Health insurance and medical care in Spain

Living in Europe | Health insurance, Medical care | Spain

Spanish National Health System

The Spanish National Health System (SNS by its name in Spanish) is a coordinated network of nationally and locally administered Health Services, comprising all health functions and services which are the legal responsibility of the public authorities.

Its most important features are:

  • Health services which are publicly funded, universal, and free to use.

  • Defined rights and duties for citizens and public authorities.

  • Political decentralization of healthcare in the Autonomous Regions.

  • Provision of comprehensive high-quality healthcare which is duly monitored and evaluated.

For further information, consult the Spanish Ministry of Health, Social Services and Equality website: (available in Spanish, English and French).

Medical and pharmaceutical care

Each Autonomous Region has a Health Service, which is the administrative and management structure comprising all centres, services and establishments of the region, provincial councils, city councils and any other administrative bodies of the region.

Following the transfer of healthcare responsibilities, all Autonomous Regions are now accountable for healthcare in their regions. In the autonomous cities of Ceuta and Melilla, the Central State Administration continues to manage healthcare through the National Health Management Institute (INGESA).

In Spain, healthcare is guaranteed by the SNS, funded by the State, to persons with the status of insured or beneficiary of an insured. Persons in one of the following situations have the status of insured:

  1. Employed or self-employed persons, registered or similar with the Social Security system.

  2. Those with the status of pensioners in the Social Security System.

  3. Recipients of any other regular benefit from the Social Security system, including unemployment benefits.

  4. Those who have exhausted their unemployment benefit and remain unemployed, their Insured status not being accredited by any other means.

In those cases, in which none of the aforementioned situations are applicable, nationals of Spain or of a Member State of the EU, the EEA or Switzerland who reside in Spain, and foreign nationals authorised to reside in Spanish territory, may hold the status of Insured provided that they can prove that they do not have an annual income of more than €100,000. Those with the status of beneficiaries of an Insured are — provided that they reside in Spain — a spouse or person with analogous relationship, an ex-spouse dependent on the Insured, and descendants or equivalent persons dependent on the Insured who are under 26 years old or who have a disability equal to or greater than 65%.

Foreign nationals authorised to reside in Spanish territory have the same right to healthcare as Spanish nationals. Those who are not registered or authorised as Spanish residents, will receive healthcare in the following circumstances:

  1. Emergency care for a serious illness or accident, whatever its cause, until discharged.

  1. Pregnancy, birth and postpartum care.

In all cases, foreign nationals under 18 years old may receive healthcare under the same conditions as Spanish nationals.

The National Health System (SNS by its Spanish name), as a provider of healthcare services, is organised on two levels: primary care and specialised care.

The principal care mechanisms in primary care are the health centres, in which a multidisciplinary team of family doctors, paediatricians, nurses and administrative staff are employed, together with social workers, midwives and physiotherapists.

Specialised care is provided in specialist centres and hospitals for outpatients and inpatients. Emergency care is offered at the hospitals twenty-four hours a day to patients who have not been admitted to hospital.

The directories of primary health care centres and hospitals are available on the Ministry of Health, Social Services and Equality web page: (available in Spanish, English and French).

In addition to the above, emergency care is the care provided to a patient in the event that their clinical condition requires immediate emergency care. This care is provided at the health centres and outside the centres, including at the patient’s home, on a 24 hour basis, with the provision of medical and nursing care, and the collaboration of other professionals.

The provision of healthcare is managed through the common services portfolio of the SNS, which is divided into three categories according to the contributions made by the user:

  1. Basic common portfolio: includes care for the prevention, diagnosis, treatment and rehabilitation of illness provided in health centres or social-health centres, together with emergency health transport, and is completely covered by public funding.

  2. Supplementary common portfolio: this includes all the services provided through outpatient stay (pharmaceutical, orthoprotesic provisions including dietary products, and non-emergency health transport). These are subject to user contributions under the same conditions as those regulating pharmaceutical provisions , taking as the base for calculation the final product price, without applying any limit to the contribution.

  3. Common portfolio of accessory services: this includes those activities, services or techniques that are not considered essential but which help to improve a pathology, and are subject to the user’s contribution and/or repayment.

Access to the services is via the individual health card (TSI) issued by each health service. This document identifies each citizen as a user of the SNS.

The format and content of the TSI, and its issue and delivery to holders, is the responsibility of the health system. It can be obtained from the corresponding health centre (primary care) according to the individual’s place of residence. However, prior to this, the individual should be recognised as insured and entitled to benefits by the National Institute of Social Security (INSS).

Entitlement to healthcare starts on the day the individual is signed up to the system, both for the insured (employed researcher) and for their beneficiaries (family). Recognition of the insured is automatic (automatically recognised by the INSS), but it is necessary to submit an application in the case of family members (beneficiaries) who do not work in Spain: the application (accompanied by a copy of the individual’s passport and foreign national identity card or the entry in the central Registry of Foreign Nationals in the case of EU, EEA or Switzerland citizens) may be submitted at any Social Security office.

The SNS covers all the medicines dispensed during hospital stays. In the case of outpatients, medicines prescribed in a SNS prescription are paid for jointly67 according to the user’s income. In the case of chronic treatment, the percentage participation is 10% with a maximum of €4.24.



The European health insurance card (TSE by its name in Spanish) makes it easier for individuals from any of the Member States of the EEA (including the members of the EU, Iceland, Liechtenstein and Norway) and Switzerland, to access healthcare services during their temporary visits abroad.

Holders of the TSE will receive treatment in the same conditions as Spanish residents with respect to conditions and costs. If the same service is provided free of charge in the country of origin, the costs of this service may be reimbursed on the individual’s return to the source country.

The TSE is not valid when the purpose of the foreign national’s displacement is to receive medical care. Nor does the card in Spain cover care provided by private healthcare providers.

For further information, please see the web page of the European Commission’s Directorate General for Employment, Social Affairs and Inclusion: (available in all official EU languages).


Individuals requiring private medical care may take out medical insurance in the country of origin that provides cover in Spain, or take out insurance with any private medical insurance company in Spain. It is important to remember that many of these companies have grace periods which may range between several months and one year before it is possible to draw on any of their services, especially in the case of maternity and surgical operations.

A brief list is provided below of the main companies. For a more complete list, please visit the Yellow Pages online and look under the headings “insurance, “medical companies” or “medical insurance”.

ADESLAS Tel.: 902 200 200

ASISA Tel.: 902 010 010

MAPFRE Caja Salud Tel.: 902 20 40 60

SANITAS Tel.: 902 102 400



In Spain, medicines are only available in pharmacies. Normally, the user is required to present the prescription issued by the healthcare specialist. Pharmacists’ opening hours are the same as those of other commercial establishments. At weekends and public holidays, there are duty pharmacists (your usual pharmacist will provide a list on the door of the address of the nearest duty pharmacist). Nevertheless, more and more pharmacies are remaining open for twelve and up to twenty-four hours per day. When requesting a medicine, pharmacies stock generic brands in addition to recognised brands, which are usually much cheaper and contain the same active substances. Homoeopathic medicines are also distributed at the pharmacist.


The website of the General Council of Pharmaceutical Associations in Spain (http://www.portal offers considerable information about the Spanish pharmaceutical system.



Ministry of Health, social Services and Equality.

Paseo del Prado, 18-20, 28071 Madrid, Tel. 901 400 100 {available in Spanish,English and French}.

National Institute of Health Management, INGESA.

Calle Alcalá, 56, 28071 Madrid, Tel. 91 338 03 65/00 51 {available in Spanish,English and French}.

Autonomous Regions



Health Councils



Health Services






Consejería de Salud

Av. De la Innovación s/n,

Edif Arena 1- 41020 Sevilla

Tel.: 955 00 63 00

Servicio Andaluz de Salud (SAS)

Av. De la Constitución, 18 - 41071 Sevilla

Tel.: 955 01 80 00




Dpto. Sanidad, Bienestar Social y Familia

Vía Universitas, 36 - 50009 Zaragoza

Tel.: 976 71 40 00

Servicio Aragonés de Salud

Paseo María Agustín, 16 - 50071 Zaragoza

Tel.: 902 555 321

Asturias (Principado de)



Consejería de Sanidad

Ciriaco Miguel Vigil, 9 - 33006 Oviedo

Tel.: 985 10 85 00

Servicio de Salud del Principado de Asturias (Sespa)

Plaza Carbayón, 1 - 33001 Oviedo

Tel: 985 10 85 00

Baleares (Islas)



Consejería de Salud, Familia y Bienestar Social

Plaça d’Espanya, 9 - 07002 Palma

Tel.: 971 17 69 69

Servicio de Salud de las Islas Balerares (ib-salut)

Reina Esclaramunda, 9 - 07003, Palma de Mallorca

Tel.: 971 17 56 00

Canarias (Islas)



Consejería de Sanidad

Avda. Juan XXIII , 17 - 35071 Las Palmas de G. Canaria

Tel.: 928 11 88 52

Servicio Canario de Salud

Avda. Juan XXIII , 17 - 35004 Las Palmas de G. Canaria

Tel.: 928 11 88 52

Rambla Santa Cruz, 53 - 38071 Sta.Cruz de Tenerife

Tel. 922 47 42 01

Pérez de Rozas, 5, planta 4ª - 38004 Sta. Cruz Tenerife

Tel.: 922 47 58 14




Consejería de Sanidad y Servicios Sociales

Federico Vial, 13 - 39009 Santander

Tel.: 942 20 82 40

Servicio Cántabro de Salud

Avda. del Cardenal Herrera Oria, s/n - 39011 Santander

Tel.: 942 20 27 70/72

Castilla y León



Consejería de Sanidad

Paseo de Zorrilla, 1 - 47007 Valladolid

Tel.: 983 41 36 00

Gerencia regional de la Salud

Paseo de Zorrilla, 1 - 47007 Valladolid

Tel.: 983 32 80 00

Castilla la Mancha



Consejería de Sanidad y Asuntos Sociales

Avda. Francia, 4 - 45071 Toledo

Tel.: 925 26 70 99

Servicio de Salud de Castilla La Mancha (SESCAM )

Av. Rio Guadiana, 4 - 45071 Toledo

Tel.: 900 25 25 25




Departamento de Salud

Traverssera de les Corts, 131-159, Pabelló Ave María

08028 Barcelona

Tel.: 93 227 29 00

Servicio Catalán de Salud (CatSalut)

Travessera de les Corts, 131-159, Edificio Olimpia

08028 Barcelona

Tel.: 93 403 85 85




Consejería de Sanidad y Consumo

Pza de San Amaro, 12 - 51071 Ceuta

Tel.: 856 20 06 80

Delegación del INGESA

Avda. Marina Española, 23, 1º - 51001 Ceuta

Tel.: 956 51 49 29

Valencia (Region)



Consejería de Sanidad

Micer Mascó, 31-33 - 46010 Valencia

Tel.: 963 86 66 00/28 00

Agencia Valenciana de Salud (AVSA )

Micer Mascó, 31-33 - 46010 Valencia

Tel.: 963 86 66 00




Consejería de Salud y Política Social

Avda. de las Américas, 2 - 06800 Mérida

Tel.: 924 00 41 00

Servicio Extremeño de Salud (SES)

Avda. de las Américas, 1 - 06800 Mérida

Tel.: 924 38 25 01/02




Consejería de Sanidad

Edif. Admtvo. San Lázaro, s/n - 15073 Santiago de Compostela

Tel.: 981 54 27 12

Servicio Gallego de Salud (SERGAS)

Edif. Admtvo. San Lázaro, s/n - 15073 Santiago de Compostela

Tel.: 981 54 27 12

La Rioja



Consejería de Salud y Servicios Sociales

Villamediana, 17 - 26003 Logroño

Tel.: 941 29 13 96

Servicio Riojano de Salud

Villamediana, 17 - 26003 Logroño

Tel.: 941 29 76 60

Madrid (Community)



Consejería de Sanidad

Aduana, 29, 2ª planta - 28013 Madrid

Tel.: 91 586 70 00

Servicio Madrileño de Salud (SERMAS )

Pza. Carlos Trías Beltrán, 7 - 28020 Madrid

Tel.: 91 586 72 27




Consejería de Bienestar Social y Sanidad

Ramírez de Arellano, 10, 3ª pl. - 52001 Melilla

Tel.: 952 69 93 01

Delegación del INGESA

Pza. del mar s/n. Edificio V Centenario Torre N, pl. 11 - 52071 Melilla

Tel.: 952 67 23 12

Murcia (Region)



Consejería de Sanidad y Política Social

Avda. de la Fama, 3 - 30071 Murcia

Tel.: 968 37 51 83

Servicio Murciano de Salud

Ronda de Levante, 11 - 30008 Murcia

Tel.: 968 36 59 00

Navarra (Region)



Departamento de Salud

Amaya, 2 - 31002 Pamplona

Tel.: 848 42 35 41

Servicio Navarra de Salud (OSASUNBIDEA)

Irunlaterra, 39 - 31008 Pamplona

Tel.: 848 42 88 00

País Vasco



Departamento de Sanidad y Consumo

Donostia-San Sebastian, 1 - 01010 Vitoria-Gasteiz

Tel.: 945 01 85 00

Servicio Vasco de Salud (OSAKIDETZA )

Álava, 45 - 01006 Vitoria-Gasteiz

Tel.: 945 00 60 00