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This is what your Tarjeta Sanitaria in Madrid will looks like.

If you’re here in Madrid working and are dado/a de alta(registered in the social security system), you’re entitled to a public health insurance card, or tarjeta sanitaria, for access to public healthcare services in Madrid.

I am a language assistant in the BEDA program, which includes private insurance from Adeslas. When I found out that I would be eligible for public health care this year, I was beyond excited. This may be because I was born in a country where free public healthcare for everybody is by no means the norm, but nonetheless I wanted to have mine as a supplement to my private insurance here and my American health insurance that I can use at a special clinic.

So, the good news is that it takes just three steps to get your public health insurance card in Madrid. Here they are:

Step One:

Get a copy of your social security number at your local TGSS office. If you don’t already have a Spanish social security number, click here to find out how to get one.

There are two important acronyms when it comes to social security: TGSS (Tesorería General de Seguridad Social) and INSS (Instituto Nacional de Seguridad Social). While you will have to visit branches of both agencies, you have to start out by going to TGSS. Both of these offices are only open from 9 AM until 2 PM. To find your nearest TGSS office click here.

In my case, I went to the office on Juan Bravo near metro Diego de León, which you can see on this map:

To get a copy of your number you can just walk in – no need to make an appointment in advance. If you go to Juan Bravo, you’ll want to get a ticket for A and you just wait for your turn. What paperwork do you need? Just bring your NIE (and if you already have a NIE but you’re still in prórroga and waiting to pick up your new card, bring the resguardofrom your fingerprints appointment in Aluche along with your expired NIE). They’ll ask you for your address (if you’ve moved, make sure you update it so that they have the system all up to date) and give you a little printout with your number. This number is yours for the rest of your life, so I would recommend holding onto the copy for dear life, and if you’re extra cautious, even make a PDF of it so you can use it for all future professional endeavors.

Step Two:

Go to INSS and get the piece of paper verifying your right to public healthcare

Congratulations! By this point you’ve made it through TGSS, but now you’re going to have to tackle INSS. Unlike going to TGSS, you’re going to have to make an appointment, which you can do here. If you don’t know which office is the closest to your house, you can put in your postal code and the INSS website will direct you to which center is the closest. In my case, I went to the office on Villanueva just off of Colón:

Again, like TGSS, this office is only open from 9-2 and I had to wait for about two weeks to get an appointment that worked with my crazy schedule. If you have extra time on your hands and more flexibility, then you shouldn’t have as much of a problem as I did. It’s a little hard making an appointment (and I’m bilingual), but once you get through it, the appointment’s a breeze.

What do you need for your appointment? Your NIE (and you have to have a NIE that’s en vigor), your padrón (the paper that says where you live), and the paper you got from TGSS. Once you present all of that information, they’ll print you out another piece of paper that says that you have the right to public healthcare. Let’s hope that you don’t end up like me and almost have to go back because every single printer in the INSS office on Villanueva nearly stopped functioning. The paper you get in INSS is GOLDEN because that’s what you need to go to our final stop…

Step Three:

Apply for your Tarjeta Sanitaria in your local Centro de Salud

Here’s a cautionary tale for our final step on our journey towards public health: please please please check which Centro de Salud corresponds to your address. It will save you a lot of time and a lot of stress. Let me give you a breakdown about my attempts to get my Tarjeta Sanitaria:

Like any normal Millennial with a smartphone, I immediately Googled the closest Centro de Salud to my house and was ecstatic to find that I had two to choose from and set off that very afternoon since the Centros de Salud are open until 8:30 PM. But wait, there was a catch. The first time I went, I ended up going to a city health clinic (Ayuntamiento de Madrid) instead of a clinic belonging to the Comunidad.

Tarjeta Sanitaria Rule #1: You MUST go to a Comunidad de Madrid Centro de Salud to get your card.

Two days later, I had some free time and decided to try again. There’s a Centro de Salud about five minutes from my apartment that I pass by all the time and my first instinct was that I could just go in and apply. When I gave the woman my address she said*, this center doesn’t correspond to you*. In my head, I was like Are you serious???  I was told that the center that
ACTUALLY corresponded to me was at this address and she gave me directions on how to get there. Of course, with my luck, my nearest Centro de Salud was twice as far away from my house as the one I had initially gone to. Fan.tas.tic. So, please, don’t be stupid like me and follow

Tarjeta Sanitaria Rule #2: Look up the Centro de Salud that corresponds with your address. Who knows, your center may actually be in another postal code or other neighborhood (like mine).

You can look up your Centro de Salud at this lovely little page. Just put in your address and you know exactly where you need to go!

What do you need when you go to your Centro de Salud? You need your NIE, the piece of paper you got at INSS, and your padrón (if you’re not empadronado, i.e. in the housing registry, then do so asap and check out our guide here. The padrón is crucial because which Centro you go to all depends on where you live. Even though the center I pass by more often is closer, I have to go to one in the next neighborhood north. Kind of inconvenient, but it’s the card I was dealt with. When you walk in, you go to the special Tarjeta Sanitaria area. Depending on the center, it may be a separate office far away from the entrance or just a separate line. Whatever it may be, you don’t have to wait with the general crowd.

When you get attended to, you present all of your documents and then they’ll ask you some simple questions. First, they’ll ask you whether it’s better for you to go to a doctor in the morning or in the afternoon. This is how they assign you your medico de familia (Primary Care doctor). I chose afternoons because my schedule’s so erratic that I wanted to be able to go during lunch or at closing hours. If you want an appointment, you can make one right then.

Before you leave, you’ll get a piece of paper that you’ll need to access all healthcare services while you wait for your actual Tarjeta Sanitaria to come in the mail right to your door. But that piece of paper is good in the interim, and congratulations, you can take advantage of public health care in Spain!

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