Setting up your healthcare in your first weeks in Spain

Terms used

• padrón — The padrón is the local register of residents kept by your town hall; it proves where you live.
• NIE — The NIE is the identification number Spain gives to foreigners, used for tax, work, housing and official procedures.

Key rules

• Order: Padrón, Social Security number, INSS if needed, regional card, GP.
• Total time: One to three months.
• Regions: Each region sets its own card procedure and accepted documents.

The order to follow

Do the steps in this order, because each one needs a document from the one before. Register at the town hall first. Then get your Social Security number. Then, only if you are not covered through work, get your right to healthcare recognised by the INSS. Then apply for the regional health card. A GP is assigned to you as part of that last step.

Step 1: Register at your town hall (padrón)

Ask for the padrón certificate. It is your proof of address, and most regions need it for the card. It is done the same day or within three days.

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.

Step 2: Get your Social Security number

Request your number at the TGSS office if you do not already have one. The card is normally linked to this number.

You prove it with the affiliation document from the TGSS. If you work for an employer, your affiliation gives you the number and your coverage together.

Step 3: INSS recognition, only if you need it

If you work as an employee or are self-employed, you skip this step: registering with Social Security gives you the right. The other groups need the INSS to recognise their right to healthcare: people with an S1, the family members of an insured person (the insured person applies) and residents with no other cover.

Book an appointment at a CAISS office. The resolution takes two to four weeks from your appointment.

Step 4: Apply for your regional health card

Apply at your health centre or regional health service with your padrón certificate, your passport, ID or NIE, your Social Security number proof and, if you needed it, the INSS document. Some regions can issue a card on the INSS document alone.

If the card is not issued at once, ask for a temporary document. The card arrives by post.

Step 5: Your GP

You are assigned a GP and health centre based on your home address, normally as part of the card process. Check that you have both, then book your first appointment. If you want a different GP or centre, ask to change.

How long it all takes

Expect between one and three months for the whole chain. Big cities can be slower. The padrón takes the same day to three days, and a Social Security number takes one to three weeks.

If you bring your family

Family members are covered as beneficiaries of an insured person and each gets their own card. A child gets a paediatrician and an adult gets a GP. The relationship rules and proofs are on the INSS recognition page. A reunified spouse, partner and children are covered this way and need no private policy; reunified parents are not beneficiaries and need their own private health insurance: Visa health insurance for a family.

Documents you need

• Padrón certificate (empadronamiento), issued by your town hall, as proof of address. If you cannot get one, some regions accept a rental contract, property deed, utility bill or sworn declaration of residence.

• Passport, ID or NIE, as your identity document for the card application.

• INSS document recognising your right to healthcare. You need it only if you are not covered through work, for example if you hold an S1, are a dependant or have no other cover.