Spain’s Tarjeta Sanitaria Individual

Spain offers high-quality, universal healthcare that is mainly paid for by taxpayers.

This means that Spain’s national health system (Sistema Nacional de Salud or SNS) offers healthcare coverage for all its residents.

While Spain’s residents receive free healthcare at point of delivery, opting out of Spain’s public healthcare (asistencia sanitaria pública) is not allowed.

If you’ll be residing in Spain, receiving such care is possible, but first you’ll need a Tarjeta Sanitaria Individual (TSI) or, more commonly, a Health Insurance Card.

Spain’s Tarjeta Sanitaria Individual

The TSI is a crucial component for receiving healthcare services such as hospital care, prescriptions, specialist appointments, and more.

It’s a card specific to Spain and any eligible individuals looking to seek care within the SNS.

The card itself serves as an ID document that allows citizens to receive health services — it is issued by each Autonomous Community’s health department.

Holding a TSI means you’ll be able to receive the same standard of access to healthcare that Spanish nationals and legal residents receive.

Private and Public Healthcare in Spain

Spain’s public healthcare system is managed by the 17 autonomous communities throughout the country.

This includes communities like Andalusia, Basque Country, Catalonia, Madrid, and more.

Regional adaptations allow the healthcare system to work more efficiently in order to provide care for everyone.

A majority of Spain’s citizens receive care under the SNS, but private insurance (seguro de salud privado) is also offered for those who prefer a wider range of provider choices.

Some choose to supplement their already existing coverage with private insurance.

For those who choose private care, monthly payments or insurance premiums are made to private providers.

Health Insurance in Spain

Who exactly receives access to the free national health system in Spain? Well, just about everyone!

A quick list of those who can receive free healthcare is made up of the following:

• Residents of Spain
• Salaried workers
• Self-employed workers
• Children
• Spouses
• Students 26 years of age and under
• Retired Spanish residents
• EU Nationals

If you fall into one of those categories, obtaining health insurance in Spain starts with the simple step of obtaining your TSI.

How to Get a Tarjeta Sanitaria Individual

Luckily, applying for a TSI is fairly straightforward!

You can complete the process after receiving a Spanish social security number or receiving your NIE (for non-Spanish citizens).

As you need to be registered as a legal Spanish resident to have access to healthcare, the NIE allows non-Spanish citizens to access the social security system, which then grants access to the public healthcare system.

Once you have your NIE, you’ll want to download a certificate from the Social Security e-Office.

You’ll navigate to the healthcare section to select “Consultation of the right and issuing of the supporting document”.

This section will allow you download the correct documentation showing that you have the right to obtain healthcare in Spain.

To apply, you’ll simply need a valid ID.

Health Insurance in Spain — Next Steps

Once you’ve received your certificate stating that you’re entitled to healthcare in Spain, you’ll apply for an actual Spanish health care card.

Some autonomous communities do allow applications to be submitted online, but you must already have your identification information in the system.

For first-time applicants, or applicants from abroad, this method might not be possible.

Conversely, applications can always be completed at the primary healthcare center local to you.

While there, you’ll need to bring four pieces of documentation:

• Valid ID and NIE
• Proof of registration
• Proof of residency
• Healthcare certificate

For EU and EEA citizens, showing proof of residency can be completed through something called a Certificado de Registro de Ciudadano de la Unión Europea.

This document can only be obtained in Spain and acts as residency proof.

A Certificado is necessary for EU/EEA citizens who will be staying in Spain for any period of time longer than 3 months.

Upon completion of your application, your Spanish healthcare card will be sent to whatever address you put on file within two to three weeks.

Voilà! You’re now entitled to use the public health services in Spain.

Validity of the Tarjeta Sanitaria Individual

If you’ve received a new version of the card from 2017 and beyond, your card is valid indefinitely.

For foreigners or remote workers, the length of time your tarjeta sanitaria could be valid for may be tied to your residence or visa.

For example, if you’re studying in Spain with a 6-month student visa, your TSI retains validity through that 6-month period.

Health Card in Spain

What kind of care does the Spanish health card provide access to?

Upon receipt of your health card, you can register with doctors or health centers in your area.

There are various kinds of health centers staffed by teams including:

• Nurses
• Pediatricians
• Family doctors
• Gynecologists

The card covers various medical services free of charge, such as preventative check-ups or hospital care.

With your Spanish healthcare card, you can obtain access to digital medical records, use it as ID during visits to hospitals, and access virtual office services.

The card also gives you access to ambulance services, or you can head straight to an ER (urgencias) or hospital (hospitales).

You can also use your Spanish healthcare card to purchase prescriptions at any Spanish pharmacy.

Pharmacies in Spain

Prescribed or over the counter medications can be picked up at any pharmacy (farmacia) throughout Spain.

Spanish pharmacies might look a little different than the pharmacies you’re used to in your own home country but will generally provide what you’re looking for.

Many Spanish pharmacies provide the basic necessities like medication, hygiene products, and beauty products.

As they’re considered part of the healthcare system, pharmacies in Spain are government regulated, which means they’re subject to strict medication distribution rules.

Spanish pharmacies are often easy to spot as they’re often lit by a neon green cross – some are even open 24/7!

Items to Note About Health Insurance in Spain

With nearly 49 million citizens to care for, the Spanish healthcare system remains a busy service for residents of Spain.

Due to this, wait times might be slightly longer for treatments or specialized services.

The ability to choose any doctor or specialist also narrows slightly when using public healthcare.

However, the free and low-cost healthcare afforded to all covers everything you might need to receive care. From family doctors, to pediatricians, and specialist visits in-between, health insurance in Spain comes with plenty of perks.

Citizens have access to a large network of health centers, hospitals, and emergency rooms.

Not to mention, the tarjeta sanitaria is free to all applicants!

Ready to Get Your Tarjeta Sanitaria Individual?

If you have any lingering questions about the TSI, or healthcare in Spain in general, additional information can also be found at the Ministry of Health website.

You’re also welcome to contact us here at Go! Go! España with any questions you might have.

We’d be happy to help walk you through the process of obtaining your Tarjeta Sanitaria Individual.

After you’ve read through the steps needed for a TSI, we can also help you with checklist items like obtaining your residence card, finding a job in Spain, and more.

We’re here to help walk you through all of the documentation needed to make the move to Spain just a little bit easier so you can fully enjoy your time upon arrival!

---