How does healthcare in Spain work for expats in Valencia?
Healthcare in Spain for expats depends on your status: residents who work, are self-employed or receive a UK State Pension with an S1 form can use the public system, which the Conselleria de Sanitat runs in the Comunitat Valenciana, once they are on the padrón and registered with Spanish social security.
Others rely on private insurance or, after a year of residence, can apply to join the public scheme. Your key to public care in the region is the SIP card, issued by your local health centre, and an interpreter can come with you to the doctor or dentist.
Public or private healthcare: the three set‑ups
Most expats end up with one of three set-ups.
- Public healthcare through work or a pension. GOV.UK's guide to healthcare in Spain says that if you work or are self-employed in Spain, you are entitled to state healthcare on the same basis as a Spanish worker. UK State Pension holders may be entitled to Spanish state healthcare paid for by the UK, through the S1 form.
- Private insurance. Visa holders who do not work in Spain, such as non-lucrative visa holders, need private cover. The same GOV.UK page says that if you have lived in Spain for less than a year and cannot get healthcare cover, you will need private health insurance.
- Joining the public scheme later. According to GOV.UK, if you have lived in Spain for more than a year you can apply to join the public health insurance scheme, paying a monthly fee. The Conselleria de Sanitat lists access through its own convenio especial (special agreement) among its procedures.
Many residents combine both: the public system for their GP and hospital care, and private insurance for faster specialist appointments. Whatever you choose, GOV.UK is clear that all residents in Spain need to register to access healthcare.
- Through work, self-employment or an S1
- SIP card from your local health centre
- GP and hospital care
- After a year of residence: pay-in scheme
- Needed for most non-working visas
- Insurer authorised to operate in Spain
- Cover of all public-system risks for the non-lucrative visa
- Often kept alongside public care
Registering: padrón and the SIP card
The padrón is the municipal register of residents. You sign up at your town hall, and the certificate it issues (certificado de empadronamiento) is asked for in many procedures, including healthcare. GOV.UK's Living in Spain guide tells British residents to register on the padrón municipal at their local town hall.
Take your passport or NIE and proof of your address, such as a rental contract or a purchase deed, to the town hall. Each town hall sets its own list and appointment system, so check its website before you go. Being on the padrón also matters for school places and other local services, so it is worth doing in your first weeks.
The SIP card (tarjeta sanitaria SIP) is your health card in the Comunitat Valenciana. According to the Conselleria de Sanitat's health card FAQ, if you are insured through social security you go to the health centre nearest your home with your identity document (DNI or NIE).
The Conselleria recommends bringing a recent padrón certificate and the document from the INSS (the Spanish social security institute) that proves your right to healthcare. The centre registers you in the SIP system and issues the card.
With a digital certificate or Cl@ve, you can start the registration online instead (see the SIP card procedures).
Other situations get a different document. EU visitors with a European Health Insurance Card receive a temporary inclusion document, and people with private insurance can get an inclusion document that shows a SIP number. The SIP card is valid throughout Spain.
- Register on the padrón at your town hall
- Get your Spanish social security number (INSS or S1 registration)
- Go to your health centre with your NIE, padrón certificate and INSS document
- Receive your SIP card
UK pensioners and the S1
For British pensioners, the S1 form is the route into Spanish public healthcare. GOV.UK sets out the steps:
- request the S1 application form by phone from NHS Overseas Healthcare Services;
- register the S1 with the INSS in Spain;
- wait for the INSS to send you a Spanish social security number by post;
- take it to your health centre to get your medical card, which in the Comunitat Valenciana is the SIP card.
The S1 also helps with residence. The Spanish Consulate General in London accepts the receipt for registration of the S1 on the Social Security website as proof of health cover for the non-lucrative visa. If you return to the UK, GOV.UK reminds you to contact the NHS Overseas Healthcare Team to cancel the S1, and to tell your health centre that you are leaving.
When you get your S1 form, you must register it with the INSS.
UK GovernmentSource: GOV.UK, Healthcare in Spain
Insurance for visas
Health insurance is a condition for most Spanish residence visas. Article 62 of Ley 14/2013 asks digital nomad visa applicants for public insurance or private health insurance with an insurer authorised to operate in Spain. For the non-lucrative visa, the London consulate asks for a policy that covers all the risks insured by Spain's public health system.
Consulates check the policy wording closely, and each publishes its own list, so ask the insurer for a certificate that answers your consulate's requirements point by point.
A Spanish insurer usually issues the certificate in Spanish; if yours is in English, ask the consulate whether it needs a translation. Our post on non-lucrative and digital nomad visa documents covers the rest of the file.
Medical appointments in another language
Doctors in Valencia work in Spanish and Valencian, and medical conversations are where misunderstandings matter most. An interpreter can come with you in person to a GP, a specialist, a hospital appointment or the dentist. Accompanying an individual usually costs 60–100 € per hour; tell us the date, place, speciality and languages.
A little preparation helps the appointment go well:
- bring a list of your medicines with their active ingredients, not only brand names, which differ between countries;
- bring translated copies of recent reports or test results;
- write down your questions beforehand, so the interpreter can make sure each one is answered.
The interpreter translates both ways, keeps everything confidential and does not give medical advice; their job is to make sure you and the doctor understand each other. For a short phone or video consultation, remote interpreting can be enough (see remote interpreting).
For longer treatment, the same interpreter can follow you from one appointment to the next. You will find more on our interpreting services page; our Spanish-language page on medical interpreting goes into the clinical side.
Translating medical reports
Bringing your medical history with you saves repeated tests and gives your new GP the full picture: discharge summaries, specialist letters, test results, vaccination records and prescriptions. For your doctor, a professional medical translation is usually what you need.
A sworn translation by a translator appointed by Spain's Ministry of Foreign Affairs (MAEC) is only needed when a Spanish authority receives the document.
Examples include a disability assessment, an insurance claim, a court case or a visa application, where the London consulate asks for a sworn translation of medical certificates not issued in Spanish. A sworn translation costs about 70 € per page (60–70 € per page).
We reply within 8 working hours, and the certified digital version takes 2–3 working days. If you are dealing with other post-Brexit paperwork, our post on red tape in Spain after Brexit covers residency and the TIE.
Frequently asked questions
Can I get a SIP card without being on the padrón?
The Conselleria de Sanitat recommends bringing a recent padrón certificate when you register at the health centre, so register at the town hall first. If you are in a different situation, for example without healthcare coverage, the Conselleria's FAQ tells you to ask the health centre to refer you to its social worker.
Do I still need private insurance once I have residency?
It depends on how you are covered. Workers, the self-employed and S1 holders use the public system. If you are not covered that way, GOV.UK says you will need private insurance during your first year and can then apply to join the public scheme.
Can I register for the SIP card online?
Yes, if you have a digital certificate or Cl@ve; you then collect the card at your health centre. Without them, go to the health centre nearest your home.
Is the SIP card valid outside the Comunitat Valenciana?
Yes. The Conselleria de Sanitat says the SIP card is valid throughout Spain. For trips to other EU or EEA countries, ask the INSS for a European Health Insurance Card.
Will the health centre provide an interpreter?
Do not count on it. You can bring your own interpreter to the GP, a specialist or the dentist; accompanying an individual usually costs 60–100 € per hour.
Do my medical reports need a sworn translation?
Not for your doctor, who needs an accurate medical translation. A sworn translation by a MAEC-appointed translator is needed when an authority receives the report, such as a consulate, a court or an assessment board.
