Registering a family member for Spanish public healthcare has two halves. The Seguridad Social recognises the right, and your local health centre issues the card. Here is how to do both yourself.
Eligibility
You can only register a family member if you already hold the right to public healthcare yourself, for example as an employee, an autónomo, a pensioner, or a recipient of a Seguridad Social benefit.
The family member must
- Have legal and effective residence in Spain.
- Have no compulsory public healthcare cover through any other route.
-
Be one of the following:
- Your spouse, or your registered unmarried partner (pareja de hecho).
- A descendant of you or your spouse, under 26.
- A descendant of you or your spouse, aged 26 or over, with a recognised disability of 65% or more.
If your spouse or partner already holds the right in their own name, they must be the one to submit the request, not you.
Documents you'll need
The session times out while you fill in the form, so have everything ready before you start.
Always
- Your DNI or NIE, and your número de la Seguridad Social.
- The family member's DNI or NIE. For under 14s this can be supplied later, but it becomes mandatory once they turn 14.
For a child or other descendant
- Libro de familia, or birth certificate.
- Not needed for a baby under three months old, as the Registro Civil sends the birth details to the INSS automatically.
For a spouse or partner
- Marriage certificate, or your certificado de pareja de hecho.
For a descendant aged 26 or over
- Certificado de reconocimiento del grado de discapacidad.
If the family member is arriving from another EU country
- You may be asked for a certificado de no exportación de asistencia sanitaria, confirming they are not carrying healthcare cover over from that country. This has to be requested from the institution in the country they are leaving, so start it early.
Step 1: choose how you will identify yourself
There are two routes.
Card A - with certificado digital or Cl@ve
Easier routeOpen Tu Seguridad Social, or go straight to the alta de beneficiarios service.
Adding a beneficiary needs a higher level of identification than simply checking your own entitlement. If you pick the registration option, the site tells you this and then shows which identification methods you can use.
Once you are in, go to the asistencia sanitaria section, add the family member, and select the relationship.
If you are acting on someone else's behalf, they confirm it through a link sent to their mobile by SMS, and you attach the standard representation document at the end.
Do not have one yet?
A certificado digital or Cl@ve makes this trámite, and most other Spanish administration, considerably simpler. We can walk you through getting one.
Card B - without certificado digital or Cl@ve
Use the INSS portal for people without digital identification. You will need an email address and a device with a camera.
Open the INSS portal for people without digital identification- 1 Upload photos of both sides of your DNI or NIE.
- 2 Take a live selfie holding the document. You can do this on the device you are using, or scan a QR code to switch to a phone.
- 3 Enter your province and municipality of residence.
- 4 Download form 6-071 if you have not already, fill it in, and attach it along with your supporting documents.
You are then given a verification code. With that code and your DNI or NIE you can check the status of your request, see anything the case handler has added, and attach further documents if the INSS asks for them.
Worth knowing before you start
Without a digital identification method, the resolution reaches you by post rather than online, and you cannot receive electronic notifications from the Seguridad Social. If you expect to deal with Spanish administration again, it is usually worth setting one up first.
Step 2: after you submit
For a baby under three months old, the right is recognised automatically and immediately, and you can download the proof of entitlement straight away.
For everyone else, your request goes to the Dirección Provincial for the province where your address is registered with the Seguridad Social, which carries out the checks. Download the receipt before you close the page.
Check your registered address first. If you have moved and never updated your address with the Seguridad Social, the request is routed to the wrong province.
The law gives the INSS a maximum of 30 days to resolve and notify, counted from when the request is registered, or from when any documents they have asked for are supplied. That is a legal ceiling rather than an expected wait, and it does not run while they are waiting on you. The resolution is sent to your home address.
Step 3: get the health card
The INSS decision gives your family member the right to healthcare. It does not give them a card or a doctor. That last step happens at your local health centre.
Once the right is recognised, download the documento acreditativo del derecho a asistencia sanitaria from the Seguridad Social. Then go to the health centre for the address where you are registered as resident (empadronado), and take:
- The documento acreditativo.
- The family member's DNI or NIE, or libro de familia for a child.
- A recent certificado or volante de empadronamiento, usually one issued within the last 90 days.
The health centre issues the card and assigns a doctor or paediatrician. Requirements and the name of the card vary between regions, so check your regional health service page before you go.
The Tarjeta Sanitaria Europea is a different document, issued by the Seguridad Social for travel within Europe. It is not a substitute for the regional card.
Sources
Official sources
- Seguridad Social guide to registering a beneficiary (Spanish)
- Seguridad Social page for this trámite
Last verified: 4 August 2026
This guide reflects the official process at the date shown. Procedures and requirements can change, and regional health services set their own rules for the final step.
Where we can help
Most of this is form filling. What tends to stall people is everything that happens outside these websites: getting an empadronamiento appointment, registering a pareja de hecho, obtaining a certificado de no exportación from another country, or following up when a Dirección Provincial goes quiet.
If you would rather not handle those, we prepare the paperwork, submit on your behalf and follow it through with you.
See our family healthcare registration service