How to apply for a public health card in Spain

Here's everything you need to know about registering with Spain's public health care service and the steps to apply for a health card in different regions in Spain.

How to apply for a public health card in Spain
Image: valelopardo/Pixabay

Spain has a good public health care system with primary healthcare services available within a 15-minute radius from where you live, in most of the country. Spain spends an average of 8-9 percent of its GDP on healthcare.

Who is eligible for public healthcare in Spain?

In order to qualify for healthcare in Spain, you have to be paying into the social security system or be eligible through one of a few certain ways. Here’s a list of those who can access it.

  • Pensioners resident in Spain, including those from a country that has a mutual agreement. This includes all countries in the European Economic Area (EEA). They must also have a permanent residence certificate.
  • Employees and autónomos (self-employed) workers registered with social security and paying into the system.
  • Residents who get certain social security benefits in Spain.
  • Those who previously registered for social security payments, but whose entitlement has now expired.
  • Those whose spouse pays into the social security system.
  • Children and other dependents of those paying into the social security system.
  • Those recently divorced or separated from a partner who is registered with social security and paying in. 

When you register for public healthcare in Spain you will receive a Tarjeta Sanitaria Individual or TSI card. As the name suggests, these are individual cards for each person. Children also get their own.

How do I apply for a public heath card?

Each of Spain’s autonomous communities has its own healthcare system and applying for your health card (often called TSI) varies slightly depending on where you live. Here’s what you need to know about apply for your card in some of the most popular regions for foreigners. 


In Catalonia, your public health card is known as a CAP card (Centre d’Atenció Primaria). In order to register, you usually need to go to your local CAP clinic and fill out an application form. You will also have to take several documents with you including your social security certificate, your green residency certificate, NIE or TIE and your padrón certificate.

During the pandemic, Catalonia has made it much easier to apply for your CAP card and now allows you to apply for it online. You will need digital copies of your NIE, TIE or residence card, your empadronamiento certificate and your social security certificate (given to you when you register with social security) to upload. If you don’t have these, you can authorise CATSALUT to look into your information and verify these documents online. You can apply for it here

Once this has all been processed, you will be assigned a doctor and can make an appointment from that moment onwards. Your CAP card will be sent to you in the post later and could take up to a month to arrive.


In Valencia your health card is known as a SIP card. All the information about the SIP cards can be found here

You can get one by going to your local health centre and applying there. You will need to take the necessary documentation such as your social security certificate, your green residency certificate or TIE and your padrón certificate.


In Madrid, you can apply for your TSI card either in person or online, if you have a digital certificate.

You will need to show your residency card, TIE or DNI, your padrón certificate and a Document Accrediting you to the Right of Health Assistance called the DAD. This is issued by the Social Security office and shows whether you’re recorded as a worker, self-employed, pensioner or beneficiary. You can apply for the DAD certificate here

Those with a digital certificate can apply through this link which will allow you to attach the documentation you need.

Whichever way you apply, you will receive your physical card in post to your home address.

The Madrid region has also recently introduced a virtual health card, which you can get after you have applied for the physical one. This will allow you to make appointments and access your test results , You can download it here

Once downloaded, you can go to your local health centre in order to activate it via a QR code and a pin number. You can also activate it from home by calling the phone number on the app. Someone will then give you the activation code.


In Andalusia, you can only apply for your health card in person at your local healthcare centre. You can only renew it online or request a new one if you’ve lost it. You must take with you originals and photocopies of your NIE or TIE, the social security DAD certificate that Madrid also requires, and your padrón certificate. 

You can find out more about the process here


In the Balearic Islands, the healthcare system is known as IB-SALUT. There are three ways to apply for your health card on the islands, these include by phone, in person at your local health clinic and online using your digital certificate or [email protected].

You will need your NIE or TIE and a recent colour photograph of yourself. IB-SALUT will then check your padrón and social security status for you and send you your card in the post. You can find all the information here

Canary Islands

In the Canary Islands you can only apply for your TSI card in person at your local health centre. Remember to take all the necessary identity documents with you such as NIE, TIE or residency certificate and your health clinic will let you know if they need any other documentation.

READ ALSO: TSE card: How to get a Spanish European Health Insurance card

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Toxic gas fears as Canary Islands volcano lava nears sea

A vast river of molten lava from a Canary Islands volcano was edging towards the sea on Tuesday, destroying everything in its path and provoking fears it will generate clouds of toxic gases when it hits the water.

Toxic gas fears as Canary Islands volcano lava nears sea
Toxic gas fears as Canary Islands volcano lava nears sea. Photo: DESIREE MARTIN / AFP

A new fissure emerged on the slopes of the Cumbre Vieja volcano overnight, belching out more lava and forcing hundreds more people to flee their homes.

“The lava flow is moving inexorably towards the sea and absolutely nothing can be done about it,” said Ángel Víctor Torres, regional head of the Canary Islands.

“We are completely powerless in the face of this advancing lava flow which is moving at 200 metres (655 feet) per hour and has already swept away everything in its path… and will continue to do so on its way to the sea.”

Located on La Palma island, the volcano has forced 6,100 people from their homes and destroyed a large number of properties and land spanning a huge area since it erupted on Sunday afternoon, say island officials.

So far, it had destroyed 185 buildings, of which 63 were homes, regional authorities added.

READ ALSO: Canary islanders flee as volcano vents its fury

Toxic cloud

The volcano straddles a southern ridge in La Palma, one of seven islands that make up the Atlantic archipelago which lies off the coast of Morocco.

When the molten lava reaches the sea, experts warn it will send clouds of toxic gas into the air and will also affect the marine environment. The authorities have set up a no-go zone to head off curious onlookers.

“The clouds created by the interaction of seawater and lava are acidic” and “can be dangerous if you are too close,” volcanology expert Patrick Allard from the Paris Globe Institute of Physics told AFP.

By Tuesday afternoon, the lava had slowed to around 200 metres per hour although it was not clear exactly when the white-hot mass of molten rock, which has a temperature of nearly 1,000 degrees Celsius (1,830 degrees Fahrenheit), would reach the sea.

Although it is currently located about two kilometres (1.2 miles) from the shore, experts say its speed can be “very variable”.

“It is very, very important not to forget that the emergency is ongoing, that the volcano is still active and we must avoid getting close to both the lava and the volcano itself,” said Spanish Prime Minister Pedro Sánchez.

Smoke rises from cooling lava after the Cumbre Vieja volcano erupted on the Canary Island of La Palma on Sunday. Photo: JOSE MARIA MONTESDEOCA / AFP

‘We’ve lost everything’

Overnight, long lines of cars could be seen waiting to leave the area as police sirens wailed, the fiery glow of the erupting volcano lighting up the dark skies.

“You have practically your whole life there… then one day the volcano decides to erupt and puts an end to it all,” evacuee Israel Castro Hernández told AFPTV late Monday after his home was destroyed by the wall of lava.

“We keep looking over there and we just can’t believe it: we keep thinking that our house is underneath that volcano,” said his wife, Yurena Torres Abreu.

The pair were among 500 people evacuated overnight after the new fissure emerged following an earthquake with a magnitude of 4.1 at 9:32 pm, the Involcan volcanology institute said.

“So many friends have lost everything,” said Yurena’s sister, Elizabeth Torres Abreu, who also lost her house.

“They left their homes as we did with just the clothes on their back and little else. They’ve left their entire life there.”

Although the eruption has not caused any casualties, the damage to land and property has been enormous, with Torres estimating the figures to be well over €400 million. 

Volcanologist Stavros Meletlidis from Spain’s National Geographic Institute told Spain’s RNE radio it was not clear when the lava would reach the sea.

“It can accelerate very quickly, especially when the topography changes… or it can stop on a plain for several hours,” he said.

Although the Cumbre Vieja is shooting up vast plumes of thick black smoke several hundred metres into the sky and between 8,000 and 10,500 tonnes of sulphur dioxide per day, the airspace over La Palma has remained open.