These Days with this health situation we are facing, it shows us how essential it is for all citizens to have access to a quality health service.

Bearing in mind that Spain has one of the best public health services in Europe and that their public services practically cover all existing medical services it’s important to know that if you are foreigner and you are a resident in Spain you can access to the Spanish social security system. 

The Spanish Health Care System is accessible for Expats if they fulfil with some conditions. We will explain you how to access to the Spanish Social Security System in Barcelona (Cataloniaand Madrid, because each community has its own conditions of admission. 


The procedure of applying for the signing of the Special Agreement for the Provision of Health Care for persons residing in Spain who are not insured or beneficiaries of the National Health System. 

Persons who reside in Catalonia and who don’t have a recognized right to healthcare from the National Health System can request thisIs important to highlight that these people can have access to the Catalan Health Service (CatSalut) and Integral health system for public use of Catalonia (SISCAT) if these conditions apply for them 

  • Proof of being enrolled in a municipal census in Catalonia.  
  • Not having access to public healthcare through another entity different from the Catalan Health Service.  
  • Not having admitted the status of insured of beneficiaries of the National Health System.   
  • Not being covered by a particular case foreseen in the law.  
  • Not being entitled to public healthcare in submission of community regulations and international standards. 
  • Not being endorsed to a special agreement for the provision of public healthcare. 
  • Not being authorized to the provision of public healthcare for people applying for international protection. 
  • Not being entitled to provision of health care for victims of human trafficking in the period of recuperation and reflection. 
  • Proof of having an income lower than the quantity equivalent to the basic income for inclusion and social protection according with the law.  
  • The candidates must sign a certificate by which they consent to CatSalut to validate the data declared and confirm their authenticity 

How this process works?

You must present the application to the Primary Care Center (CAP) if you can apply for public healthcare through census registration even if you aren’t insured or beneficiaries of the NHS.

The next list of documents you must also present with the application form:

  • Proof of being registered with a municipal census in Catalonia.
  • Proof of income below the amount corresponding to the basic income for inclusion and social protection in accordance with the law.
  • Proof of not having access to public healthcare by another entity different from the Catalan Health Service (Servei Català de la Salut).
  • NIE, TIE or PASSPORT. Bear in mind that if you present a passport, it’s obligatory to deliver the documentation of identification that was submitted to present the census registration application.
  • Document signed by the applicant by which you authorize CatSalut to verify the data declared and check their veracity.
  • Document signed by the applicant by which you authorize CatSalut to charge you the sum of the expenses of the corresponding healthcare services in the event of having enough financial resources.


The procedure for demanding the underwriting of the Special Agreement for the Provision of Health Care for people living in Spain who are not underwritten, or recipients of the National Health System works like this:

  • This procedure can be requested by persons who live in the Community of Madrid and do not have a distinguished right to health care from the National Health System.
  • For this agreement to be authorize you will have to pay 60 EUR per month if you are under 65 years old, and 157 EUR per month if you are older.

How this process works?

The application:

  • Identify yourself with your ID or passport.
  • Fill in the forms and prove your unceasing residence in Madrid for one year, it will also be valid to deliver evidence of residence in an alternative Spanish municipality prior to your census enrolment in Madrid.

Around one month a motion will be released assessing the relevance of underwriting the Special Assistance Agreement.

If you obtain a positive result, the concerned party will have a three months for the formalisation of the agreement, to contact the Sub directorate General for Health Planning and Insurance through the telephone numbers offered, and will have to sign the Special Agreement in duplicate.

If you need more information or help in getting the right documents, do not hesitate to contact us. Our immigration department has helped clients from all 60 different countries, we are here to help you and make your application process smoother. 

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