Public health card (tarjeta sanitaria individual, TSI)
Reviewed on October 28, 2026
Summary
The tarjeta sanitaria individual (TSI, individual health card) is the card you use for public health care: family doctor, health centre, specialists and prescriptions. It is issued by the health service of your autonomous community (region) and applying is free. Usually you need to be registered in the padrón (empadronamiento) and to have your right to health care recognised. If you are in Spain without legal residence, you also have this right: since 13 March 2026, Real Decreto 180/2026 sets a common procedure, with a temporary document that gives you access from the day you apply and an answer within a maximum of 3 months.
Who is this for?
For people who live in Spain: with a residence permit (workers, family members, etc.) and also foreigners without legal residence. It is not for tourists or for short stays covered by another country's social security or insurance.
Key facts
- Cost of the card
- Free
- Who issues it
- The health service of your autonomous community (for example, SERMAS in Madrid or CatSalut in Catalonia)
- Usual requirements
- Empadronamiento + recognised right to health care
- Who recognises the right
- The INSS (national social security institute) if you have legal residence or work; your autonomous community if you do not have legal residence
- Without legal residence
- Real Decreto 180/2026: temporary document when you apply; answer within a maximum of 3 months
- Time (Madrid)
- About 3-4 weeks from when they validate your documents
- Emergencies
- Call 112 or go to the emergency department (urgencias): do not wait until you have the card
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Official sources
- Real Decreto-ley 7/2018, on universal access to the Sistema Nacional de Salud (BOE) · checked on October 28, 2026
- Real Decreto 180/2026, of 11 March, right to health care of foreigners without legal residence (BOE) · checked on October 28, 2026
- Ministerio de Sanidad: approval of the royal decree that strengthens universal access · checked on October 28, 2026
- Ministerio de Sanidad: Individual health card · checked on October 28, 2026
- Social Security e-office: Health care (INSS) · checked on October 28, 2026
- CatSalut: Getting your first Tarjeta Sanitaria Individual (TSI) · checked on October 28, 2026
- Comunidad de Madrid: Health card · checked on October 28, 2026
- Comunidad de Madrid: Health care for foreigners (DASE) · checked on October 28, 2026
Nuevo en España offers public information from official sources, quoted and dated. It is not legal advice, it does not book appointments (cita previa) and it does not carry out procedures on anyone's behalf. Rules change: always check the linked official source. For your specific case, consult a lawyer or a free support organisation for migrants.
Other guides
- How to register your address in Spain (empadronamiento)
- Renew your residence permit (including the Real Decreto 316/2026 permit)
- Social Security number (NUSS / NAF)
- Open a bank account
- Get your degree or diploma recognised (homologación or equivalencia)
- Driving licence: exchange (canje) or theory test
- Path to Spanish nationality by residence