How to Get Your Regional Health Card (TSI/SIP) Without Delays

Your health card is your ticket to Spain's public healthcare system. Without it, you cannot book a GP appointment, get a prescription, or see a specialist through the public system. The card goes by different names depending on which autonomous community you live in — TSI (Tarjeta Sanitaria Individual) in most regions, SIP in Valencia, and TIS in Catalonia — but the function is the same.

This guide covers how to get one, what documents you need, and how to avoid the delays that trip up most newcomers.

What is the TSI/SIP?

The health card is a plastic card (or increasingly a digital card on your phone) that identifies you within Spain's public healthcare system. It links you to:

• Your assigned centro de salud (public health centre)
• Your assigned medico de cabecera (GP / family doctor)
• Your prescription history and medical records
• The right to specialist referrals, hospital care, and emergency treatment within the public system

Each autonomous community manages its own health service, which is why the card name and exact process vary by region. But the underlying system is national — your card works across Spain if you need care while travelling.

Who can get one?

You are entitled to a public health card if you fall into any of these categories:

• Employed or self-employed and registered with Spanish Social Security (Seguridad Social)
• Dependant of someone registered with Social Security (spouse, children under 26)
• Enrolled in the convenio especial (the pay-in public healthcare scheme)
• Receiving a pension from an EU/EEA country with an S1 form
• Under 18 or pregnant, regardless of immigration status
• Registered resident in some autonomous communities that have extended universal coverage (e.g., Valencia, Catalonia, Basque Country, Navarra)

Prerequisites: what you need first

Before you can apply for your health card, you must have these in place:

Checklist

• NIE number (on your TIE card or green EU certificate)
• Empadronamiento (padron registration) at your current address
• Social Security number (NUSS) — obtained from a Tesoreria General de la Seguridad Social office
• Proof of entitlement: employment contract, Social Security alta, S1 form, or convenio especial confirmation

The most common blocker is the Social Security number. If you are employed, your employer should register you and provide this. If you are self-employed, you get it when you register as autonomo. If you are not working, you will need to visit a Seguridad Social office to request one based on your residency status.

Step-by-step process

Step-by-step main guidance

1. 1Get your Social Security number (NUSS) — Visit a Tesoreria General de la Seguridad Social office with your NIE, passport, and empadronamiento. If employed, your employer handles this. Processing is usually same-day.
2. 2Find your assigned centro de salud — Your health centre is determined by your registered address (empadronamiento). You can look it up on your regional health service website or call the regional health line.
3. 3Visit the centro de salud to register — Bring your NIE, empadronamiento, Social Security number, and passport. The admin desk (mostrador) will register you in the system and assign you a GP.
4. 4Receive your health card — In some regions you get a temporary card on the spot. The permanent plastic card arrives by post in 2-6 weeks. Many regions now offer a digital version through their health app.

Regional variations

Madrid (TSI)

• Register at your centro de salud with NIE, empadronamiento, and Social Security number.
• Temporary card issued on the spot. Plastic card arrives by post in 3-4 weeks.
• Digital card available through the Tarjeta Sanitaria Virtual app.

Comunidad Valenciana (SIP)

• Register at your centro de salud or through the GVA Salut+ app.
• Valencia has extended coverage to all registered residents regardless of immigration status.
• SIP card includes a unique SIP number used for all health system interactions.

Catalonia (TIS)

• Register at your CAP (Centre d'Atencio Primaria).
• Catalonia also provides universal coverage to all registered residents.
• Digital card available through La Meva Salut app.

Andalucia (TSI)

• Register at your centro de salud.
• You can also manage appointments and access your digital card through ClicSalud+.

What if you do not have a Social Security number yet?

If you have just arrived and do not yet have your Social Security number but need to see a doctor:

• Emergency care is always available at hospital urgencias departments regardless of your status.
• Your EHIC card (for EU citizens) covers necessary care during the transition period.
• Private insurance can cover you immediately while you wait for public system registration.
• Some centros de salud will register you provisionally with just your empadronamiento and NIE, especially for pregnant women and children.

How long does it take?

The full process from arriving in Spain to having a health card in hand typically takes:

• If employed: 1-3 weeks. Your employer registers you with Social Security, then you visit your centro de salud.
• If self-employed: 2-4 weeks. You register as autonomo first, which gives you Social Security, then visit your centro de salud.
• If using convenio especial: 4-8 weeks. You need to apply, wait for approval, then register at your centro de salud.
• If using an S1 form: 2-6 weeks. You register the S1 at your local INSS (Instituto Nacional de la Seguridad Social) office, then visit your centro de salud.

Common mistakes

• Going to the centro de salud without a Social Security number — They cannot register you without it. Get the NUSS first.
• Not having your empadronamiento updated — If you have moved since your initial registration, update your padron first. Your centro de salud is assigned by address.
• Assuming your private insurance covers public system access — Private and public are completely separate systems in Spain. Having Sanitas does not give you a TSI card.
• Not asking about the digital card — Many people wait weeks for the plastic card when a digital version is available immediately.
• Registering at the wrong centro de salud — You must go to the one assigned to your address. If you go to the wrong one, they will redirect you.

After you get your card

Once registered, you can:

• Book GP appointments online, by phone, or through your regional health app
• Get prescriptions — Your GP can prescribe medications that you pick up at any pharmacy. Public system prescriptions have subsidised pricing (you pay a percentage based on income, typically 40-60%)
• Get specialist referrals — Your GP refers you. You cannot self-refer to specialists in the public system
• Access hospital care — Emergency and planned procedures through the public system at no additional cost
• Use your card across Spain — If you travel to another autonomous community, your card is valid for necessary care

Related guides

• Public Healthcare Eligibility in Spain by Residency Type
• How to Register at Your Local Centro de Salud in Spain
• Private Health Insurance for Spanish Visas: No Copays and No Deductibles
• Convenio Especial in Spain: Who Should Use It