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HEALTH

How to apply for a public health card in Spain

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

How to apply for a public health card in Spain
Not everyone who lives in Spain can gain access to public healthcare in the country. (Photo by HANNAH MCKAY / POOL / AFP)

Spain has the seventh best public healthcare system in the world according to the World Health Organisation (2021 rankings).

With primary healthcare services available within a 15-minute radius from where most people live and an average of 8 to 9 percent of annual GDP expenditure on healthcare, the public’s opinion of Spanish healthcare is generally very high, although long waiting times and a lack of healthcare personnel have slightly tarnished this reputation in recent years. 

If you’re thinking of moving to Spain or want to have an alternative to private healthcare,  you may be considering if you can have access to Spain’s public healthcare, and if so, what the process involves.

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 other ways. Here’s a list of those who can access la sanidad pública.

  • 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 applying for your card in some of the most popular regions for foreigners. 

Catalonia

In order to register for your TSI public health card in Catalonia, you usually need to go to your local CAP (Centre d’Atenció Primaria) primary healthcare centre 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, green residency certificate or TIE and your padrón certificate.

During the pandemic, Catalonia made it much easier to apply for your TSI card and now allows you to apply for it online. You will need digital copies of your green residency certificate, TIE or residence card, your padrón 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 TSI card will be sent to you in the post later and could take up to a month to arrive.

The new design of Catalonia’s Catsalut health card

Valencia region

In the Valencian community 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.

The SIP, the public health card in Spain’s Valencia region.

Madrid

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 the post to your home address.

Madrid’s public health card

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.

Andalusia 

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 green residency document or TIE, the social security DAD certificate that Madrid also requires, and your padrón certificate. 

You can find out more about the process here

Andalucía’s public health card

Balearics

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

The Balearic Islands’ public health card

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, social security documents and padrón and your health clinic will let you know if they need any other documentation.

The Canary Islands’ public health card

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

Most regions will have a similar or slightly different to the regions mentioned above. Make sure to get into contact with your local health centre to ask about what you need to bring along when you register. 

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HEALTH

What is the average waiting time across Spain to see a doctor?

Find out the average amount of time you'll have to wait to see your GP, a specialist and get a non-urgent surgery in your region of Spain.

What is the average waiting time across Spain to see a doctor?

Where you live in Spain greatly affects the amount of time you’ll have to wait, from the first appointment with your family doctor to seeing a specialist and even through to an operation, if you need one. 

Two and half years after the beginning of the Covid-19 pandemic, which almost brought the country’s clinics and hospitals to breaking point, how is the situation now?

Here are the average waiting times in each region of the country, with data published by the regional health authorities. 

Andalusia
In Andalusia, the average wait time to see a doctor is four days. To see a specialist such as a dermatologist or a cardiologist, however, you will be waiting three months. Wait times for non-urgent surgeries vary depending on what you need. 

Aragón
Those living in Aragón will typically be able to get a doctor’s appointment within three days, but to see a specialist, it is one of the worst regions in the country, with an average waiting time of four months.

Asturias
The latest waiting times to see a doctor or a specialist in Asturias have not yet been published, but if you need a special test such as an MRI, you will be waiting more than three months.

Balearic Islands
In the Balearics, the average waiting time for an appointment to see your GP is one week, while if you need to see a specialist, you will be waiting around two months. For a non-urgent surgery, you will be on the waiting list for an average of four and a half months. The Balearic Islands are one of the worst places if you need a diagnostic test though with an average wait of more than six months. 

Basque Country
Data from the Basque Country has so far not been made available. 

Canary Islands
Like in Aragón, the Canary Islands is one of the worst places to live if you need to see a specialist with the longest waiting time of more than four months.

Cantabria
Cantabria has so far not updated its data on waiting times to see a specialist, but if you need a non-urgent surgery it has one of the longest waiting times at six months.

Castilla-La-Mancha
Those in Castilla-La-Mancha have one of the shortest wait times to see a GP, being able to book an appointment within just 48 hours. They’ll have to wait longer to see a specialist, however, with an average wait of two months. Those waiting for non-urgent surgery will be waiting another four months.

Castilla y León
In Castilla y León you’ll wait an average of six days before being given an appointment and two months to see a specialist.

Catalonia
Residents of Spain’s northeastern region wait an average of five days in order to get a doctor’s appointment. For diagnostic tests, the wait time depends on what you need. You will be on the list for five months on average for a colonoscopy and two months for an MRI.

If you need to see a specialist again it will completely depend on what type of specialist you need to see. For example, if you need to see a urologist you’ll have to wait five months, but if you need to see a neurologist you’ll be able to get an appointment in less than three months. If your doctor thinks you require non-urgent surgery, you will need to wait another four and half months.

Extremadura
In Extremadura, you’ll have to wait an average of four days for an appointment, while the waiting time to see a specialist will be around two months. Like Cantabria, Extremadura is one of the worst places to live if you need non-urgent surgery, as you’ll be waiting around half a year.

Galicia
Those in Galicia will be able to see a doctor in just three days, however, they have not published recent data on the wait time to see a specialist. They have however published data for non-urgent surgery which is an average wait of three months.

Madrid
Like in Galicia, in Madrid the waiting time for an appointment is just three days, but two months to see a specialist. For a test like an ultrasound or a CT scan, you will be waiting two months. If you need a non-urgent surgery, you’ll be on the waitlist for a further three months.

Murcia
The average wait time to see your GP has not been made available yet, but like in Andalusia, you’ll be waiting more than three months if you need to see a specialist. It’s one of the best regions for wait times for diagnostic tests though as you will be waiting less than one month. 

Navarre
Navarre has one of the shortest wait times for an appointment, available in just 48 hours. If you need to see a specialist, you’ll be waiting a further two months. Those waiting for a non-urgent surgery will have to wait an average of three months.  

La Rioja
Along with Castilla-La Mancha and Navarre, La Rioja has the shortest wait time to get a doctor’s appointment. Here, you’ll be able to see your GP in just 48 hours. This region is also the best to live in if you need to see a specialist or get a specialised test, with a wait of less than one month. If you need non-urgent surgery though it’s not so good, as you’ll be waiting an average of four months.

Valencia
Those living in Valencia have the longest wait out of all the regions for an appointment, where you’ll wait more than a month just to see a GP. When it comes to seeing a specialist you’ll need to wait another three months. And if you need surgery, you will have to wait four and half months on top of that.

The types of non-urgent surgeries the data refers to are hip and knee replacements. For other types of surgeries, it will depend on how urgent it is and what type of surgery it is. At the beginning of the year, there were more than 706,000 people waiting for an operation in Spain, according to data from the Ministry of Health.

You should be aware, however, that official data doesn’t always represent reality. Some readers have told us that currently, they are having to wait a month to see their GP in Catalonia and seven months to see a specialist.

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