Quick Overview
Spain offers free public healthcare if employed or paying social security. Register at your local Centro de Salud after getting your Social Security number from TGSS. Your SIP/health card arrives in 1-4 weeks. Self-employed pay €294+/month for social security which includes healthcare. Non-working residents can apply for Convenio Especial (€60-157/month). Private insurance costs €35-150/month and offers shorter waits and English-speaking doctors.
Key Facts
Public healthcare
Free if employed/paying social security
Health card processing
1-4 weeks after registration
Self-employed social security
€294+/month (includes healthcare)
Convenio Especial
€60-157/month for non-working residents
Private insurance
€35-150/month
Regional systems
CatSalut (Barcelona), SERMAS (Madrid), GVA Salut (Valencia)
How It Works
Healthcare Registration for Expats in Spain
Spain's public healthcare system (SNS - Sistema Nacional de Salud) provides excellent free care for those contributing to social security. If employed, your employer registers you automatically. Self-employed (autónomos) pay €294+/month which includes full healthcare. The process: (1) Get your Social Security number at TGSS office (bring NIE, passport, Form TA.1); (2) Register at your assigned Centro de Salud (health center) based on your address, bringing NIE, Padrón, SS number, and employment proof; (3) Receive temporary paper immediately, plastic health card (SIP/Tarjeta Sanitaria) mailed in 1-4 weeks. Each region has its own system: CatSalut in Catalonia, SERMAS in Madrid, GVA Salut in Valencia. Non-working residents can apply for Convenio Especial (€60-157/month) after 1 year residence. Many expats supplement with private insurance (€35-150/month) for shorter waits, English-speaking doctors, and dental coverage. Download your regional health app for appointment booking.
Registering for Spain's public healthcare system
Determine healthcare eligibility
Understand which system you qualify for.
Get Social Security number
Register at TGSS office to receive SS number.
Register at local health center (Centro de Salud)
Enroll for healthcare at your assigned center.
Receive health card (Tarjeta Sanitaria/SIP)
Wait for official health card to arrive by mail.
Consider private health insurance
Optional private insurance for faster service.
Apply for Convenio Especial (if non-working)
Special agreement for healthcare if you don't qualify otherwise.
Download regional health app
Install app for appointments and medical records.
Healthcare Registration for Expats Costs in Spain (2025)
Included in social security contributions
Required for public healthcare
Mailed within 1-4 weeks
Includes full healthcare coverage
For non-working residents after 1 year
Optional, varies by age and coverage
GP and specialist consultations
Heavily subsidized
Copay depends on plan
| Service | Cost | Notes |
|---|---|---|
| Public healthcare (employed) | Free | Included in social security contributions |
| Social security registration | Free | Required for public healthcare |
| Health card (SIP) | Free | Mailed within 1-4 weeks |
| Self-employed social security | €294+/month | Includes full healthcare coverage |
| Convenio Especial | €60-157/month | For non-working residents after 1 year |
| Private insurance | €35-150/month | Optional, varies by age and coverage |
| Doctor visits (public) | Free | GP and specialist consultations |
| Prescriptions (public) | €0-10 | Heavily subsidized |
| Doctor visits (private) | €0-50 | Copay depends on plan |
| Total estimate | Free if employed / €60-294+/month if self-employed or non-working | |
*Spain has excellent public healthcare that's free for workers. Private insurance is optional but popular for shorter waits. Prices current as of January 2025.
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