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Spanish Health Cards by Region (2026): SERMAS, TSI, SIP, SAS and SCS

Jules

Editor

Updated: October 2026 | Found helpful by 4 others

As of October 2026, Spain's public health card (tarjeta sanitaria) is free and issued by your regional health service: SERMAS in Madrid, CatSalut (the TSI) in Catalonia, the GVA (the SIP card) in Valencia, SAS in Andalusia and SCS in the Canary Islands. You request it after the padronand once you hold a healthcare entitlement or insured status, and Catalonia's uninsured route and Madrid's DASE route add their own padron-history conditions.

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Where Does the Health Card Fit in Your Arrival Steps?

Passport and visa or EU status, then address evidence, then padron where required, then NIE and TIE or EU registration, then NUSS and health entitlement, then the regional health card, then digital identity, then online municipal, DGT and AEAT services. This is an operational sequence, not a legal order: an FNMT certificate can often come before the TIE, and some workers get a NUSS before the padron.

  1. Address evidence and the padron where required
  2. NIE and TIE, or EU registration
  3. NUSS and a healthcare entitlement or insured status
  4. The regional health card (this page)
  5. Digital identity, then online services
Illustration of a shield, an umbrella, and a health cross, for health, home, and liability insurance cover in Spain.
Health, home, and liability: Spanish cover at a glance.

What Do You Need to Get a Spanish Health Card?

The card is regional, so the issuer and the channel depend on where you are registered. The fields below come from the five regional services this guide covers.

Regional health card procedure, October 2026. No office guarantees a processing time.
Local termTarjeta sanitaria (TSI in Catalonia, SIP in Valencia)
Issued byThe regional health service: SERMAS, CatSalut, GVA, SAS, SCS and others
TriggerPadron plus a healthcare entitlement or insured status
DocumentsID; Padron certificate; INSS, S1 or employment evidence, as the region requires
FeeFree
DeadlineNo deadline
ChannelThe regional health service; in Andalusia the first request is in person at the centro de salud
CaveatCatalonia's uninsured-access route and Madrid's DASE route have their own padron-history conditions.

Whether you have an entitlement in the first place is a separate question: see health insurance in Spain for public and private cover.

How Does the Health Card Differ by Region?

National residence law does not change by region; the health card, its local name and the request channel do.

RegionHealth cardSource
MadridSERMAS card; the DASE route for specified uninsured or irregular situations requires padron historyComunidad de Madrid: health services
Catalonia (Barcelona)CatSalut issues the TSI; the uninsured route has continuous-padron and income conditions, and some cards need annual renewalCatSalut
Comunitat ValencianaGVA SIP card at the assigned health centre; +Salut uses SIP credentialsGeneralitat Valenciana: Sanitat
AndalusiaFirst SAS card request in person at the centro de salud, with padron and entitlement evidenceJunta de Andalucia: salud
Canary IslandsSCS card plus padron and entitlementServicio Canario de la Salud

More on two of these services: SERMAS and CatSalut.

What About the Other Regions?

The other 12 autonomous communities, plus Ceuta and Melilla, run their own health card administration. This guide does not cover them, and the rules above should not be copied across: check the current requirements with your own regional health service before you apply.

Which Route Fits Your Situation?

Worked scenario, October 2026. The winner is the most defensible process, not a paid product.
#SituationBest answerRunner-upWhyRuled out
B8Uninsured resident in CataloniaCheck CatSalut special-access route after required padrón periodPrivate insurance pending entitlementRegional route matches actual coverage gapCopying Madrid DASE rules: wrong region/document

Frequently Asked Questions

Is the Spanish health card free?

Yes. The regional health card (tarjeta sanitaria) carries no fee, as of October 2026. It is issued by your regional health service, for example SERMAS in Madrid or CatSalut in Catalonia, once you hold a healthcare entitlement or insured status.

Do I need the padron to get a health card in Spain?

Yes. The trigger for the regional health card is the padron plus a healthcare entitlement or insured status. Regions typically ask for your ID, a padron certificate and INSS, S1 or employment evidence, as each region requires.

What are the TSI and the SIP card?

They are regional names for the same kind of public health card. In Catalonia, CatSalut issues the TSI (Tarjeta Sanitaria Individual). In the Comunitat Valenciana, the GVA issues the SIP card at your assigned health centre, and the +Salut service uses SIP credentials.

Can I get a health card in Catalonia without insurance?

Catalonia has its own CatSalut route for uninsured residents, with continuous-padron and income conditions, and some second-level cards need annual renewal. Madrid's DASE rules are a different regional route, so do not apply them in Catalonia.

How do I request a health card in Andalusia?

In Andalusia, the first SAS health card request is made in person at the centro de salud, with padron and entitlement evidence.

Sources

Change log

Updated

  • Published: Spanish health cards by region (SERMAS, TSI, SIP, SAS, SCS)
  • Added links to the convenio especial and visa health insurance pages