sends the card by post, make sure the address you gave is the one you live at.

Documents you need

• Bring a valid ID: your DNI, NIE or passport.

• Get a recent padrón certificate (proof you are registered at your address in the town hall). Your region decides whether it checks this document electronically or asks you to bring it.

• If you cannot get a padrón certificate, most regions accept a rental contract, a property deed, a utility bill or a sworn declaration of residence instead.

• Bring proof of your Social Security number (NSS), such as the affiliation document from the TGSS (Spain's Social Security office), often called the TA.0, or an employment contract or payslip showing the number.

• If you work as an employee, bring your ID, padrón and a payslip or registration document showing your Social Security number. You do not need an INSS resolution.

• If you hold an S1 form, bring the S1 registered with the INSS, the certificate of registration the INSS gives you, plus your ID and padrón.

• If you are not affiliated through work, bring the INSS resolution recognising your right to cover, with proof of no other coverage.

• If you are applying for a dependant, bring the main insured person's details and proof of the relationship, plus proof of dependency or cohabitation. For a child, bring the parent's details and the family book or birth certificate.

  • The proof of each family relationship is on the INSS recognition page.

• Fill in the application form and bring a photo if your region asks for them.

• Get a sworn translation (traducción jurada) of any document not in Spanish or the region's co-official language, such as a foreign marriage or birth certificate.

• Get an apostille or legalisation for foreign public documents that prove family ties or dependency.

A civil document issued in another EU country needs no apostille, and a sworn translation is needed only if it is not in Spanish or the co-official language and the health service asks; multilingual standard forms replace translations. If you are a non-EU citizen, documents from Hague Convention countries need an apostille plus sworn translation; documents from other countries need full legalisation plus sworn translation — see Does this document need an apostille, a translation, or both?

Quick answers about the Spanish health card

Does my health card expire and need renewing?

In most regions the card does not expire if your entitlement is permanent, for example as a Social Security-insured resident or dependant. If your entitlement is temporary, such as one tied to a residence permit, the card shows a validity date. You must prove you are still entitled when that date arrives.

Do I need the public health card to use a private clinic?

No, private clinics do not require the public health card. You need your private insurer's card and your ID. The public card is only needed for the public system, including prescriptions or referrals under it.