On this page
Health services are run by each autonomous community. The tarjeta sanitaria details come from the Comunidad de Madrid, so check your own region. Amounts for the convenio especial were shown without a year.
At a glance
- Automatic recognition
- Workers, pensioners, exhausted unemployment benefit
- Card fee (Madrid)
- No fee
- Card arrives
- About 3–4 weeks (Madrid)
- Convenio especial
- €60/month under 65, €157/month from 65
Your checklist
First steps
Your checklist stays on this device.
Recognition and the card are two steps
The right to healthcare is recognised first. The Madrid page asks for a recognised right to healthcare from the INSS, for registration on the padrón in Madrid and, for foreigners, a valid residence permit or one in renewal.
The card of a foreign resident has limited validity tied to the residence document, and you must show that the permit is valid each time you renew it.
Convenio especial conditions
You need at least one year of continuous effective residence in Spain immediately before applying (time in the EU, EEA, Switzerland or the UK counts), padrón registration, and no access to public health protection by any other route.
Documents include an identity document, proof of one year of residence, a padrón certificate and, for nationals of listed countries, a sworn statement that you have no right to public cover at home. EU citizens with five continuous years of legal residence in Spain are entitled to public healthcare and do not need to sign.
What this guide does not cover
A Ministry page covers a March 2026 decree on healthcare for foreigners without legal residence, which this guide does not cover. We also did not confirm how other regions run the card application or whether an appointment is needed in Madrid.
Common questions
Do foreign residents get public healthcare in Spain?
Yes, if they are residents with the right recognised and no cover through another route. Workers, pensioners and people who have exhausted unemployment benefit are recognised automatically, according to the Seguridad Social form.
How do I get the tarjeta sanitaria?
In Madrid you apply in person at your health centre. It requires padrón registration, a recognised right to healthcare and, for foreigners, a valid residence permit. The card arrives in about three to four weeks.
Does the tarjeta sanitaria cost anything?
The Madrid page says no fee is required.
What is the convenio especial?
A paid scheme for economically inactive people who need health cover to reside in Spain. It requires one year of continuous residence, padrón registration and no other access to public cover.
What if I need care before the card arrives?
The Madrid page says to go to your health centre.
Official sources
Read this first
- Seguridad Social: healthcare benefit application (form 6-071)Who is recognised, exclusions, documents and who can be added as beneficiaries
- Comunidad de Madrid: tarjeta sanitariaCard requirements, no fee, delivery time and validity for foreigners
- Ministry of Health: convenio especialConditions, documents and monthly contribution
Rules can vary by nationality, work or study status, and city. Confirm your route with the official authority before you act.