Applies to: For people entitled to an exportable S1; eligibility depends on the competent country and personal situation.
Before you start
- S1 issued by the responsible institution.
- Identity/residence and address evidence requested by INSS.
- Dependant information where applicable.
The steps
Ask the competent institution
Contact the country responsible for your healthcare to establish whether it can issue an S1. A foreign pension or nationality alone does not prove eligibility.
Check dates and dependants
Confirm when cover begins and who is included before cancelling other cover.
Register the S1 in Spain
Follow the INSS registration process and provide the requested identity, residence and supporting documents. Keep the acknowledgement.
Get regional health access
After entitlement is recognised, follow your autonomous community’s health-service process for the health card and local centre.
Check travel cover separately
An S1 registers entitlement in the country of residence. Check who issues your EHIC/GHIC and what applies when travelling.
Important details
UK applicants
The UK’s official Spain guide explains UK-funded S1 eligibility and the INSS/local-health-centre sequence. Applicants insured elsewhere must ask their own institution.
Insurance transition
Do not cancel visa-required private cover solely because you requested an S1. Confirm the entitlement, effective date and immigration requirements first.
Each family member must be recorded
Confirm the issuing institution’s dependant arrangements and register each eligible person. Then ask the regional health service for each person’s record/card, rather than assuming the main holder’s plastic card covers the whole household.
After the S1 is registered
Obtain evidence of recognition, find the address health centre, confirm your assigned doctor/paediatrician and book a first visit for ongoing conditions. Use the public-healthcare guide for the detailed sequence and the pharmacy guide for medication continuity.
See the bigger picture
Pair these practical steps with the Spain-wide essentials.
Sources & next steps
Reviewed 1 October 2026. This independent guide provides general information. Requirements, fees and office arrangements can change; the responsible authority’s current instructions control your application. Commercial service links explain products, not official rules.