Healthcare in Spain: How to Register and What’s Covered

Distant Horizons

Whether you’ve just landed in Spain or you’ve been bouncing between empadronamiento appointments and NIE renewals, one thing’s for certain — you’ll need healthcare. And in Spain, that starts with the SIP card.

This is your one-stop guide to registering for Spain’s public healthcare system — nationwide — and understanding what exactly is (and isn’t) included.

What Is the SIP Card?

The SIP card (Sistema de Información Poblacional) is your personal healthcare ID in Spain. You’ll need it for:

  • GP and hospital appointments
  • Emergency services
  • Prescription medicines
  • Maternity, paediatrics, and more

Some regions call it something slightly different (like TSI in Catalonia), but “SIP card” is widely understood across Spain.

Who Can Access Public Healthcare in Spain?

You’re likely eligible if:

1. You’re working (employed or self-employed) in Spain: If you’re paying into Spain’s Seguridad Social, you’re entitled to full public healthcare.

2. You’re receiving a UK or EU state pension: You can register an S1 form, which allows the Spanish state to provide healthcare reimbursed by your home country.

3. You’ve lived in Spain over a year and aren’t otherwise covered: You can apply for access under the Convenio Especial — a public healthcare pay-in scheme.

4. You’re a dependent of someone covered: Spouses, partners, and dependent children can often be included under someone else’s social security record.

How to Register and Get Your SIP Card

Step 1 – Get your empadronamiento (padrón certificate): Register your address at your local town hall (ayuntamiento). You’ll need a rental contract, recent utility bill, or property deed.

Step 2 – Get a Social Security Number (NUSS): If you’re working, your employer will handle this. Otherwise, apply via the Social Security Portal.

Step 3 – Apply for your SIP card at your local health centre (Centro de Salud):

  • Bring your passport or national ID
  • NIE
  • Empadronamiento certificate
  • Proof of Social Security contributions or S1
  • Proof of address

In many cases, the SIP card is issued immediately or sent to your address.

What’s Covered by Public Healthcare?

With your SIP card, you’re entitled to:

  • GP appointments
  • Specialist referrals
  • Emergency and urgent care
  • Hospital treatment and surgery
  • Maternity and paediatric care
  • Mental health services (referral required)
  • Subsidised prescription medication

Prescription co-payments range from 10% to 60%, based on income. Pensioners often pay less.

What’s Not Covered?

  • Dental (except emergency extractions)
  • Eye exams and glasses
  • Cosmetic or elective procedures

Do You Need Private Insurance?

Many expats opt for private insurance for:

  • Faster access to specialists
  • More English-speaking doctors
  • Wider choice of facilities

It’s mandatory if you’re applying for a residency visa and don’t yet qualify for public coverage.

Popular providers: Sanitas, DKV, Adeslas, Cigna.

Is It the Same Across Spain?

Not quite. Spain’s healthcare is decentralised, so each autonomous community manages its own system. While core services are guaranteed, there are differences in:

  • Waiting times
  • Registration procedures
  • Availability of online appointments

For example, Madrid has experienced healthcare worker strikes, while Valencia and Andalusia generally run smoother systems.

Helpful Resources

Final Thoughts

Getting your SIP card means you’ve officially joined Spain’s health system — one of the best in Europe. Once you’re in, you’ll have reliable, low-cost access to high-quality care.

Got a special case? Not sure if you need the S1 or Convenio Especial? Start with your Centro de Salud — they’ve seen it all before. And don’t forget to bring copies. Everything takes copies in Spain.

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