Find out what to expect from the medical system in Spain if you’re moving there to live and work or to retire. Understand how to register with the system and what to do in the event of an emergency…
The Spanish healthcare system is funded by social security contributions and combines public and private healthcare. Citizens who pay social security automatically have the right to use the Spanish healthcare system. The government sets the overall budget for the country, but each region takes individual responsibility.

To benefit from the Spanish National Healthcare system and medical assistance, residents must enrol with the General Social Security Fund (Dirección General de la Tesorería General de la Seguridad Social – TGSS). This gives access to free or low cost healthcare. Provincial social security offices are located throughout the country.

  • Contact information for local TGSS offices
  • The European Commission has published a detailed pamphlet called Employment, Social Affairs and Inclusion in Spain (PDF). Chapter two contains information regarding healthcare.

Private medical insurance, as well as the Special Agreement (Convenio Especial), which allows people to access the state-run healthcare service by paying a monthly fee, is also available to those not covered by the security and healthcare system.

The Healthcare System

Any person legally resident in Spain can benefit from the Spanish social security and healthcare system provided they fall into one of the following categories:

  • Employed workers
  • Self-employed workers
  • Students
  • Workers affiliated with a work co-operative
  • Civil servants or military personnel



Spain’s social security system has two levels:

  1. Contributory: The contributory scheme consists of one general and five special schemes, which includes the majority of the working population. Students are covered by a special protection plan.
  2. Non-contributory: The non-contributory level is for people with no or with a very low income. The benefits include medical assistance.

Social Security Number

Any resident, either salaried or self-employed, is issued with a social security number. This entitles a person to healthcare, sickness, unemployment benefits, as well as government pensions. Once a number is obtained, it is valid for life.

Employers request a social security number for an employee if they don’t already have one. Self-employed workers may make the application themselves or hire a gestor to complete the process for them.

The application form and required documentation should be presented to a local office (local to the applicant’s workplace or home) of the TGSS. Once the application has been submitted, the worker receives a certificate of registration (documento de afiliación) and a registration number.

The following documents must be presented:

  • A form of national identification with one photocopy; a Número Identificatión de Extranjero (NIE) is sufficient
  • Residency certificate or passport with one photocopy
  • Form TA1 (PDF)

If a person loses their job or ceases to work, they must notify the Tesorería General de la Seguridad Social immediately. The worker is liable for contributions until the agency is notified.