The tarjeta sanitaria: your access to free healthcare in Spain

The tarjeta sanitaria is the document that gives you access to Spain's public health system. Whether you are an employee, self-employed, a dependent family member, or a resident without contributory coverage, this guide explains who is eligible, what documents to bring, and how to apply.

Table of Contents

1. What is the tarjeta sanitaria?
2. Who is entitled to public healthcare?
3. Required documents
4. Where and how to apply
5. After the application: timelines and using your card
6. The European Health Insurance Card (EHIC)
7. Frequently asked questions

What is the tarjeta sanitaria?

The tarjeta sanitaria — or individual health card — is the official document that gives you access to Spain's National Health System (SNS, Sistema Nacional de Salud). It is issued free of charge by the autonomous community (comunidad autónoma) where you reside.

With this card, you can:

• See a GP at a public health centre (centro de salud)
• Be referred to a specialist (médico especialista)
• Receive emergency care at any public hospital in Spain
• Obtain prescribed medications at a reduced cost or free of charge depending on your situation

Each card is issued in your name and carries a unique identifier specific to the health service of your autonomous community (called SIP number, CIP, NUSS, or another code depending on the region). This number is separate from your Social Security affiliation number.

Important: The tarjeta sanitaria is not private health insurance. It gives you access to public healthcare services covered by the SNS, funded through social contributions and taxes.

Who is entitled to public healthcare in Spain?

In Spain, everyone registered with the Social Security system automatically has the right to public healthcare coverage. This right also extends to other categories of residents.

Workers (employed and self-employed)

Whether you are an employee or a self-employed worker (autónomo), registering with the Social Security (alta en la Seguridad Social) automatically grants you the right to public healthcare. For employees, it is the employer who carries out this registration before the first working day. For autónomos, the process is completed personally before starting the activity.

Dependent family members

Spouses, minor children and other dependants of a Social Security contributor can be registered as beneficiaries (beneficiarios) and access the same healthcare coverage without contributing themselves.

Job seekers and social benefit recipients

People receiving unemployment benefit (prestación por desempleo) or other social assistance remain covered for the duration of their entitlements.

Residents without contributory coverage and undocumented persons

Anyone residing in Spain and registered on the municipal register (empadronamiento) for at least 90 consecutive days can apply for the health card, even without contributing to the Social Security system.

Royal Decree 180/2026 goes further: it guarantees access to public healthcare for foreign nationals without legal residence status. The application is made through a simple self-declaration (declaración responsable) submitted at the health centre or regional health service. A provisional document is issued immediately, allowing access to healthcare from the moment the application is submitted, without waiting for the administrative decision.

Required documents

The documents required vary depending on your situation.

For everyone (common documents)

• Municipal registration certificate (certificado de empadronamiento), issued within the last 3 months

If you are an employed or self-employed (autónomo) worker registered with Social Security

• NIE (Número de Identificación de Extranjero) or passport
• Social Security affiliation number (número de afiliación a la Seguridad Social — NAF): this is a personal number printed on the document issued when you registered with Social Security. If you do not have it yet, you can request it at an INSS office before applying for your health card.

If you are a dependent family member (spouse, child)

• NIE or passport of the beneficiary
• Document proving the family relationship (marriage certificate, birth certificate)
• Health card of the main insured person

If you are undocumented (Royal Decree 180/2026)

• Valid passport
• Proof of habitual residence: certificado de empadronamiento or, failing that, any document that can attest to your presence in Spain (utility bills, school certificate, social services letter, etc.)
• Self-declaration (declaración responsable)

Tip: Requirements vary by autonomous community. Check with your local centro de salud or INSS office.

Where and how to apply

Go to the health centre (centro de salud) closest to your home — the one that corresponds to your empadronamiento address. Present your documents and ask to be registered with a family doctor (médico de familia).

A provisional document will be issued to you immediately. The physical health card will then be sent by post, within a timeframe that varies by autonomous community.

Note: In some autonomous communities (e.g. Catalonia, Madrid), the application can be completed online through the regional health service portal, provided you have an electronic certificate or Cl@ve account.

After the application: timelines and using your card

Receiving your card

A provisional document is issued immediately at the health centre. This document is valid as a health card until you receive the physical card, which arrives by post within 2 to 6 weeks depending on the autonomous community.

What the health card is used for

The health card allows you to:

• See your family doctor (médico de familia) without a prior appointment in most cases
• Be referred to a specialist (médico especialista) by your GP
• Receive emergency care (urgencias) at any public hospital in Spain
• Obtain prescribed medications at a pharmacy at reduced cost or free of charge (depending on your situation)

Presenting your card

You must present your health card at every visit to a public health centre or pharmacy. If it is lost or stolen, report it to your health centre to obtain a duplicate.

Change of address

If you move to another municipality or autonomous community, you must update your empadronamiento and register at the health centre of your new address.

The European Health Insurance Card (EHIC)

The European Health Insurance Card (EHIC, or Tarjeta Sanitaria Europea — TSE in Spanish) is a document separate from the national health card. It certifies your entitlement to public healthcare during temporary stays in other European Union countries, the European Economic Area (EEA), and Switzerland.

Who can obtain it?

Any person affiliated with the Spanish Social Security system with active healthcare coverage in Spain can apply for the EHIC — including Algerian nationals.

What is it used for?

It allows you to access necessary medical care (emergencies, unexpected illness) in covered countries, under the same conditions as local insured persons. It does not replace travel insurance and does not cover pre-planned treatment.

How to obtain it?

The application is made through your regional health service (depending on your autonomous community):

• Online via the health service portal or the Sede Electrónica of the Social Security, if you have a digital certificate or Cl@ve account
• In person at a Social Security office or health centre

The card is valid for 2 years and must be renewed before it expires.

Important: The EHIC is only valid in EU/EEA countries and Switzerland — it does not work in Algeria or other third countries.

Frequently asked questions

Does the health card have an expiry date?

It depends on the autonomous community and your situation. For Social Security contributors, the card is generally valid indefinitely. For those accessing public healthcare through non-contributory routes or as undocumented residents, validity is 1 to 2 years and must be renewed at the health centre before it expires.

Can I go to A&E without my health card?

Yes. Emergency care (urgencias) at Spanish public hospitals is guaranteed to everyone, regardless of whether you have a health card. Simply present a form of ID.

How much do prescription medicines cost?

Medicines prescribed by a public health system doctor are partially or fully subsidised depending on your situation:

• Active workers: co-payment between 10% and 60% of the price
• Unemployed with no income, minimum social benefit recipients: free (0%)
• Retirees: co-payment between 10% and 60% depending on income (with a monthly cap)

I've lost my health card. What should I do?

Go to your centro de salud to report the loss and request a duplicate. There is no charge for this.

Is my card valid throughout Spain?

Yes. The Spanish health card is valid across the entire country. Outside your autonomous community, you are covered for emergencies and necessary care, although your family doctor remains linked to your home community.

What happens if I leave Spain for more than 90 days?

If you leave Spain for more than 90 consecutive days, your health coverage may be suspended. On your return, you should check your status at your health centre or INSS office.