TSI and healthcare in Catalonia: how to apply

Healthcare in Catalonia: a 15-step plan

1. Work out on what grounds you are entitled to public healthcare

   With CatSalut, the procedure depends on your personal circumstances and the cover you are recognised as having. People entitled through the INSS follow the corresponding procedure, and there are separate options for foreign residents without access to the INSS and for other groups. Ask CatSalut or your CAP which procedure applies to you and which documents they need. The type of residence permit alone does not tell you that you are automatically entitled, nor that you will automatically be refused.

   • Identified my grounds: employment, autónomo, DNV, no lucrativa, family member
   • Checked whether I or a family member has an alta in the Seguridad Social
   • If not entitled, looked at the CatSalut conveni especial: one year of residence in Spain and registration in Catalonia

   Where: Ley 16/2003, article 3; Llei 9/2017; CatSalutTiming: before going to the CAPCost: free; conveni especial €60 or €157 a month

   When you need help: a DNV with an employer abroad, a change of grounds or a family with different statuses. Entitlement depends on the details, and they are worth going through with a gestor.

2. Get a social security number (NAF, NUSS)

   The NUSS is your number in the social security system; getting one is a separate administrative procedure. It does not replace the TSI and is not a universal precondition for every application to CatSalut. If you have no access through the INSS, check the procedure CatSalut provides for your situation.

   • Prepared my NIE or TIE, phone number, email and address
   • Applied through Importass or at a TGSS office (form TA.1)
   • Saved the document with my number: more in the article how to get a NUSS

   Where: TGSS, Importass portalTiming: not stated on the TGSS pageCost: no fee stated on the TGSS page

3. Register at your address (padró)

   For the TSI you need a certificate of registration at your address (certificat d'empadronament) issued no more than three months before your visit. Your address also determines your CAP. In Barcelona, registration is handled by the Ajuntament, the city council.

   • Applied for registration: empadronamiento in Barcelona
   • Got the certificate and checked the date of issue
   • Registered my children and other family members

   Where: Ajuntament de BarcelonaTiming: certificate for the TSI no older than 3 monthsCost: see the Ajuntament page

   When you need help: you have no rental contract or the owner objects to registration. How to register without a contract is explained in the article on the volante certificate.

4. Get your TSI at your CAP

   You request the TSI at the CAP for your registered address; according to the Generalitat, you can also apply online. You can find your CAP by address or ask on 061. CatSalut sends the card by post free of charge, and each family member needs their own.

   • ID document: DNI, NIE or passport
   • Registration certificate no older than three months
   • A copy of your Seguridad Social registration document, if you hold one, or consent to an online check of your data
   • For a child: birth certificate or a document showing legal guardianship

   Where: CAP for your address, CatSalutTiming: not stated on the CatSalut pageCost: first card free, duplicate €10

   If the access procedure is unclear or you have been refused, ask the CAP for the reason and the documents required. Check whether your case falls under the INSS or another CatSalut procedure. tarjeta sanitaria in Catalonia Official source

5. Get a family doctor and paediatrician assigned

   Once you have a TSI, you are assigned to a primary care team (EAP) and a doctor, the médico de capçalera; children are seen by a paediatrician. You can choose your doctor and CAP yourself, but you can change them no more than once a year, except for objective reasons such as moving house or changing jobs.

   • Found out the name of my doctor and my children’s paediatrician
   • If I need a different doctor at the same CAP, requested the change through La Meva Salut
   • Noted down the CAP’s contact details

   Where: CAP, La Meva SalutTiming: reply to a change request within 10 working days; no reply means approvalCost: free

6. Set up La Meva Salut

   La Meva Salut is the CatSalut patient portal: CAP appointments, treatment plan and e-prescriptions, test results, vaccinations, and eConsulta for messaging your doctor. You log in with a password, idCAT Mòbil, Cl@ve or a digital certificate.

   • Went to the CAP with my TSI and DNI, NIE or passport and asked for a password
   • Created the password using the email link and the SMS code within 4 days
   • Or logged in with Cl@ve: how to get Cl@ve

   Where: CAP, lamevasalut.gencat.catTiming: create the password within 4 daysCost: free

7. Book doctor’s appointments through whichever channel suits you

   Routine appointments are booked in La Meva Salut, by phoning the CAP, in person at reception or through 061. Non-urgent questions about treatment and medical certificates can be sent through eConsulta, with no visit needed.

   • Tried booking in La Meva Salut
   • Saved the CAP’s number and 061
   • Know how to book for my child: booking a family doctor

   Where: La Meva Salut, CAP, 061Timing: depends on the CAPCost: free

8. Know where to go for urgent care: CAP, CUAP, hospital, 112, 061

   If life is at risk, call 112. If you are not sure where to go, 061 Salut Respon gives medical advice by phone. Urgent problems that are not life-threatening are handled at the CAP or at a CUAP, an urgent primary care centre; go to hospital urgències only when it is really necessary.

   • Found the nearest CUAP and a hospital with urgències
   • Saved 112 and 061 on every family member’s phone
   • Carry my TSI and ID document with me

   Where: CAP, CUAP, hospital, 112, 061Timing: immediatelyCost: free if you are entitled to public healthcare

9. Get your medicines with an e-prescription

   Doctors issue prescriptions electronically, and they appear in your treatment plan in La Meva Salut. At the pharmacy you show your TSI. The co-payment for medicines depends on income and status (working or retired), and some people are exempt; your level of cover is shown on the TSI.

   • Checked my treatment plan in La Meva Salut
   • Brought my TSI to the pharmacy
   • If the co-payment looked wrong, checked my level at the CAP

   Where: pharmacy, La Meva SalutTiming: while the prescription is validCost: a share of the price under the rules on the Ministry of Health page

10. Specialists: by referral

    In the public system you see a specialist on referral from a primary care doctor or for urgent medical reasons. You go to your family doctor first, and they decide whether you need a specialist.

    • Gave my family doctor my medical reports and previous diagnoses
    • Got a referral and found out how the appointment will reach me
    • Keep an eye on the appointment in La Meva Salut

    Where: CAP, hospital or specialist centreTiming: depends on the specialtyCost: free in the public system

11. Decide whether you also need private insurance

    For a DNV and no lucrativa, insurance can be a requirement of the authority, and then the authority sets its terms: an insurer authorised in Spain and cover for the whole period. Without such a requirement, private insurance is a personal choice and does not replace the public system.

    • Checked whether my grounds require insurance: insurance for a residence permit
    • If required, my policy meets the requirements for the whole period
    • At renewal, checked that my cover was never interrupted

    Where: the authority’s requirements for your groundsTiming: for the whole validity of the permitCost: depends on the policy

    When you need help: your insurance was rejected at application or renewal. Go through the requirements with an extranjería lawyer.

12. Dental care: what the public system covers

    For adults, the common services programme covers treatment of acute conditions (infections, inflammation, injuries), extractions and a preventive check-up. Orthodontics, implants and cosmetic work are not included. For children, pregnant women and some other groups, the Ministry of Health plan extends cover; ask at your CAP how this works in Catalonia.

    • Found out at the CAP where the public-system dentist sees patients
    • Booked the children in for a preventive check-up
    • Treat dentures and fillings for adults as a private clinic expense

    Where: CAP, primary care dentistryTiming: by appointmentCost: free within the common programme

13. Transfer your medical history

    Your previous history will not reach CatSalut automatically. Bring your family doctor your medical reports, a list of medicines with their active ingredients, your children’s vaccinations and the results of important tests, preferably translated into Spanish or English.

    • Collected medical reports, diagnoses and treatment plans
    • Had the main documents translated
    • Checked that my child’s vaccinations are recorded and visible in La Meva Salut

    Where: CAP, translatorTiming: before the first visitCost: translation is paid separately

    When you need help: the document is for an official procedure rather than for the doctor. In that case you may need a sworn translation.

14. Change your CAP when you move

    Your CAP depends on your address, so after moving you first update your registration and then your address with CatSalut, at the CAP or through 061. Moving house counts as an objective reason, so the “one change a year” limit does not apply.

    • Changed my address in the padró
    • Gave my new address to the CAP or through 061
    • Requested a change of CAP and doctor through eCAP or with a form at the CAP

    Where: Ajuntament, CAP, 061Timing: reply within 10 working daysCost: free

15. Before you have a TSI: urgent care and proof of entitlement

    In Catalonia you will get urgent care even without a card, but if you are not entitled to public healthcare you may be billed. Children under 18 and pregnant women get access from CatSalut through a separate application at the CAP. If you are already entitled through the Seguridad Social, you can download the document proving it (documento acreditativo) from the INSS online service.

    • Checked my entitlement and downloaded the document from the INSS service
    • If recognition through the INSS is required, checked the relevant procedure; otherwise asked about access through CatSalut.
    • Applied at the CAP for a child or a pregnant woman
    • Keep receipts for any care I paid for

    Where: INSS (online, by post, at a CAISS by appointment), CAPTiming: not stated on the INSS pageCost: free

    When you need help: you received a bill for care but believe you were entitled. It is worth challenging it with a gestor or a lawyer.