How to Get Your Health Card in Spain (Tarjeta Sanitaria) 2025

Last Updated: January 2025

The Spanish health card (tarjeta sanitaria individual or TSI) is your key to accessing Spain's excellent public healthcare system. Whether you need a doctor's appointment, prescriptions, or hospital care, you'll need this card.

Quick answer: Register at your local health center (centro de salud) with your padrón certificate, NIE/passport, and proof you qualify for public healthcare. Card issued in 2-4 weeks.

But the process varies by region, employment status, and nationality. This complete guide walks you through every step to get your tarjeta sanitaria in Barcelona, Madrid, Valencia, and across Spain.

What you'll learn:

• Who qualifies for Spanish public healthcare
• Required documents (padrón is essential)
• Step-by-step registration process by city
• How to book appointments at health centers
• What to do if you're employed, self-employed, or unemployed
• Private insurance alternative
• Timeline: 2-6 weeks total

What Is the Tarjeta Sanitaria?

The tarjeta sanitaria individual (TSI) is your Spanish health card that gives you access to public healthcare services.

What it looks like: Plastic card with your photo, name, social security number, and assigned health center.

What it gives you access to:

• General practitioner (GP) visits - Free
• Specialist appointments - Free (with GP referral)
• Hospital care - Free
• Emergency services - Free
• Prescriptions - Subsidized (pay 10-60% depending on income)
• Diagnostic tests (x-rays, blood work) - Free

What it doesn't cover:

• Dental care (except emergencies/extractions)
• Optometry/glasses
• Some medications (non-essential)
• Private hospital rooms

Important: This is separate from your European Health Insurance Card (EHIC). The tarjeta sanitaria is for residents; EHIC is for visitors.

Who Qualifies for Spanish Public Healthcare?

EU/EEA/Swiss Citizens

You qualify if you:

• Are employed in Spain (contributing to social security)
• Are self-employed (autónomo) and paying social security
• Are unemployed but previously worked in Spain
• Are retired receiving Spanish pension
• Are studying in Spain (under certain conditions)
• Have resided in Spain for at least 1 year (padrón registered)

Even if unemployed: EU citizens who've lived in Spain 1+ year qualify for free healthcare.

Non-EU Citizens

You qualify if you:

• Have residence permit (TIE card)
• Are employed (work contract + social security)
• Are self-employed (autónomo)
• Are family reunification beneficiary
• Are refugee/asylum status

Children under 18: Always qualify for public healthcare regardless of parents' status.

Who Doesn't Qualify

• Tourists/visitors (use EHIC or travel insurance)
• Non-residents without work authorization
• Digital nomads without residence permit
• Recently arrived with no social security contributions

If you don't qualify: You must have private health insurance. See section at end.

Required Documents to Get Health Card

Essential Documents (Everyone)

1. Padrón Certificate (Certificado de Empadronamiento)

• Proof you're registered as resident in your municipality
• Must be recent (issued within last 3 months)
• Get it from your town hall (ayuntamiento)
• Critical: You cannot get health card without padrón

2. NIE or Passport

• Foreign identity number (NIE) - preferred
• Valid passport if you don't have NIE yet
• Original + photocopy

3. Social Security Number (NASS)

• Número de Afiliación a la Seguridad Social
• Issued automatically when you start working
• OR assigned when registering at health center

4. Passport Photo

• Recent color photo
• Standard passport size
• Some regions don't require (card printed on site)

Additional Documents (Depending on Status)

If employed:

• Work contract (contrato de trabajo)
• Recent payslip (nómina)
• Proof of social security registration from employer

If self-employed (autónomo):

• Proof of autónomo registration
• Recent social security payment receipt

If unemployed (but worked before):

• Life working report (informe de vida laboral)
• Proof of previous employment in Spain

If retired:

• Pension certificate
• Proof of pension payments

If student:

• University enrollment certificate
• Proof of health insurance (some regions)
• Scholarship documentation (if applicable)

If EU citizen not working:

• Proof of sufficient funds (bank statements)
• Health insurance from home country (EHIC)
• 1-year padrón certificate

Step-by-Step: How to Get Your Health Card

Step 1: Register on Padrón (If Not Already)

You cannot skip this step. Padrón registration is mandatory.

How to register:

1. Go to your local town hall (ayuntamiento)
2. Bring: Passport, rental contract, NIE (if you have it)
3. Fill out padrón form
4. Receive padrón certificate (usually same day)

Cost: Free

Time: 30 minutes

Step 2: Find Your Assigned Health Center

Spain assigns you to a health center based on your address.

Find your centro de salud:

• Google: "centro de salud [your address]"
• Call regional health info line:
  • Madrid: 012
  • Catalonia: 061
  • Valencia: 900 161 161
  • Andalucía: 955 545 060

You must go to YOUR assigned center (not any center).

Step 3: Book Appointment (or Walk In)

Some regions require appointment, others accept walk-ins.

Barcelona/Catalonia:

• Book online: https://catsalut.gencat.cat
• Call: 061
• Walk-in: Monday-Friday 8am-3pm (be early, queues long)

Madrid:

• Book online: https://tarjetasanitaria.sanidad.madrid.org
• Call: 012
• Walk-in: Accepted at most centers

Valencia:

• Book: https://www.san.gva.es
• Call: 900 161 161
• Walk-in: Varies by center

Andalucía:

• Book: https://www.sspa.juntadeandalucia.es
• Call: 955 545 060
• Walk-in: Most centers accept

Best strategy: Try booking online first. If no appointments available within 2 weeks, walk in at 8am.

Step 4: Attend Appointment at Health Center

What to bring:

• All documents listed above
• Photocopies of everything
• Completed application form (if downloaded)

At the appointment (15-30 minutes):

1. Administrative staff reviews your documents
2. Verifies your padrón address
3. Confirms you qualify for public healthcare
4. Enters you into the system
5. Assigns you a GP (médico de cabecera)
6. Takes photo (or you provide one)
7. Issues social security number if you don't have one

They'll give you:

• Receipt confirming registration
• Temporary health card number (to use immediately)
• Info on when permanent card arrives

Timeline: 15-30 minute appointment.

Step 5: Receive Your Health Card

Delivery method varies by region:

Madrid: Card mailed to your address in 10-15 days

Barcelona/Catalonia: Pick up at health center in 2-4 weeks (they'll notify you)

Valencia: Mailed to address in 2-3 weeks

Andalucía: Some centers print on-site (instant), others mail in 2-4 weeks

Average timeline: 2-4 weeks from registration to receiving card.

Can you use healthcare before card arrives? YES. Your temporary number works immediately for appointments and prescriptions.

Step 6: Activate Online Access (Optional)

Most regions offer online portals for:

• Booking GP appointments
• Requesting prescriptions
• Viewing test results
• Accessing medical records

To activate:

• Go to regional health portal
• Register with your health card number
• Set up username/password
• Digital certificate required in some regions

Useful for: Booking appointments without calling, repeat prescriptions.

Regional Differences: Barcelona vs Madrid vs Valencia

Barcelona (Catalonia)

System: CatSalut (Servei Català de la Salut)

Application process:

• Book appointment online or walk in
• Bring padrón + NIE + proof of coverage
• Photo taken on-site
• Card ready in 2-3 weeks (pick up at center)

Booking appointments:

• Online: https://catsalut.gencat.cat
• Call: 061
• La Meva Salut app (digital health card)

Health card name: TSI-CatSalut

English support: Limited (mostly Catalan/Spanish)

Find health center: https://catsalut.gencat.cat/ca/centres-sanitaris/

Madrid

System: Servicio Madrileño de Salud (SERMAS)

Application process:

• Book online preferred: https://tarjetasanitaria.sanidad.madrid.org
• Walk-ins accepted
• Bring padrón + NIE + employment proof
• Photo provided or taken
• Card mailed in 10-15 days

Booking appointments:

• Online: Madrid Digital
• Call: 012
• App: Tarjeta Sanitaria Virtual Madrid

Health card name: Tarjeta Sanitaria Individual

English support: Some centers in expat areas (Chamberí, Salamanca)

Find health center: https://www.comunidad.madrid/servicios/salud

Valencia

System: Agencia Valenciana de Salud

Application process:

• Book: https://www.san.gva.es or call 900 161 161
• Walk-ins vary by center
• Padrón + NIE required
• Card issued in 2-3 weeks

Booking appointments:

• Online: GVA Salut portal
• Call: 900 161 161
• App: GVA+Salut

Health card name: Tarjeta SIP

Bilingual: Valencian/Spanish

Find health center: https://www.san.gva.es

Andalucía

System: Servicio Andaluz de Salud (SAS)

Application process:

• Book or walk in
• Many centers print cards on-site (instant)
• Padrón + NIE required
• If not instant, 2-4 weeks mail

Booking appointments:

• Online: https://www.sspa.juntadeandalucia.es
• Call: 955 545 060
• App: Salud Andalucía

Health card name: Tarjeta Sanitaria Andaluza

English support: Good in Costa del Sol (Málaga, Marbella)

Find health center: https://www.sspa.juntadeandalucia.es

Common Problems & Solutions

Problem 1: "You Need Social Security Number First"

Issue: Health center says you need NASS before registering.

Solution:

• If employed: Get it from your employer (they register you)
• If self-employed: Register as autónomo first
• If unemployed EU citizen: Health center should issue one at registration

Workaround: Insist they assign you one during registration (they can).

Problem 2: "Your Padrón Address Doesn't Match Health Center"

Issue: You registered at wrong health center.

Solution:

• Find correct center for your address
• Go to that center instead
• Each address assigned to specific center

Problem 3: "You Don't Qualify - Need Private Insurance"

Issue: You're not employed or contributing to social security.

Who this affects:

• Digital nomads
• Early retirees not receiving pension
• Recently arrived non-EU

Solution:

• Get private health insurance (€40-100/month)
• OR wait 1 year on padrón (EU citizens)
• OR start working/contributing to social security

Problem 4: "Appointment Slots Full for 2 Months"

Issue: Online booking shows no availability.

Solution:

• Walk in at 8:00 AM when center opens
• Most centers serve walk-ins despite online calendar
• Be prepared to wait 1-2 hours

Best days: Tuesday-Thursday (avoid Monday chaos, Friday laziness)

Problem 5: Card Never Arrives

Issue: 6+ weeks passed, no card received.

Solution:

• Return to health center with receipt
• Ask for card reprint
• Verify mailing address was correct
• Use temporary number meanwhile

Health Card for Children

Children under 18 always qualify for public healthcare regardless of parents' status.

Required documents:

• Child's birth certificate (Spanish or translated)
• Child's passport or DNI
• Parents' NIE/passport
• Padrón certificate showing child's residence
• Parents' health card (if parents have one)

Process:

• Same as adults: register at assigned health center
• One parent attends appointment with child
• Card issued in 2-4 weeks
• Photo not always required for babies/young children

Pediatric care: Children assigned to pediatrician (pediatra) instead of GP until age 14-16.

Using Your Health Card

Making Doctor Appointments

For GP (médico de cabecera):

• Call your health center
• Book online through regional portal
• Walk in for urgent issues

Appointment wait times:

• Routine: 1-7 days
• Urgent: Same day or next day
• Emergency: Go to urgencias (ER)

First appointment: Introduce yourself to your assigned GP, discuss medical history.

Getting Specialist Referrals

Process:

1. See GP first
2. GP evaluates and refers to specialist if needed
3. Specialist appointment scheduled by system
4. Attend specialist appointment

Specialist wait times:

• Urgent: 2-4 weeks
• Routine: 1-3 months
• Some specialties (orthopedics, dermatology): 3-6 months

Faster alternative: Private insurance for specialists (€50-150/visit).

Prescriptions

How it works:

1. Doctor prescribes medication
2. Prescription linked to your health card electronically
3. Go to any pharmacy
4. Show health card
5. Pay subsidized price (10-60% of cost)

Prescription costs:

• Employed: Pay 40% of medication cost
• Pensioners: Pay 10%
• High income: Pay 60%
• Chronic conditions: Capped monthly maximums

Repeat prescriptions: Request through online portal or call GP.

Emergency Care

For emergencies:

• Call 112 (ambulance)
• OR go to hospital urgencias (ER)
• Show health card at admission

ER wait times:

• Life-threatening: Immediate
• Urgent: 1-2 hours
• Non-urgent: 3-6 hours (go to health center instead)

Cost: Free with health card.

Private Health Insurance Alternative

If you don't qualify for public healthcare, or want faster access:

Top Private Insurers in Spain

1. Sanitas

• €50-120/month
• Wide network
• English customer service
• Online booking

2. Adeslas

• €45-110/month
• Largest network
• Good coverage

3. Asisa

• €40-100/month
• Competitive prices
• Popular with expats

4. DKV

• €60-130/month
• Premium service
• International coverage

What private insurance includes:

• Immediate specialist access (no GP referral needed)
• Faster appointments (2-7 days vs weeks/months)
• Private hospitals
• Dental coverage (some plans)
• English-speaking doctors

Costs:

• Basic: €40-60/month
• Standard: €70-100/month
• Premium: €120-200/month

When to choose private:

• You don't qualify for public
• You need faster specialist access
• You prefer English-speaking doctors
• You want dental coverage

Timeline Summary

You can access healthcare immediately with temporary number while waiting for card.

Frequently Asked Questions

Q: Can I get health card without NIE? A: Yes, you can start the process with just passport. NIE will be required eventually but health center can proceed with passport initially.

Q: Do I need appointment or can I walk in? A: Varies by region. Madrid/Andalucía accept walk-ins easily. Barcelona/Catalonia prefer appointments. Walk in at 8am to be safe.

Q: How long is health card valid? A: No expiration for residents. If you move address, update at health center. If you leave Spain, card becomes inactive.

Q: Can I use my health card in other EU countries? A: No, tarjeta sanitaria is only for Spain. For EU travel, request European Health Insurance Card (EHIC) separately.

Q: What if I lose my health card? A: Request replacement at your health center. Free replacement. Temporary number still works while waiting.

Q: Can I choose which doctor I want? A: You're assigned a GP based on your address. You can request a change at your health center if you have good reason.

Q: Is dental care covered? A: Very limited. Only emergency extractions and some surgical procedures. Most dental care requires private insurance or out-of-pocket.

Q: Do I need health card for prescriptions? A: Yes, to get subsidized prices. Without card, you pay full price (can be 3-10x more expensive).

Next Steps

Register on Padrón First

You can't get health card without padrón. Start here.

Find Your Health Center

Locate your assigned centro de salud:

• Madrid health centers: https://www.comunidad.madrid/servicios/salud
• Barcelona health centers: https://catsalut.gencat.cat
• Valencia health centers: https://www.san.gva.es

If You Don't Qualify: Get Private Insurance

Compare private health insurance options with English-speaking providers.

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This guide was last updated in January 2025. Health card procedures can vary by autonomous community. Always verify current requirements with your local health center.