How to get the tarjeta sanitaria in Spain 2026

The tarjeta sanitaria (health card) is your key to public healthcare in Spain: a family doctor, specialists, prescriptions with a co-payment, emergencies. This guide covers who's entitled (including Ukrainians under temporary protection), who recognises that right, what you need (no separate NIE application; for temporary protection the resguardo or the resolution is enough) and how to apply step by step.

Who is entitled

The right to public healthcare in Spain comes from residence, not from a job, contributions or a benefit — that is how Ley 16/2003 is worded as amended by RDL 7/2018. Ukrainians under temporary protection only need to present the resguardo of their application or the resolution granting protection. Foreigners without legal residence are recognised the same right by RD 180/2026 if there is no coverage from another country.

The right to public healthcare in Spain is broader than many people think. In particular:

What the right attaches to. Once temporary protection has been granted, the resolution granting it itself carries the residence and work authorisation (Orden PCM/169/2022, art. 5.1). And what gives the right to public healthcare is precisely residence — not a job, not registration with the Seguridad Social, not receiving a benefit: that is how Ley 16/2003, art. 3.1 and art. 3.2 c) are worded as amended by RDL 7/2018. That was the whole point of the 2018 reform: the earlier model tied the right to being a worker or a benefit recipient, and that is where the belief that "no job, no healthcare" still comes from. The RD 1192/2012 articles with those «asegurado» categories (art. 2–8) were repealed by RDL 7/2018 — if a region's website still lists "worker, pensioner, benefit recipient" (the Comunidad de Madrid page still does), that is the old wording, not a current condition. The State fixes the right and the comunidades autónomas issue the card (Ley 16/2003, art. 3 bis.2) — no rule lets a region add an employment condition. What does vary by region is which papers the desk asks for: if you are asked for a Seguridad Social number, that is a paperwork question, not a sign that the right is missing (Ucrania Urgente FAQ: the CCAA health service uses your Seguridad Social number to register the card).

Who recognises the right. According to the Seguridad Social, since 1 August 2018 recognition of the right belongs to the Ministerio de Sanidad with the collaboration of the INSS, but until the implementing regulation is adopted the previous procedure remains: the INSS checks the requirements, recognises the right and keeps the coverage database, and the region issues the card from that data (Ley 16/2003, art. 3 bis.2). The INSS «Solicitud de reconocimiento del derecho a la asistencia sanitaria» is filed online or at an office; a foreigner needs a TIE or passport, proof of legal residence (for a TP holder that is the protection resolution, which is itself the residence authorisation) and the volante if the padrón is recent. Madrid, Valencia and Andalusia ask residents for this INSS document when processing the card. For foreigners without legal residence, applicants for international protection and subscribers to the convenio especial, the right is recognised not by the INSS but by the CCAA health service.

You don't need a NIE; the usual route is empadronamiento

Many people think you have to apply for a NIE separately for the health card. You don't: TP holders are assigned a NIE when they file the application and it is printed on the resguardo, and other foreigners only need an identity document at the centro de salud — a passport or a TIE. For most people the usual route to the tarjeta sanitaria is empadronamiento (registration in the municipal padrón): with the padrón you apply for the card at your nearest centro de salud. How mandatory the padrón is depends on the region: in Catalonia CatSalut calls it the basic requirement for the ordinary TSI, in Valencia the volante is only "recommended" (no older than 6 months), in Madrid they ask for a volante issued within 90 days.

Application steps

You apply for the health card at the centro de salud for your address. On the ordinary route you first register in the padrón, then submit a passport or TIE, the padrón certificate and, where asked, the INSS document — in person or online via your CCAA health service. Ukrainians under temporary protection need no padrón: the resguardo or resolution is enough. A provisional document is issued on application, so you can see a doctor right away.

The path depends on whether you already have a padrón.

Under temporary protection and still without a padrón

Don't wait for empadronamiento — you already have the right to care from your status:

1. Take your TP status document — the resguardo (receipt of the temporary-protection application at the police, with your NIE) or the resolution/TIE.
2. Go to the centro de salud in your area (or the unit your CCAA has designated). According to the Ucrania Urgente FAQ, they accept the resguardo or the resolution and issue the documento certificativo or the card — without a padrón certificate. In Andalusia this is the form «Solicitud de tarjeta/alta/modificación de datos en BDU» plus the resguardo or the resolution; in Catalonia, the application at the CAP plus the resolution or the TP application.
3. Get the provisional document — access to a doctor right away.
4. Later, once you have housing, register (empadronamiento) and update your address at the centro de salud.

Ordinary route (with housing/padrón)

1. 1

   Empadronamiento

   Register in the padrón and get a recent certificate (volante/certificado).

2. 2

   Find your centro de salud

   The one nearest your registered address.
3. 3

   Submit the documents

   Passport or TIE + padrón certificate + (where asked) the INSS document recognising the right — at the centro de salud or online on your CCAA health service's website.

4. 4

   Provisional document

   You get a provisional document — immediate access to a doctor.

5. 5

   Doctor and card assigned

   You're assigned a médico de cabecera; the permanent card arrives by post or is collected at the centro de salud.

1. Empadronamiento. Register in the padrón and get a recent certificate (volante/certificado).
2. Find your centro de salud — the one nearest your address.
3. Submit the documents at the centro de salud (or online on your CCAA health service's website): passport or TIE + padrón certificate + (where asked) the INSS document recognising the right.
4. Get the provisional document — access to a doctor right away while the card is prepared.
5. You're assigned a centro de salud and a médico de cabecera (family doctor). The permanent card, according to the Ucrania Urgente FAQ, arrives by post; in Madrid it is handed out at the centro de salud where you applied.

Documents

For the tarjeta sanitaria you normally need a passport or TIE, a recent padrón certificate (volante or certificado de empadronamiento) and — in Madrid, Valencia and Andalusia for residents — the INSS document recognising the right to healthcare. Temporary-protection holders can present the resguardo or the resolution instead of a padrón. No separate NIE is needed: for TP holders it is already printed on the resguardo.

• Passport or TIE;
• Padrón certificate (volante/certificado de empadronamiento), recent — on the ordinary route;
• INSS document recognising the right — where asked (Madrid, Valencia, Andalusia for residents);
• for temporary protection — the TP resguardo or resolution/TIE (works without a padrón — see the TP steps above).

It's managed regionally: each CCAA has its own procedure

The tarjeta sanitaria is managed by each autonomous community (CCAA) separately, although it's valid throughout Spain. So the exact procedure, name and online services vary:

• in Valencia the card is called SIP (Sistema de Información Poblacional): apply at the centro de salud or online («Alta de un ciudadano en el SIP» with a certificado digital or Cl@ve), the volante is recommended, and until the card arrives you get the documento de inclusión temporal;
• in Catalonia, TSI (targeta sanitària individual): for TP, the application at the CAP with the resolution or the protection application, the resguard provisional with the CIP number arrives by e-mail, the card by post;
• in Madrid, a valid TIE, a volante issued within 90 days and the INSS document; for non-EU foreigners the card's validity matches the TIE's and the date is updated at the centro de salud after renewal; the card is collected in person at the centro de salud;
• in Andalusia, the BDU form at the centro de salud; for TP the resguardo or the resolution is enough.

Check the health-service website of your CCAA for the current steps and appointments.

Moving and temporary trips are different procedures. Moving to another CCAA does not reopen your right: it is tied to residence in Spain (RDL 7/2018), and the card is valid across the whole SNS (RD 183/2004, art. 2.2). But the card is processed anew: padrón at the new address → centro de salud → the new region's card (in Madrid, with TIE, volante and the INSS document). For a temporary stay in another region a different document is needed: in Madrid, the Documento de Asistencia a Desplazados (DAD), issued at the centro de salud on the spot and free of charge to people who habitually live in another CCAA; in Valencia, the documento de inclusión with your home-region card; in Andalusia, the assignment of a doctor and centre with your home-region card and DNI/NIE. The basis is Ley 16/2003, art. 4 c): in the region where you are displaced you are entitled to the SNS catalogue of services on the same terms as residents. The Ucrania Urgente FAQ is more cautious: the card can only be used in its own CCAA, elsewhere it is urgencias. We give both positions as they stand; for planned appointments in another region ask for the desplazado document.

This article is informational; the procedure depends on your autonomous community and may change — verify with your CCAA's official health service and with ucraniaurgente.inclusion.gob.es (for Ukrainians under TP). Facts checked in September 2026 against the BOE, the Seguridad Social, Ucrania Urgente and the official portals of Madrid, Catalonia, Andalusia and Valencia. Need a Russian-/Ukrainian-speaking doctor or help with the procedure? Check our verified directory.