How to access the Spanish public healthcare system as a beneficiary

Healthcare in Spain

Has your husband or wife been granted S1 entitlement to public healthcare in Spain? Have you got a few more years to retirement? Or maybe you aren’t working but your spouse has a job or is self-employed …
Good news is that you can ‘piggy-back’ access to the state healthcare system as a spouse. 

Using S1 form
If your spouse has been granted an S1 but you’re not of retirement age, then you can ride off the back of their S1. You’ll need to request an S1 from the Pensions Authorities (NHS) in the UK, and this useful article explains how to do this. 

Once you receive the S1 with dependant as beneficiary confirmation, take this along with your passport, marriage certificate, residency document and Padron certificate to the INSS (Spanish Social Security) – don’t forget to book an appointment first. 

Spouse is working, or Self employed
If your spouse is working or self-employed, then you can also gain access to the public healthcare system in Spain. If you’re a British citizen, you’ll need to provide several documents, as follows:

When you have all these (and copies), make an appointment at the INSS either online via this link or by sending an email to
You can also submit your application online – this link to the UK government website goes through this process step-by-step.
Alternatively, some gestores can arrange the whole process for you for a small fee.

What happens after you’ve submitted your application?
In the case of an S1 registration, you’ll need to wait for a letter to confirm your access to healthcare – this can take up to 3 months to come through. If you haven’t received the letter within 90 days of the application, it’s best to book another appointment and request information of the progress at the INSS office.

In the case of a spouse who has access due to work or self-employment, access is usually granted straight away, and you walk away with the ‘access to healthcare’ letter. 

You need to register the letter with your local Centro de Salud (Healthcare Centre), where they will order your Health Card (Tarjeta Sanitaria) and assign you a doctor. The Health Card should be delivered to our home address within a few weeks – in the meantime, the Access letter is sufficient to confirm your eligibility for treatment.

The information in this article was correct on the date published.
Article last updated 17/10/2021.

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