Get your health card (Tarjeta Sanitaria)
The Tarjeta Sanitaria Individual (TSI) is your access card to Spain's public healthcare system. It is free and entitles you to treatment at public health centres, hospitals, and specialists.
Official sources
The steps
- 1
Confirm your eligibility
Public healthcare in Spain is linked to social security contributions. If you are employed, your employer registers you. If you are autónomo, your contributions give you access. DNV holders need to either contribute to social security or hold private insurance that is accepted by the authorities. EU citizens living in Spain are entitled to register.
If you are not contributing to Spanish social security (e.g. you are a non-lucrative visa holder relying on private insurance), you will not receive a TSI. Your private insurance replaces it in that case. - 2
Get your empadronamiento certificate
You need a current volante de empadronamiento (address registration certificate) from your ayuntamiento. This confirms your residency in the municipality.
- 3
Register at your local health centre (centro de salud)
Go to the centro de salud nearest to your registered address. Ask to register as a new patient and apply for your TSI. The process is handled at the administrative desk (most centres do not require an appointment for this).
Time: 30 minutes
Documents needed
- Valid passport or residence card (TIE)
- NIE
- Empadronamiento certificate (volante de empadronamiento)
- Proof of social security affiliation (if applicable — your employer provides this, or the INSS if you are autónomo)
madrid: Madrid's health centres (centros de salud) are managed by Comunidad de Madrid. You are assigned to the centre for your address. Find your assigned centre at comunidad.madrid.barcelona: Catalonia's health system (CatSalut) assigns a primary care centre (CAP) to your address. Register at your assigned CAP.malaga: Andalusia's health system (SAS — Servicio Andaluz de Salud) manages health centres in Málaga. Register at the centre for your empadronamiento address. - 4
Receive your TSI card
You may receive a temporary certificate on the day, with the physical TSI card mailed to your address within a few weeks. Use the temporary certificate in the meantime.