Management and Applications

Management, recognition of entitlement and control

Since the entry into force of Royal Decree-Law 7/2018, of 27 July, on universal access to the National Health System, on 1 August 2018, the recognition and control of the right to health protection and health care at public expense is the responsibility of the Ministry of Health, with the collaboration of the National Social Security Institute and the Social Marine Institute (ISM) as essential entities to verify the concurrence of the requirements.

However, until such time as the form of this collaboration is determined by regulation, the procedures in force and the databases existing prior to its entry into force are maintained, so that, to date, the procedure of prior verification of requirements and subsequent recognition of entitlement by the National Social Security Institute and the Social Marine Institute, in their respective areas of management, is maintained, with this information being recorded in the Health Insurance Database managed by the National Social Security Institute.

In cases of medical assistance for foreigners who are not registered or authorised as residents in Spain, applicants for international protection, victims of human trafficking in a period of recovery and reflection, as well as subscribers to the special agreement regulated in Royal Decree 576/2013, of 26 July, the Autonomous Regions (Public Health Services) are responsible for recognising the right to medical assistance.

Once the right to health protection and health care at public expense has been recognised, it shall be enforced by the competent health administrations, which shall facilitate citizens' access to medical assistance services by issuing the individual health card.

The competent bodies for aliens may communicate to the Ministry of Health and to the National Social Security Institute or to the Social Marine Institute, without the consent of the person concerned, the data that are essential for carrying out the necessary verification of the recognition and control of the right to health protection and health care at public expense.

Likewise, the Ministry of Health, the National Social Security Institute or the Social Marine Institute may process the data contained in the files of the managing bodies, common services and bodies of the competent public administrations that are essential for verifying the recognition and control of the aforementioned right. The aforementioned transfer of such data shall not require the consent of the data subject.

The Ministry of Health and the National Social Security Institute or the Social Marine Institute shall process the information referred to in the two preceding paragraphs for the purpose of communicating to the competent health administrations the data necessary to verify at all times that the conditions and requirements for the recognition of the right to health protection and health care at public expense are maintained, without requiring the consent of the interested party.

Any modification or variation that may be communicated by the Ministry of Health and the National Social Security Institute or the Social Marine Institute shall have the appropriate effects on the individual health card.

Documents which must accompany the application

IN ALL CASES, THE FOLLOWING VALID DOCUMENTS MUST BE SUBMITTED WITH THE APPLICATION:

Accreditation of the identity of the applicant, of the beneficiaries and, where applicable, of the person representing the applicant, by means of the following documentation:

Spanish Citizens: National Identity Card (DNI), for everyone over 14 years of age.
Foreigners: foreigner's identity card (TIE) or, if applicable, passport or identity document valid in their country.

Documentation accrediting representation, depending on whether they are:

A natural person representing another natural person: standard form of representation.

A person providing support measures for people with disabilities, documentation to prove it.
A de facto guardian, document proving guardianship and cohabitation.
Curator or legal guardian, the corresponding judicial decision.

When the application is for a non-naturalised holder or beneficiary, accreditation of legal residence in Spain.

Certificate of census registration in the corresponding municipality of residence, when it has been recently formalised and may not yet be registered in the census database.

Certificate issued by the authorised Social Security or healthcare institution of the country of origin, certifying that it does not recognise the export of the right to medical assistance, in the case of citizens of Member States of the European Union (EU) or States party to the Agreement on the European Economic Area (EEA) or Switzerland, the United Kingdom or countries with a Bilateral Agreement that regulates the export of the right to medical assistance to Spain (Andorra, Chile, Morocco and Tunisia).

ADDITIONALLY, IN CASE OF APPLYING FOR ENTITLEMENT FOR BENEFICIARIES:

Accreditation of the relationship with the holder, by the following means:

Spouse: family book or marriage registration certificate.

Unmarried couple: certificate of registration in one of the existing public registers or, failing that, the corresponding public document to accredit the existence of an unmarried couple.

Child, grandchild and sibling: family book or birth certificate
- for a child under three months old, it is NOT compulsory to present this documentation.
- for children, grandchildren and siblings over 26 years of age with a recognised disability of 65% or more, a certificate of recognition or a card accrediting the degree of disability is also required.
Guardianship or foster care: document issued by the competent authority to accredit the status of guardianship or foster care of the holder, his/her spouse or unmarried partner.

In the case of minors under the guardianship of the Administration, the Administration that has guardianship of the minor must present a certificate of constitution of the guardianship.