Access to Healthcare

112 is an emergency phone number (not an information line). It’s a free citizen helpline number for any kind of emergency which happens on Spanish territory (as well as other countries in the European Union). Some examples of emergency situations are:

• Health emergencies
• Firefighters (firefighting and rescue)
• Citizen safety (Police, Civil Protection, etc.)
• Road accidents and incidents

If you call 112 because you need urgent medical assistance, you’ll be referred to a healthcare professional and they’ll continue collecting the information required in order to evaluate the seriousness of the situation make sure you receive the most suitable healthcare. They will also guide you on any first aid you can carry out whilst waiting for help to arrive. You can put your phone on hands-free mode in order to help the person whilst you are given instructions by phone.

The public health system

In Spain, there’s what’s known as the “universal healthcare system” within the public health system. This means that the whole population of the country, including foreign nationals, refugees, asylum seekers and stateless persons can access medical attention or healthcare through the National Health Service (Sistema Nacional de Salud or “SNS”) in specific circumstances which we’ll explain later.

The Asylum law 12/2009 states that refugees and asylum seekers have access to “education, healthcare, housing, social assistance and social care, […] under the same conditions as Spanish people”.

If you still haven’t legalized your administrative situation, check this section.

Private healthcare

In addition to the Sistema Nacional de Salud (SNS), in Spain there are also private medical centres. Anyone can access private healthcare. However, in this case, you must pay for the price of the medical consultation, or have taken out a policy or medical insurance beforehand which covers these costs.

Depending on the type of medical attention you require (primary or specialised care), you should go to one place or another (medical centre, hospital, clinic, etc.). Below, we’ll explain the differences to you:

• Primary healthcare in Medical Centres: Primary medical attention is given at what we call “medical centres” or “primary healthcare centres”. These are healthcare centres which are smaller than hospitals, where you’ll be seen by a healthcare professional who can refer you to a medical specialist where necessary.

It’s recommended to request an appointment in advance, but if you need to see a doctor urgently, you can go to any medical centre or public hospital, and head to the “Emergency” area.

We all have a medical centre assigned to us depending on where we are registered as residents (‘empadronado’). If you move house to another neighbourhood or city, it’s important you process your new registration as a resident (‘empadronamiento’) and register at the corresponding medical centre in order to facilitate your access to healthcare. If you don’t have a fixed address in Spain, you can process your registration as a resident (‘empadronamiento’) by indicating that you are registered at Social Services (‘Servicios Sociales’).

• Specialist attention: Specialist medical attention is normally received through a referral from primary healthcare. That means that when a primary healthcare doctor considers it necessary, they will give you an appointment with a specialist doctor (e.g. orthopaedic surgeon, gynaecologist, oncologist, etc.) Remember that hospitals also have a medical service without prior appointment available for medical emergencies.

Medical centres and hospitals are found across Spain. You can find your closest medical centre or hospital in the Health Ministry search engine. 

In addition, most Autonomous Communities have a health centre search engine on the internet:

• In Madrid, you can find your closest medical centre here.
• In Catalonia, find your healthcare centre on the CatSalud website, by clicking here.
• In Andalusia, find your healthcare centre by clicking here.

What documentation do I have to take with me?

In order to make an appointment in a medical centre you’ll need:

• An identification document: Passport, proof of asylum application (white sheet), red card or valid N.I.E. (foreigner ID number).

 If you’ve expressed your desire to seek asylum and you’re waiting to have the interview, you can request a medical appointment by providing your passport and the proof of your desire to seek asylum.  In the latter case, when you have your interview and formalize your asylum application, you must update your details by providing your health centre with your N.I.E.

• Health card (or the proof of the health card application).

Can I access free healthcare assistance without a health card or ID document?

If you still don’t have your health card, and you have a medical emergency, you can go to a hospital or medical centre with your passport or N.I.E. They will usually ask for your registration as a resident (‘empadronamiento’), but if you don’t have permanent residence in Spain you can register at Social Services.

If you don’t have an ID document and still haven’t been able to legalize your administrative situation and you’re denied healthcare assistance, request to speak to the Social Worker/s at the primary healthcare centre so they can assess your situation and support you in accessing the healthcare system.

You can also state that you’d like to speak with the medical centre manager in order for them to explain the reason for the refusal. Ask that they provide you with a written copy of the regulation they are applying and inform you of the channels you can follow in order to present a complaint or claim.

How do I apply for the health card? 

Warning! As a result of the exceptional situation arising from COVID-19, the procedure for applying for a Health Card may have changed. We recommend that you consult a medical centre in your place of residence to confirm how to apply for the health card at this time.

In Madrid, the application for a health card is carried out through the “Registro” service in the Public Enquiry Offices.  In order to apply, you should make an appointment here. 

You should apply for the health card at the medical centre closest to your residence. You need to have a Social Security number (also called Social Security membership number) in order to apply for this.

If you already have a Social Security number assigned, go to the medical centre closest to your residence with your number and ID document and apply for your health card there. The card will take approximately a month to arrive, but the medical centre will give you a proof of application which you can use while you wait.

In order to obtain your Social Security number you must:

1. Ask for an appointment at the Instituto Nacional de la Seguridad Social (INSS): Search for the closest “INSS” office using this link  and request an appointment through the website or by phone. Make sure you check what documentation is required by the INSS in your Autonomous Community and take it with you when you attend the appointment.
2. Apply for your Social Security number: Once there, you should complete and present your application for “recognition of the right to healthcare assistance”. They will give you a document which declares you have the right to healthcare assistance and assign you a Social Security membership number.

Social Security is a public system which ensures that the population has access to medical assistance and guarantees a pensions system in the event of retirement, unemployment, sickness, disability, work accidents or maternity. Everyone who has authorisation to reside in Spain can receive public healthcare assistance by attending the Social Security office and providing their N.I.E., red card or proof of seeking asylum (white sheet).

If you’re not being supported by an organisation or reception system body, you can request the services of an interpreter.

If you don’t speak Spanish well, ask your medical centre whether they have a free interpreting service which could assist you during your visit to the doctor. The availability of this service varies according to the autonomous community where you are. In some medical centres and hospitals there are permanent mediation and translation services through entities such as Salud Entreculturas (Hospital Ramón y Cajal), Cruz Roja , etc.

In addition, some autonomous communities have a free telephone interpreting service which should be requested when making an advance appointment. Other communities don’t have this service and they rely on the support of volunteers from social entities (e.g. Cruz Roja, Permondo, etc.).

If you need an interpreter, mention this when making the appointment.

Si no hablas bien español, pregunta en tu centro de salud si disponen de un servicio de intérprete gratuito que pueda asistirte durante tu visita al médico. La disponibilidad de este servicio varía en función de la comunidad autónoma en la que te encuentres. En algunos centros de salud y hospitales, existen servicios permanentes de mediación y traducción a través de entidades como Salud Entreculturas (Hospital Ramón y Cajal), Cruz Roja, etc.

If you need an interpreter, mention this when making the appointment.

How do I obtain it?

To obtain medication you should present the prescription which the doctor gave you to the pharmacy, together with your health card (if you have one). Some medication can be obtained without a medical prescription (e.g. paracetamol, ibuprofen, medication for allergies, colds, mild or moderate pain, etc.).

Do I have to pay for the medication the doctor has prescribed for me?

In general, you have to pay for your medication. However, if you have a health card and a Social Security number, Social Security will pay some of the cost of the medication. This way you won’t have to pay the full price of the medication. On the Health Ministry website you can find detailed information about payment contributions for medication.

If you have a health card in the Community of Madrid you can check the price you should pay for your medication through this link. 

If you still haven’t formalized your asylum application, or you still don’t have your NIE, you can access free healthcare but you don’t have pharmaceutical coverage. In this case, you will have to pay the total amount of the medication you require.

Regarding medication acquired without a medical prescription, you always have to pay the full price of the medication.

Do you need more information, help or support to access healthcare in Spain?

There are entities and platforms such as Yo Sí Salud Universal which can help facilitate access to certain medication and/or treatment for people in a vulnerable situation who cannot afford the costs.

If you need more information about how to access healthcare in Spain, consult the materials available at Yo Sí Salud Universal

Find out about their mutual support groups which may be able to help you access healthcare. Find all the information by clicking here, or by sending an email to [email protected]