Application for recognition of the right to access public healthcare

What do you need to know?

Carrying out this procedure produces a certificate verifying the status of insured person or beneficiary of public health care.

Once you have had this entitlement recognised, you will be able to request an individual healthcare card (TSI). You will therefore be able to access not just medical services but also pharmaceutical provisions at discounted prices, regardless of whether you have a private insurance policy.

Who does it apply to?

This procedure is aimed at:

• Foreign nationals hired in Spain who wish to access the Spanish Social Security's healthcare system for the first time. Official recognition is given for individuals registered with the Social Security System.
• Anyone wishing to include a beneficiary of an insured person.
• Anyone wishing to request a change of beneficiaries from one insured person to another.
• Other cases

In the case of workers, pensioners or recipients of Social Security benefits, the Entitlement is officially recognised by the National Institute of Social Security (INSS).

What requirements must be met?

The following requirements must be met for insured person status:

• Being registered or in an equivalent position (employed workers, self-employed individuals, Social Security pensioners or beneficiaries of social security or unemployment benefits and signatories to a special covenant with Social Security)
• Being legally resident in Spain and not having mandatory healthcare coverage through another channel.
• Minors who are wards of the Authorities are also entitled.

In order to be a beneficiary, the following requirements must be met:

• Not having the status of a beneficiary of Spanish healthcare benefits.
• Having authorised and actual residence in Spain.
• Being a spouse, unmarried partner, child, grandchild, ward or sibling of the insured person. In the case of children, grandchildren and siblings over the age of 26, a recognised disability at a level equal to or above 65%. Ex-spouses are also entitled, provided they verify their right to maintenance.
• Cohabiting with and being financially dependent on the insured person.
• Not otherwise being entitled to healthcare.

How long is it valid for?

It does not expire for as long as the conditions required to be an insured individual or a beneficiary of the right are met or until the death of the individual.

You can apply at any time.

It should be noted that entitlement to healthcare, not just for insured persons but also for the beneficiaries in their care, begins on the day of registration with the Social Security System and becomes effective on the day following the date of submission of registration with the corresponding system. It starts, in all other cases, on the date stated in the decision granting recognition of the entitlement.

What do you need to do?

It should preferably be made online through the Social Security e-Office. Applicants also have the possibility of requesting an appointment with the INSS to carry out the formality in person.

The procedure varies according to whether your status is that of worker, pensioner or beneficiary of Social Security benefits or you fall within other cases. It will also depend on whether or not you have a Spanish national identity document (DNI) or identity number for foreign nationals (NIE) and a digital certificate or not.

What steps must you follow?

The following instructions are intended for individuals who are registered with Social Security or in an equivalent position (workers, pensioners or beneficiaries of Social Security benefits). Recognition of entitlement to health care for these individuals becomes effective on the day following their registration.

ONLINE WITH DIGITAL CERTIFICATE

STEP 1: Go to the Social Security e-Office

• Access the Social Security e-Office.
• Select the option "Citizen > Healthcare > Healthcare. Application for recognition of entitlement (as insured person)” so you can start the application.
• Select the desired identification method. Select the option “DNI or certificate”.
• Once the identification method has been selected, the portal “Tu Seguridad Social” will open.

STEP 2: Download your healthcare entitlement certificate

• Once you access the portal “Tu Seguridad Social”, you will see a start page with your employment information.
• You will see a section entitled “Healthcare” which will state, if you have registered status or an equivalent position, that you are entitled to healthcare and the insured group, where appropriate (insured person or beneficiary).
• Select “Download Certificate”. Downloads are automatic.

STEP 3: Include a new beneficiary (where necessary)

• The “Healthcare” will let you add beneficiaries in “Add new beneficiary”.
• You will be able to include your beneficiaries
• You will be able to automatically download the insured person and beneficiaries certificate in “Insured person and beneficiaries certificate”.

STEP 4: Apply for the individual healthcare card

• Once you have obtained recognition of your right to access public healthcare, you can apply for your individual healthcare card (TSI).
• In order to find out about the procedure for obtaining the card, consult the information on the formality, which contains all the details on how to obtain it.

ONLINE WITHOUT DIGITAL CERTIFICATE

STEP 1: Go to the Social Security e-Office

• You can only perform this procedure if you have a DNI or NIE. (You cannot access this procedure with a passport). You will be asked to upload a photo of the identity document containing your DNI number or NIE.
• Go to the Social Security e-Office and select the option “Citizens > Healthcare > Application  WITHOUT certificate for Social Security benefit procedure (National Social Security Institute)”.
• Once inside, select “Recognition of entitlement to healthcare and management of beneficiaries > Apply”
• Include all the data that are requested, verify you email address and enter the code you will have received via email. You will be asked to identify yourself through a photo with your ID and with the front and back of your ID.
• Take a photo, following the instructions, and add a photo featuring both sides of your DNI or NIE.
• Select the option you want. If you want to include a beneficiary, select “healthcare application for the insured person’s beneficiaries”.
• Include the data and documents requested.

STEP 2: Apply for the individual healthcare card (TSI)

• Once you have obtained the application for recognition of entitlement to healthcare, you can apply for your individual healthcare card.
• To find out about the procedure for obtaining the card, go to information on the procedure, which provides full details.

IN PERSON

STEP 1: Request an appointment

• To request recognition of entitlement to healthcare in person, you will need to request an appointment for submitting your documents at the social security centre.  
• To arrange an appointment, you will need to go to the Social Security e-Office (“Citizens > Appointment for benefits and other services > Make appointment for pensions and other benefits (INSS). Without certificate”).

STEP 2: Go to the place indicated and hand over the documents

• Consult the webpage to find out which Social Security offices are available.
• Go to the place indicated in the appointment to hand over the documents.
• Hand over the official form duly completed, together with the requisite documents.

STEP 3: Obtain your healthcare entitlement certificate

• Once the procedure has started, the deadline for its decision and notification is 3 months, starting from the date of registration of the application. Nevertheless, the certificate may be issued on the spot.

STEP 4: Apply for the individual healthcare card (TSI)

• Once you have obtained the application for recognition of entitlement to healthcare, you can apply for your individual healthcare card.
• To find out about the procedure for obtaining the card, go to information on the procedure, which provides full details.

VERIFICATION OF ENTITLEMENT TO PUBLIC HEALTHCARE

If you wish to verify whether you are an insured person for or beneficiary of public healthcare:

• If you do not have a digital certificate, go to the Social Security e-Office > Citizen > Healthcare > Healthcare: Consultation of entitlement and issue of accrediting document (without certificate). Go to “Check entitlement to healthcare” and fill in all the data. Go to “See result of consultation” and enter the reference number assigned in the request to access the requested information.

• If you have a digital certificate, go to the portal “Tu Seguridad Social”. Here you will be able to find full information on your entitlement to healthcare, as well as the beneficiaries included, and download the insured person and beneficiaries certificate.

The result of the consultation will be available within a period of 30 days. Once that period has ended without any reply, a new application will have to be made.

Who can submit the application?

Applications can be made by citizens in person or through a representative.

As for beneficiaries, applications have to be submitted by insured persons on behalf of the individuals in their care.

What documentation is needed?

It is advisable to have prepared certain details and documents that may be required during the application.

Both the insured individuals and, where applicable, the beneficiaries for whom this application is being processed must submit the following documents:

• In the case of citizens of member states of the European Union (EU), the European Economic Area (EEA) or Switzerland: 
  • Identity document valid in your country or passport
  • Certificate of registration as an EU national
• In the case of family members from other countries of citizens of EU member states, the EEA or Switzerland: 
  • Identity document valid in your country or passport
  • Residence card for family members of EU nationals
• For other individuals who are not Spanish nationals: 
  • Valid passport.
  • Identity card for foreign nationals (TIE) providing evidence of authorisation to reside in Spain. If you are not required to obtain this card, you must present your authorisation to reside in Spain, stating the relevant identity number for foreign nationals (NIE).
• In case of spouses or unmarried partners: 
  • In the case of the spouse: 
    • Family register or marriage registration certificate.
  • In the case of the unmarried partner: 
    • A certificate of registration in the register of the autonomous community or locality of residence or proof of constitution of the partnership by means of a public deed.
• In the case of the ex-spouse or legally separated partner: 
  • Separation or divorce ruling.
  • Document recognising the right to receive compensatory maintenance.
• In the case of descendants: 
  • Family book or birth certificate to provide evidence of the relationship with the insured individual or his/her spouse, dependent ex-spouse or unmarried partner.
  • For children under three months of age, it is not necessary to present this documentation, since the Register Office will send the birth and social security registration data to the Spanish National Social Security Institute.
  • Descendants who are adopted or in the process of being adopted must obtain the supporting document confirming the adoption or start of the adoption process from the competent body in the Autonomous Region.
• In the case of beneficiaries or equivalent individuals over 26 years of age with a degree of disability equal to or greater than 65%: 
  • Certificate of recognition of the degree of disability.
• In the case of individuals under legal guardianship or in foster care: 
  • Document issued by the competent authority attesting to the status of the individual as a minor under the legal guardianship of the insured individual, his/her spouse, former dependent spouse or unmarried partner.
  • In the case of an adult placed under guardianship, a certificate from the City Council confirming cohabitation with the applicant.
• In the case of the brother or sister of the insured individual: 
  • Family register or equivalent document attesting to the status of the individual as the brother or sister of the insured individual.
• In the case of minors under public guardianship:
  • Administrative decision on declaration of abandonment.

How long does it take?

If you have done the online procedure set up for individuals registered with the Social Security System through the portal “Your Social Security”, you will automatically obtain the certificate of recognition of entitlement to healthcare and the inclusion of beneficiaries. In such cases, the entitlement is recognised starting from the day following the date of registration.

If you have made the request through any of the other channels in place, the deadline for the decision is three months starting from the date of submission.

What does it cost?

The application is free.

Want to know more?

Body responsible for the formality

National Social Security Institute (Government of Spain).

Further information

You can also consult the Application and procedures for Social Security benefits portal (available only in Spanish).

Important linked formalities

If you are a beneficiary of an insured individual, that individual must have obtained the social security number and registration in the system through the following steps:

• Obtaining a social security number (NUSS)
• Registration with the social security system

To complete the process online, you can use a digital certificate:

• Digital certificate

Once you have obtained the certificate of recognition of the right to access public healthcare, you will be able to apply for your individual healthcare card:

• Individual healthcare card (TSI)