Public Health Card (TSI) in Catalonia: How Newcomers Get One

You have a sore throat, a prescription to collect, or a child who needs a check-up, and the pharmacy or the clinic asks for a card you do not have. In Catalonia, public healthcare runs on a single card, and getting it involves a few steps in a particular order, often in Catalan or Spanish. This guide explains how it works for newcomers in Barcelona. It is general information, not legal or medical advice, and the rules for your own situation may differ.

What is the TSI, and do I need one?

The TSI is the card that proves your right to public healthcare in Catalonia and shows your assigned level of coverage. According to CatSalut's own FAQ, you need it to use public hospitals and health centres and to get prescriptions funded at the pharmacy. Every person has their own card, including children, and it is not used at private health companies. Emergency rooms accept patients without documents, but CatSalut says you should present the card afterwards so you are not billed for the care.

If you use only private doctors, you do not need a TSI. Many newcomers start that way and add the public system later. Our guide to seeing a doctor in English compares the two routes.

Who is entitled to one?

CatSalut states that every resident of Catalonia is covered under Catalan Law 9/2017, and its access page lists the routes by situation:

• People recognised by the national Social Security institute (INSS) as insured or as beneficiaries, such as employees, autónomos and pensioners, apply for the TSI at their CAP or through CatSalut.
• People who fit none of those groups still request a TSI at the CAP, and CatSalut assigns a coverage level based on their circumstances.
• Foreign nationals who are not registered or authorised to reside in Spain can qualify under Royal Decree-law 7/2018 after more than three months on the padrón.
• People can also join the Ministry of Health's special agreement and pay a monthly contribution, covered below.

For all of these, CatSalut says you must be registered in a municipality in Catalonia to receive the physical card. The padrón is the first step. Our padrón guide explains how to register in Barcelona.

How do I apply, step by step?

• Step 1, register on the padrón and get a certificate. CatSalut asks for one issued less than three months ago, unless your council lets it check online.
• Step 2, if you will work, get a Spanish Social Security number. GOV.UK's guidance for UK nationals says to get it from the Tesorería General de la Seguridad Social (TGSS) office, then register at your local health centre.
• Step 3, apply. Online, CatSalut's form checks your details against the padrón and INSS. If approved, you receive a provisional receipt by email with your personal identification code (CIP), which gives access to services until the card arrives. In person, go to the CAP for your address with your ID (DNI, NIE or passport) and the padrón certificate.
• Step 4, wait for the card. CatSalut posts it free to your home. Its page does not state how long delivery takes, so rely on the provisional receipt in the meantime.
• Step 5, if you apply for someone else, such as a child, bring documents proving the relationship.

What if I am not covered through work?

The Ministry of Health runs a special agreement (convenio especial) for foreign nationals without work income who need public cover. You must have lived in Spain for at least one continuous year before applying, and time in other EU or EEA countries, Switzerland or the UK counts. You must also be on the padrón and have no access to public healthcare by any other route. The ministry's page gives the fee as €60 a month under 65 and €157 a month from 65.

The agreement gives access to the common service portfolio, including primary and specialist care, outpatient and hospital, with no copayments or waiting periods, according to the ministry. Outpatient pharmacy, orthopaedic products, dietary products and non-urgent transport are paid in full by the patient. Foreign pensioners who can prove cover from their pension country do not need it, and neither do EU or EEA citizens with permanent residence after five continuous years, the ministry says.

In your first year, private insurance is the usual bridge. GOV.UK's guidance for UK nationals says to buy private health insurance if you have been resident for under a year and have no other cover. Our private health insurance guide covers costs and what to look for.

What if I get a UK State Pension and an S1?

GOV.UK says S1 holders register the form with the INSS, either at a local office or online. The INSS posts you a Spanish Social Security number, which you take to a health centre to get a medical card. The page also says that holding an S1 rules out joining the special agreement. It was last updated in July 2022, so check GOV.UK and the INSS before relying on the details.

How do I choose or change my doctor?

Your first CAP is normally the one for your home address. CatSalut's free-choice FAQ says you can choose any primary care team in the public network, and change doctor within a CAP when the doctor has room for new patients. You can request another change a year after the last one, or sooner if you move house. The answer must reach you within 10 working days, and if it does not, the request counts as granted. Apply in person at the CAP you want, and if it is run by the Institut Català de la Salut you can also apply online through its website or La Meva Salut.

Changes of address or phone number can be made at your CAP or by calling 061 Salut Respon. If you lose the card, you can ask for a replacement at your CAP or on 061. For children under six, see our guide to CDIAP early help, and for English-speaking paediatricians, the paediatrician guide.

Does the TSI work abroad or in private clinics?

No to both. CatSalut says the TSI is for the public system, and that for travel in the EU, EEA and Switzerland you need the European Health Insurance Card issued by the INSS through its electronic office. For English-speaking private care, see our guide on whether doctors in Spain speak English.

Looking for a private English-speaking doctor while your TSI is processed? Browse by neighbourhood: All of Barcelona, or by area: Eixample, Poblenou, Sarrià-Sant Gervasi, Les Corts, Diagonal Mar & Vila Olímpica, Gràcia, El Born & Barri Gòtic and Sants.