(Britain’s exit from the EU has not changed the rights of those Britons living in Spain in the future, providing you are registered as resident and have the green-coloured certificate (credit-card-sized or A4 sized) OR the equivalent TIE photo card that shows you were resident in Spain by the end of the transition period (31st December 2020). If you meet the requirements you can still register after 31st December 2020. If you arrived to live after the end of 2020, different rules and entitlements could apply to you).
For Spanish public healthcare, as a British national living in Spain, you will first need to register as a resident with the Spanish government and also register on the census of your local town hall, (padrón/certificado de empadronamineto). Please click here to find out how to do these two things if you have not already done so.
KEY FIRST STEP: For fuller details and up-to-date information on how to go on to register for healthcare in Spain (and who is entitled to it), please see in detail the UK government’s Living in Spain guide Healthcare section.
Once you have seen the Living in Spain information above, below is some helpful extra information on the process to register, including finding your nearest INSS office and your nearest public health centre. This additional information is aimed primarily at those British residents who are getting a UK State pension or other UK benefit that entitles them to free Spanish healthcare through the S1 form:
Getting an INSS appointment to register your S1 form from the UK (or other similar inquiry)
To find your nearest social security office in Spain – INSS, Instituto Nacional de la Seguridad Social – (National Social Security Institute) please click here and enter the name of the town or village where you live (for the areas we currently cover in detail on this website).
Otherwise, use the search service on the Spanish government website by clicking here to find the nearest office. (In ‘Localización’, choose province ”Por Provincia” and then select from the drop down list and press ‘Aplicar Filtros’. On the same page, at the bottom, if you click on the ‘+’ sign next to the words ‘Buscador de Oficinas Cercanas’ you can find a searchable map. Make sure you are choosing an INSS office – Instituto Nacional de la Seguridad Social – and not a TGSS office, which is a different part of the service).
As long as you stay within the province where you have your residence, you can make an appointment at any INSS. (Occasionally you may see INSS offices referred to as a CAISS on some other websites. These are the same places).
Take your S1 to the INSS appointment, (plus your residency proof document, padrón and valid passport). Taking photocopies is also advisable.
If you are receiving a state pension in the UK (or other valid benefit), you will also need to take with you your S1 form from the UK health authorities. Click here for more information on the S1 including how to get it.
By providing this S1 to the INSS they can give you a certificate of proof of eligibility, (known as DOCUMENTO ACREDITATIVO DEL DERECHO A ASISTENCIA SANITARIA PÚBLICA / Acreditation document of the right to Public Heath Care).
With your INSS certificate as proof of eligibility, and your newly issued social security number on it that they give you, you will be able to register at the health centre nearest to where you live and apply for a tarjeta sanitaria (health card), which you are required to take to the doctors, hospital or the pharmacy for prescriptions each time you visit.
You can contact your chosen INSS office in person (with a prebooked appointment) or you can submit an application online.
How to book an INSS appointment
Please see above for how to find your nearest or most convenient office, or where there are appointments available.
To make an appointment at the office, you can do so via telephone or via the Social Security online platform:
i) Call the automated phone line: (0034) 901106570 (This is in Spanish so it is recommended that a Spanish speaker makes the call) Or
ii) See the online link for appointments by clicking here. If you do not have a digital certificate (certificado digital) on your computer from the Spanish government in order to log on, (or your advisor who may be helping you does not either), you can enter via the No Certificate (sin certificado) route towards the bottom of the screen. The online form to fill in for an appointment is in Spanish.
Generally, the option to select on INSS forms or phone calls, when asked, is not the ‘pensiones’ (pensions) option but ‘otras prestaciones’ (other benefits).
To submit the paperwork online: If you are confident about using your computer to apply for things online and understand Spanish*, you can currently submit your S1 document and the INSS paperwork without going to an office in person.
The link here on the British government’s Living in Spain guide explains well this process of submitting the S1 form online . https://www.gov.uk/guidance/register-your-s1-form-in-spain-online
If you have recognised dependants, (for example a husband or wife who is not yet UK pension age and who does not qualify in their own right), you can add them to the application too. For a spouse, you will need to provide a certified marriage or civil partnership certificate and a sworn translation of it. To certify a UK certificate see this UK govt. website by clicking here.
*A volunteer helper or a professional adviser (such as a ‘ gestor’) could do this online process for you as well if you have one. You can do this online even if you have no government-issued digital certificate on your computer.
Helpline: The INSS has a general helpline on (0034) 901166565 Monday to Friday (excl. holidays), from 09:00 to 20:00. Operators can help and answer questions in Spanish but there is a lot of demand and there may be a considerable wait.
If you feel you need an advisor to help you, or you do not understand Spanish and a friend cannot help, this following link explains about the very common use of ‘gestores’ (professional advisors to help fill in paperwork in Spain for a relatively small fee). Click here for information.
Some local organisations and charities may also be able to help you with the process, such as a quick understanding of paperwork in Spanish at no cost or a very low cost. Please see this link for suggestions of those that cover your local area and the types of help they may be able to give. (When you click on the link, add in the name of your town when asked to see those covering your local area).
Because of Covid-19, the INSS staff are very busy, whichever route you follow, and responses are not immediate. Even if you submit paperwork online you still may be asked to attend an appointment.
Disclaimer note: The information we provide on this page is for general guidance only based on feedback from other users and is not a replacement for contacting the INSS itself to understand what its requirements are or, alternatively, taking professional advice. Processes may change and we at Support in Spain welcome any feedback to help future users by sending an email to [email protected] (although we regret we cannot give personalised advice). We cannot be responsible for any changes or errors.
The final stage; going to the Health Centre
With your INSS certificate as proof of eligibility, and your newly issued social security number on it, you will be able to register at the public health centre nearest to where you live and apply for a tarjeta sanitaria (health card), which you are required to take to the doctors, hospital or the pharmacy for prescriptions each time you visit. (These are issued by the regional governments’ local health services that each give them different designs and names. For example; in Andalucía (Costa del Sol, Almería etc.) it is dark green, Canaries it is blue, Murcia it is burgundy, in Valencia and Costa Blanca it is known as a SIP card, etc.)
To find your nearest public health centre in Spain (for the areas we currently cover) please click here and enter the name of the town or village where you live. Normally you have to register in person, but during the Covid-19 health restrictions some centres may allow you to do this by email. Contact your local centre for more information. (You do not have to use the public health centre closest to where you live; normally you can choose another one providing it is in the same broad area and there are spaces. You also have the right to choose a doctor if you want; rules vary by region. Ask in your local health centre).
Further useful hints
If you are not entitled to register for free healthcare, you may be able to pay for access to the Spanish public healthcare system on a monthly basis if you have been on the padrón town hall census for a year (Convenio Especial). For more details on this and other healthcare provision in Spain see the UK government’s website Living in Spain. Or ask your local public health centre about the Convenio Especial. The advantage of this system (compared to private insurance) is that preexisting health conditions are covered.
If you have been living in Spain more than 5 years and hold a residency document saying “permamente” on it and cannot get public healthcare by any other route, you can also normally apply for it. Ask at the INSS office.
Any British nationals who are legally working in Spain (paying into the Spanish social security system) are entitled to register for Spanish public healthcare.
If you are a child or spouse of someone working and living, or who has worked and lived, in Spain you are likely to also have rights to Spanish healthcare. Ask at the INSS and see the UK government’s Living in Spain information.
Using the British NHS for routine, non-emergency treatment if you are resident in Spain
If you arrived to live in Spain before the end of 2020: British nationals who gain their entitlement to Spanish state healthcare through presenting their S1 form, (which normally means existing UK State pensioners, or future ones who were living in Spain in 2020 but retire after 2020), are also entitled to still use the British National Health Service, (NHS), as well for emergency and routine treatment, even for temporary stays. You will need to show your S1 form to the NHS in the UK for non-emergency treatment and not any EHIC/GHIC card. If you have any difficulty accessing NHS care you should contact the UK’s Overseas Healthcare service on +44 191 218 1999.
If you arrived to live in Spain after the end of 2020: If you have the S1 form you can continue to use the UK NHS for urgent, primary care but any NHS secondary care must be arranged and approved in advance.
British nationals settled in Spain who are not entitled to Spanish healthcare as a result of their S1 form but who get free public healthcare in Spain for another reason (for example because they have a work contract in Spain or a Spanish State pension) can use the NHS in the UK for emergency treatment only on short stays and by presenting their valid Spanish-issued blue EHIC card equivalent (know in Spain as the Tarjeta Sanitaria Europea – TSE)
For more on EHICs and TSEs see this UK government link
(According to the Withdrawal Agreement, Britain’s exit from the EU has not changed the rights of those Britons living in Spain into the future, providing you are registered as resident and have the green-coloured certificate (credit-card-sized or A4 sized) OR the equivalent TIE photo card that shows you were resident in Spain by the end of the transition period (31st December 2020). If you qualified at the end of 2020, you can still register after that date).