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Expat Exchange - Enrolling in the Public Healthcare System in Spain
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Enrolling in the Public Healthcare System in Spain

By Betsy Burlingame

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Summary: A primer on how to enroll in the public healthcare system in Spain.

If you're planning to enroll in the public healthcare system in Spain, this article covers the requirements for foreigners to be able enroll in the public healthcare system, the steps involved and more.

Spain is renowned for its excellent public healthcare system, known as the Spanish National Health System (Sistema Nacional de Salud). This system is funded by taxes and provides free or low-cost healthcare services to all residents in Spain, including access to doctors, hospitals, and pharmacies. The World Health Organization ranks Spain's healthcare system as one of the best in the world, so you can expect high-quality care. It's mandatory for all residents, and the majority of people in Spain use this system.

Eligibility for the Spanish National Health System

As an international newcomer, you can access the Spanish National Health System if you meet one of the following criteria:

  • You are a resident in Spain and work in employment or self-employment and pay social security contributions.
  • You are a resident in Spain and receiving certain state benefits.
  • You are a resident in Spain and recently divorced or separated from a partner registered with social security.
  • You are a child resident in Spain.
  • You are a pregnant woman who is a resident in Spain.
  • You are under 26 and studying in Spain.
  • You are a state pensioner, or you are staying temporarily in Spain and have an EHIC card.

Enrolling in the Spanish National Health System

To enroll in the Spanish National Health System, follow these steps:

  1. Register with the social security system: You need to obtain a social security number, which you can do by visiting your nearest Tesorería General de la Seguridad Social (TGSS) office. You will need to bring your passport, NIE number (Número de Identificación de Extranjero), and proof of employment or unemployment.
  2. Obtain your health insurance card: Once you have your social security number, you can apply for a health insurance card (tarjeta sanitaria individual or TSI) at your local health center. You will need to bring your passport, NIE number, social security number, and proof of address.
  3. Choose a doctor: After obtaining your health insurance card, you can choose a doctor from your local health center. You can change your doctor at any time.

Private Health Insurance

While the public healthcare system in Spain is of high quality, some residents choose to supplement it with private health insurance. This can provide quicker access to specialists, shorter waiting times for procedures, and access to private hospitals. If you're an expat and not eligible for the public healthcare system, private health insurance is a must. Many companies offer policies designed specifically for expats, with coverage options ranging from basic to comprehensive.

Whether you choose to rely solely on the public healthcare system or supplement it with private insurance, it's important to understand your healthcare options in Spain. With the right preparation, you can ensure that you and your family have access to excellent healthcare services during your time in Spain.

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About the Author

Betsy Burlingame Betsy Burlingame is the Founder and President of Expat Exchange and is one of the Founders of Digital Nomad Exchange. She launched Expat Exchange in 1997 as her Master's thesis project at NYU. Prior to Expat Exchange, Betsy worked at AT&T in International and Mass Market Marketing. She graduated from Ohio Wesleyan University with a BA in International Business and German.

Some of Betsy's articles include 12 Best Places to Live in Portugal, 7 Best Places to Live in Panama and 12 Things to Know Before Moving to the Dominican Republic. Betsy loves to travel and spend time with her family. Connect with Betsy on LinkedIn.


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Plaza Mayor in Salamanca, Spain

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SJB Global is a top-rated financial advisory firm specializing in expat financial advice worldwide, offering retirement planning & tax-efficient solutions with a regressive fee model.
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