Healthcare in Spain: What you need to know

Tapas, sangria, flamenco…all these wonderful Spanish clichés await you in your new life in Spain.

Healthcare in Spain: What you need to know
Photo: monkeybusiness/Depositphotos

Just one thing before you grab your castanets and go. You should really take the time to look into the healthcare system in your new country. It’s always good to know the basics, just in case.

Unless you’re already fluent in Spanish and familiar with Spain, knowing where to start can send your head spinning. That’s why we’ve pulled together this nifty guide to help you get sorted, so if you feel la fiebre coming on, you know who to call.

Registering for healthcare

You’ll be pleased to hear the Spanish healthcare system offers free or subsidised health services and prescriptions for official residents and their family members. That means once you’re a legal resident and pay Spanish social security you get access to the same healthcare as Spanish citizens. ¡Olé!

Don’t panic if you’re not paying social security. There are also deals if, for example, you’re a retired British pensioner living in Spain and not paying into the Spanish system. 

When your situation is clearer, you can start the process of registering with a doctor. But first, you’ll have to register with the state healthcare system. Spanish healthcare is decentralised, and each of the 17 regions is responsible for itself. That means you should check with your regional health authority to find out what services are available to you and how to access them.

You’ll also have to register your address on the padrón at your local town hall, or ayuntamiento, where you will be given a certificate of empadronamiento. When you first register with your doctor, remember to take this with you – it also comes in handy for other situations where you may need proof of address.

If you’re living or staying for an extended time in Spain but not eligible for state healthcare, you can take out private healthcare insurance. Insurance companies like Cigna Global offer excellent packages that include access to its global network of hospitals, clinics and doctors, as well as a 24-hour helpline so you have support around the clock.

Finding a doctor

Most likely you’ll have a health clinic, centro de salud, or an individual practice, médico de cabacera, nearby. These offer all the regular primary care services, and you can usually find one through the phone book under medicos or your local healthcare authority.

In some of the more remote or less populated areas, you may have to travel to find a healthcare provider, or there may be a doctor or nurse available on specific days. If you know people in the area they might be able to recommend a doctor, and your embassy may also maintain a list of English-speaking doctors in your area.

Once you’ve found a doctor, you will need to register before you can make an appointment. This is when you’ll need to show your empadronamiento – which must have been issued within the last three months.

You should also take your TGSS (Tresoreria General de la Seguridad Social) certificate, passport, and Foreigners’ Identity Number (N.I.E.). All three are needed to apply for your health card, or tarjeta sanitaria individual, as well as a Sistema de Informacion Poblacional, which is a non-transferable card that gives you access to Spanish healthcare.

Each time you visit the doctor, hospital, or pick up prescription meds you will be required to show this card. It will mean you are entitled to receive state health without charge, so make sure to keep it somewhere safe!

Emergency care

If you need urgent medical care you should go straight to your nearest hospital’s emergency room, or urgencia (there’s a nice easy word to remember). Most chemists, or farmacias, will also be able to tell you where to go if you need urgent medical treatment.

Spain’s general emergency number is 112, so if you need a paramedic or require an ambulance then dial that number straight away. It’s a good idea to learn the Spanish translation if you suffer from an existing medical condition or allergy so there’s no confusion over how to treat you.

In case of emergency, you will be required to show your health card to receive state treatment. Or if you have private health insurance make sure to keep your details handy.

Cigna Global’s International Health Insurance covers emergency medical care, including reasonable transportation costs to the closest centre of medical excellence in the event that the correct treatment is not locally available in an emergency. It’s good to have this peace of mind while living abroad, so there’s no doubt over what care you and your family are entitled to in case of an emergency.

Find out more about Cigna Global health insurance

Specialist care

To see a specialist through the state system you will need to get a referral from your doctor. If you have private health insurance in Spain you can often skip this step and make an appointment directly with a specialist clinic, saving you time spent potentially worrying or in pain.

With a private health care provider like Cigna Global you will get an appointment faster than if you go through the state system. Cigna can also find you an English-speaking doctor so there’s no language barrier throughout the diagnosis and treatment.

Get a free quote from Cigna Global


Spanish farmacias are easy to spot, just look out for the flashing green cross in or outside the window. Unlike in some other countries, all medicine, including over the counter painkillers like paracetamol and ibuprofen, must be purchased in a farmacia. If you are new to your area and not sure where your closest farmacia is, you can find it here.

If you have a minor ailment or common illness, the highly-trained pharmacists can provide you with treatment. In the bigger cities where there are more tourists this can often be done in English; however, further inland or in remote areas this may not be as easy. If your problem is more serious or ongoing, you should still see your doctor for a proper diagnosis.

Make sure to take your health card along with you when you pick up any prescription medicines. You still have to pay 60 percent of the cost, but in general, medication is fairly reasonable. If you are a pensioner you are entitled to free prescriptions.

Something to keep in mind is that you are living in the land of the siesta, so most farmacias close for a couple of hours in the afternoon and re-open around 5pm. On weekends they can close earlier, so make sure to check and visit early on in the day if necessary. Some regions have emergency pharmacies that are open 24 hours so if it’s urgent you can pick up medicine out of regular hours.


Although the Spanish state healthcare system is one of the best in the world, it’s always useful to have access to private healthcare. Cigna Global specialises in healthcare for expats, offering flexible coverage at every level so you can enjoy your paella without worrying about all that cholesterol in the prawns.

This article was produced by The Local Client Studio and sponsored by Cigna Global.

For members


Do I have to do Spain’s annual tax declaration if I arrived recently?

There’s less than a month left to file Spain’s annual tax return, so where do new arrivals stand regarding this? Are they already tax residents? What if they didn’t work in Spain last year and only arrived in 2024?

Do I have to do Spain's annual tax declaration if I arrived recently?

The Spanish tax system can seem a little complicated at times. This is especially true if you’ve just arrived in the country and don’t speak the language.

A common question among newcomers to Spain is whether or not you’ll need to do an annual tax declaration if you recently arrived in the country.

The Local has covered the tax declaration, known simply as la renta in Spanish, in considerable detail before. You can find our collection of tax articles here

But do you have to do Spain’s annual tax declaration if you arrived recently?

The Local Spain spoke to lawyer Maryem Essadik, CEO of Spain-based Marfour International Law Firm, to find out more. 

Do people who have recently arrived in Spain have to file an income tax return?

“It depends on your status as a tax resident or non-resident in Spain, which will be determined based on the requirements provided for in Article 9 of Law 35/2006, of November 28, on Personal Income Tax (LIRPF). 

“If considered a tax resident, that person will be required to submit a Personal Income Tax return, provided that they obtain the minimum amounts to be required to submit it.”


Spanish tax residence begins after 183 days in the country. Are there any circumstances in which a person who has recently arrived in Spain (less than 183 days) has to do it?

“If a person stays less than 183 days in Spain during the fiscal year, they will generally be considered a non-tax resident in Spain, and it must be taken into account that “sporadic absences” abroad could be part of said calculation, in accordance with Article 9 of the LIRPF. 

“Additionally, a person may be considered a tax resident in Spain (even if they do not remain in Spanish territory for more than 183 days during the fiscal year) if their base of activities or centre of economic interests is located in Spain, or when your family are considered tax residents in Spain, unless the opposite is duly proven.

“The person who is considered a non-tax resident will only pay tax in Spain on the Spanish-source income obtained during the corresponding fiscal year. 

“Your obligation to file an income tax return will depend on the type of income obtained and whether the payer has applied and paid the corresponding withholding/payment on account, to the extent that they are required to do so.”


Keeping in mind that the 2024 Declaración de la Renta applies to the previous year, would they have to pay taxes in Spain for their 2023 income if for example they arrived in March 2024?

On the basis that in 2023 that person did not reside in Spain, in principle they would be considered a tax non-resident in said country. 

Therefore, as mentioned, they should only be taxed in Spain in 2023 if they obtain any income from a Spanish source.