Application for recognition of the right to access public healthcare

What do you need to know?

It is a certificate attesting to a person’s status as insured individual or beneficiary of Spanish public healthcare for Spanish and foreign nationals living in the country.

VERY IMPORTANT:

There are people who, although they do not have the status of insured individuals, have the right to public healthcare. In order to have an individual healthcare card (TSI), which gives you access to the public healthcare system, you must apply for a certificate recognising your right to access public healthcare.

You can also access subsidised prescriptions, regardless of whether or not you have private insurance. Since it is considered one of the best public healthcare systems in the world, having access to it makes it all the more worthwhile.

There are countries with which agreements are in place in terms of healthcare and other benefits. This may be of particular interest to students. To find out your status, go to the offices of the Spanish National Social Security Institute (INSS).

Recognition of the right to access public healthcare must be requested by:

 

  • Individuals residing in Spain who are unable to access healthcare through another form of insurance (employees, self-employed individuals, pensioners, recipients of periodic social security benefits and unemployed individuals who have used up their unemployment benefit or subsidy).

 

  • Individuals who are the beneficiaries of an insured individual:
    • The spouse or unmarried partner of an insured individual.
    • Former spouse or legally separated partner. In both cases, he or she must be dependent on the insured individual and entitled to compulsory maintenance payments.
    • The descendant, or similar, of the insured individual or his or her spouse, or of his or her former dependent spouse or unmarried partner. In both cases, he or she must be dependent on the insured individual and be under 26 years of age or, if over that age, have a recognised disability to a degree greater than or equal to 65%.

 

It must also be used to request the transfer of beneficiaries from one insured individual to another.

Who does it apply to?

It applies to people who do not have the status of insured individual or beneficiary of social security. This group includes the following:

  • Those who are beneficiaries of an insured individual (spouse and children who are minors, for example).
  • Those wishing to request the transfer of beneficiaries from one insured individual to another.
  • Foreign nationals hired in Spain who wish to access the Spanish social security healthcare system for the first time.

What requirements must I meet?

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.
  • This requirement does not apply to individuals who move to Spain temporarily.

 

It is important to know that the right to access public healthcare, both for the insured individual and for his or her dependants, begins on the day that he or she registers with the social security system and is effective from the day following that on which the person is registered with the relevant system.

 

The right expires when the conditions required to be an insured individual or a beneficiary of the right are lost, or in the event of death.

 

Once the right to healthcare has become effective, you can request the issuance of the individual healthcare card to access healthcare.

 

The inclusion of false data and the fraudulent obtaining of benefits may constitute a criminal offence.

 

You should be aware that the application was initially designed to be submitted on paper to the Provincial Directorate of the Spanish National Social Security Institute (INSS), and, therefore, you may find references that do not relate to the electronic method.

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 and it is effective as of the day following submission of registration in the relevant system.

What do you need to do?

Due to the COVID-19 health crisis, the body responsible for this procedure is giving priority to online rather than in-person procedures, with the latter being used only in exceptional cases.

What steps must you follow?

ONLINE

STEP 1: The insured individual must obtain the social security number and registration
  • Before starting the application process, the insured individual giving the right to his or her dependants must have obtained a social security number and have applied for registration in the system.
  • In order to find out about the procedure for obtaining a social security number and the procedure for registering with the social security system, consult the information on those formalities, which contains all the details on how to obtain them.
 
STEP 2: Obtain the digital certificate
  • In order to apply online, you must first obtain a digital certificate.
  • To get information about the procedure for obtaining the digital certificate, access the information on the formality, where there is a description of all the details about how to obtain it.

 

STEP 3: Go to the website
  • Once you have obtained the digital certificate, you can use the Social Security website.
  • Select the option "Citizen > Healthcare > Healthcare. Application for recognition of the right to healthcare" in order to be able to start the application.
  • The information is available in English, French, Catalan, Spanish and other co-official languages of the Spanish state.

 

STEP 4: Fill in the standard application form and attach the required documentation
  • Once you have accessed the procedure on the website, follow the steps indicated and provide all the information and documentation requested.
  • You must obtain and fill in the application form, and attach a copy of the documents detailed in the instructions.
  • You must have software that allows you to complete the application and save it in order to attach it.
  • Consult the relevant Social Security website for more information and download the form that relates to you.
  • The information is available in English, French, Catalan, Spanish and other co-official languages of the Spanish state. The form, on the other hand, is available in Spanish.
  • It is advisable to have prepared certain details and documents that may be required during the application.
    • The log-in session is limited in time. Therefore, if it expires while you are completing the application, you will need to restart it and finish any steps you have pending.
    • The total size of the documentation to be attached cannot exceed 5 MB.

 

STEP 5: Obtain the certificate of recognition of the right to healthcare
  • Once the formality has been completed, you will receive an acknowledgement of receipt (ZIP) consisting of the receipt for the application in PDF format and the signature of the server, which guarantees that the transaction has been carried out correctly.
  • If you do not receive the confirmation message or, as the case may be, you receive an error or transmission failure message, you will have to submit the documentation later or by other means.
  • The Spanish National Social Security Institute will send the outcome of the request to the address of the interested party. The procedure, once initiated, must be decided and notified within thirty days of the date on which the application was registered. Where this period has elapsed without notification of the outcome being received, you can take it that your application has been rejected.

 

STEP 6: 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.
  • 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.

 

IN PERSON:

STEP 1: The insured individual must obtain the social security number and registration
  • Before starting the application process, the insured individual giving the right to his or her dependants must have obtained a social security number and have applied for registration in the system.
  • In order to find out about the procedure for obtaining a social security number and the procedure for registering with the social security system, consult the information on those formalities, which contains all the details on how to obtain them.

 

STEP 2: Request an appointment
  • In order to request recognition of the right to access public healthcare, it is advisable to make an appointment to present the documentation at the social security centre.  
  • To make an appointment, you must go to the Social Security website ("Citizens > Appointments for pensions and other benefits").
  • The website for making an appointment is available in English, French, Catalan, Spanish and other co-official languages of the Spanish state.

 

 

STEP 3: Fill in the application form and gather the required documentation
  • Consult the relevant Social Security website for more information and download the form that relates to you.
  • The information is available in English, French, Catalan, Spanish and other co-official languages of the Spanish state. The form, on the other hand, is available in Spanish.
  • Once you have completed the form, and before starting the application, consult and prepare the documentation that you will be asked for to obtain the certificate of recognition.

 

STEP 4: Go to the place indicated and hand over the documentation
  • Go to the place indicated in the appointment to submit the documentation.
  • Consult the website to find out which Social Security offices are available.

 

STEP 5: Obtain the certificate of recognition of the right to healthcare
  • The procedure, once initiated, must be decided and notified within thirty days of the date on which the application was registered. However, they usually issue the certificate on the spot.
  • Where that period has elapsed without you having received notification of the outcome, you can take it that your application has been rejected and request that a decision be issued.

 

 

STEP 6: 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.
  • 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.

Who can submit the application?

The application must be submitted by the individual in person.

What documentation must be attached to the application?

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 in the Central Register of Foreign Nationals.

 

 

  • For other individuals who are not Spanish nationals: 
    • 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).

 

  • Other situations depending on the circumstances: 
    • 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.

 

  • 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 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.

How long does it take to process the application?

  • If you applied online, the Spanish National Social Security Institute will send the outcome of the request to the address of the interested party. The procedure, once initiated, must be decided and notified within thirty days of the date on which the application was registered. Where this period has elapsed without notification of the outcome being received, you can take it that your application has been rejected.

 

  • If you applied in person, the procedure, once initiated, must be decided and notified within thirty days of the date on which the application was registered. However, they usually issue the certificate on the spot. Where that period has elapsed without you having received notification of the outcome, you can take it that your application has been rejected and request that a decision be issued.

What does the application cost?

It is FREE.

Want to know more?

Which body is responsible for the formality?

National Police Corps (Ministry of the Interior, Government of Spain).

Where can I find more information?

You can also consult the Government of Spain's Immigration 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:

If you want to carry out the whole procedure online, you need to have the following 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:

IMPORTANT NOTICE

The procedures tend to change frequently. Therefore, only what is provided by the regulations in force at the time of carrying out the procedure in question is applicable.