The healthcare system in Spain is one of the most advanced in Europe and, most importantly, one that provides universal care for its citizens and residents. There are some important things to understand about this system to grasp its functionality and benefits fully. Central to this system is the concept of the Tarjeta Sanitaria Indivisual-TSI, commonly referred to as the Health Insurance Card.
This card is the gateway to Spain’s comprehensive healthcare services, offering access to medical consultations, specialist appointments, hospital care, and even prescription medications. Whether you’re a Spanish national, a legal resident, or a foreigner meeting specific criteria, the Tarjeta Sanitaria ensures equitable healthcare access.
What Is Tarjeta Sanitaria (Health Insurance Card) in Spain?
The Tarjeta Sanitaria Individual-TSI or Health Insurance Card, in English, is a health card that is issued to everyone in Spain who are eligible for public health insurance provided by the National Health System in the country, known as the Sistema Nacional de Salud (SNS). The card is issued by the health department in each Autonomous Community* in Spain, so the responsible body may differ depending on where you live.
Once it’s verified that you are eligible for public insurance, you will receive this insurance card which serves as an official identification and access document for Spain’s comprehensive healthcare services. You must bring this card with you whenever you see a physician in a public facility, as this will streamline the process of visiting a doctor and show you are a recipient of public health insurance.
*Autonomous Communities in Spain are self-governing regions with their own rules and management; there are currently 17 Autonomous Communities.
Who Is Eligible for a Tarjeta Sanitaria (Health Insurance Card) in Spain?
Anyone who is eligible for the National Healthcare System (Sistema Nacional de Salud) in Spain is eligible for a health insurance card— this usually includes the following:
- All Spanish citizens.
- All foreign residents who are employed in Spain.
- Retirees who receive state pension.
- Anyone contributing to the Social Security System (Sistema de Seguridad Social) in Spain.
How to Apply for a Spain Tarjeta Sanitaria (Health Insurance Card)?
The application process for a Tarjeta Sanitaria may differ based on which region you’re living in Spain, but it usually includes the following steps:
- Obtain a Social Security Number.
- Find a healthcare centre near you.
- Prepare the required documents.
- Submit your application.
Obtain a Social Security Number
You cannot apply for health insurance care in Spain without having a social security number (Número de Seguridad Social). In most cases, you obtain this from your employer if you’re a foreign employee. But if, for whatever reason, you still do not have your social security number or are self-employed, you must apply for it yourself.
You can do this by visiting a Social Security Office (Tesorería General de la Seguridad Social) in your area of residence and submitting a number of required documents. For more detailed information, make sure to contact the nearest social office in your area.
Locate a Health Center
Once you have secured your social security number, you can initiate the application for your health insurance card. The first step in this application is to find out where you must submit your request. There are several local health centres that correspond to your area of residence, and each is available on the local website of your Autonomous Community, e.g., for Andalusia, Catalonia, Madrid, etc.
You can try to find a corresponding healthcare centre in your area here, but both methods of research are in Spanish only, and it still would be easier for you to search via your Autonomous Community.
Prepare the Required Documents
You need to prepare a number of important documents when you apply for your health insurance card for the first time. The required documents may differ based on your locality but usually include the following:
- Complete the application form (which you can usually find at the health centre).
- Your ID.
- A document proving your right to public health insurance in Spain.
- Proof of residence in the country.
- Proof of immigration status in Spain (your residence permit or registration certificate).
Please note that you can check here whether you can retrieve the document proving your right to health insurance in Spain.
Submit Your Application
Then, you have to submit your application to the proper authorities and wait while your health card request is processed. If it is, the card will be sent to your local healthcare centre from where you applied, and you must pick it up in person in most cases. Some regions may send it to you by post, so verify it with the administration.
Can I Apply Online for a Tarjeta Sanitaria?
You can apply online for a Tarjeta Sanitaria (health insurance card) in some specific Autonomous Communities. In others, you have to apply in person, and online applications may be available only if you need to apply for a new card in case yours is damaged, stolen, or expired.
This may be the case because for online applications, you must already have a digital ID in the system, and for first-time applicants, it may not be possible. Please make sure to contact your nearest health office to ask them whether an online application is possible for your area.
How Much Is the Fee for a Tarjeta Sanitaria in Spain?
The application for a Tarjeta Sanitaria (health insurance card) in Spain is free of charge. Please note that the application for a new card (in case of damage, loss or theft) may cost you a small fee— usually around EUR 3, but it may change depending on your residence area.
Does a Tarjeta Sanitaria (Health Insurance Card) Ever Expire?
Older cards issued before 2017 may have an expiration date. But, newer versions of the card do not expire and are valid indefinitely. You may be required to obtain a new card if it gets damaged, lost or stolen.
However, as a foreigner, you may be staying in the country for a limited period, and the validity of your health insurance card may be linked to the validity of your visa and temporary residence.
Why Do I Need a TSI in Spain?
You need a Tarjeta Sanitaria Individual (health insurance card) in Spain for several important reasons:
- Access to digital medical records. The health card allows you to access your digital medical records. This provides you with a convenient way to review your medical history, test results, and treatment plans, enhancing your involvement in your healthcare decisions.
- Electronic prescription. With the card, you can benefit from electronic prescriptions. This means you can collect prescribed medications directly from the pharmacy without needing a printed prescription. It streamlines the process and reduces paper waste.
- Identification in health centres and hospitals. The health card serves as your official identification within the Spanish healthcare system. It ensures that you’re accurately recognized when you visit health centres or hospitals, helping streamline administrative processes.
- Centralized clinical information. Health professionals can access your clinical information through the centralized system linked to your health card. This makes it easier for doctors and medical staff to provide you with well-informed and coordinated care.
- Virtual office services. Your health card enables you to access the services offered through the Virtual Office of the Ministry of Health and Consumption. This online platform likely provides various healthcare-related resources and tools for your convenience.
Can I Have Access to Healthcare Without a Tarjeta Sanitaria?
If you don’t have a Tarjeta Sanitaria (health insurance card) in Spain, you can still get medical help. It usually just means that you can’t use the public health insurance system. You can still receive care in any facility, public or private, but you cover the costs alone.
If you do visit a private care provider and you have private insurance, your insurance will most likely cover your expenses. But in this case, you may need to possess a private insurance card which your company issues.
Can I Include My Family Members in My Tarjeta Sanitaria?
You can include your family members as recipients of public health insurance, but not in your Tarjeta Sanitaria. Each family member must have their own individual card, which contains their own personal data and medical information. Please note that the information and data that is on the card are non-transferable.
What if I Lose My Tarjeta Sanitaria (Health Insurance Card)?
If you lose your health insurance card, it gets damaged or stolen; you can request a new one same as applying for your card the first time. However, in this case, since you’re already registered in the system, you may request a new card online without having to visit a local health centre in person.
What if I’m an Asylum Seeker or a Refugee in Spain?
If you’re an asylum seeker or a refugee in Spain, you are not eligible for a Tarjeta Sanitaria. However, this does not mean you are not eligible for healthcare services. It just means that you might access healthcare through a different process. As an asylum seeker or refugee in Spain, your healthcare access is typically governed by specific provisions to ensure your basic health needs are met.
But ultimately, you can only receive a Tarjeta Sanitaria if you are considered a legal resident in the country.
What Is the Difference Between a Tarjeta Sanitaria (TSI) and a Tarjeta Sanitaria Europa (TSE)?
While both are health insurance cards, there is a significant difference between the two:
- TSI. – The Tarjeta Sanitaria Individual is specific to Spain and is issued to individuals who are eligible for public health insurance provided by the Spanish National Health System (Sistema Nacional de Salud – SNS).
- TSE. – The Tarjeta Sanitaria Europea (European Health Insurance Card), often referred to as the EHIC card, is a document that allows European Union (EU) citizens to access necessary healthcare services during temporary stays in other EU member states, as well as in a few additional countries like Norway, Iceland, Liechtenstein, and Switzerland. In this case, it allows Spanish citizens to access health care in other EU countries.
Do I Need a Tarjeta Sanitaria if I’m an EU/EEA Citizen?
If you are an EU/EEA citizen and living only temporarily in Spain, your EHIC is all you need to access necessary medical care during your stay. But if you are moving to Spain for long-term residence, you need to register as a resident, sign up for the public health insurance system and obtain a Tarjeta Sanitaria.