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Tarjeta Sanitaria Europea: applying for the EHIC as a Spanish resident

Anyone living as a resident in Spain who occasionally travels to Germany, Austria or another EU country should carry the Tarjeta Sanitaria Europea (TSE, international EHIC) in their wallet. The card is free of charge, is issued by the Spanish Seguridad Social and guarantees you access to medically necessary treatment within the public healthcare system during a temporary stay abroad – under the same conditions as locals. In this guide you'll learn who can apply for the TSE, which documents you need, how the online application via the Sede Electrónica of the Seguridad Social works, where the card does NOT apply, and what to do if a trip is coming up but the card hasn't arrived yet. We also clarify the important difference to the Balearic Tarjeta Sanitaria Individual (TSI), which you use to visit your GP on Mallorca.

Applying for the Tarjeta Sanitaria Europea: EHIC Spain 2026

Are you travelling soon and your TSE has expired or hasn't been applied for yet?

What is the Tarjeta Sanitaria Europea?

The TSE is a personal, non-transferable and free-of-charge document that certifies entitlement to medically necessary services during a temporary stay in another Member State. It applies regardless of whether the stay is for tourism, work or study purposes. The legal basis is the European Coordination Regulation (EC) No. 883/2004, which ensures that anyone socially insured in Spain is treated under the same conditions as a locally insured person when in another EU country.

Important for expats: the TSE is not a substitute for health insurance in Spain itself. Anyone newly moving to Mallorca first needs access to the Spanish system – for example through employment, the S1 form for pensioners or private health insurance. Only after that does the TSE make sense as a travel document within Europe.

Feature Tarjeta Sanitaria Europea (TSE)
Purpose Medically necessary treatment during a temporary stay abroad
Cost Free of charge
Validity period Up to 5 years (according to the Seguridad Social)
Delivery By post to the address registered with the Seguridad Social, approx. 5 days
Issuing body Instituto Nacional de la Seguridad Social (INSS)
Valid in 27 EU countries as well as Iceland, Liechtenstein, Norway, Switzerland, United Kingdom

TSE, TSI and EHIC: these terms you shouldn't mix up

For many newcomers to Mallorca, the variety of terms causes confusion. TSE (Spain) and EHIC (English) are the same document. The Tarjeta Sanitaria Individual (TSI), on the other hand, is the local health card of the Balearic health service IB-Salut, which you use on Mallorca to access your GP and the public hospitals. You'll find more details on the Balearic system in our overview of healthcare on Mallorca and of the hospitals on Mallorca.

Document What it's for Scope of validity
TSE / EHIC Travel within Europe, temporary stays EU + Iceland, Liechtenstein, Norway, Switzerland, UK
TSI (IB-Salut) Regular access to GP and clinics in the Balearics Balearics only (Spain)

Note: The TSE does not replace the TSI. For everyday life on Mallorca you still need the TSI, which you apply for at the Centro de Salud in your place of residence – the usual requirements are Empadronamiento and a social security number or Residencia.

Who can apply for the TSE?

Anyone entitled to public healthcare in Spain can apply – that is, employees, autónomos, pensioners with recognised entitlement, or their co-insured family members (beneficiarios). The person holding the entitlement also submits the application on behalf of their family members; a separate application for children or a spouse is not necessary, as long as you include them in the application.

If you work as an employee or are registered as self-employed, you can check your status at any time via your Vida Laboral. Anyone starting out as a new autónomo will find background information on correct registration in our guide on accounting as an autónomo.

Requirements and documents needed

For the online application you basically need very little, but it has to be correct:

Required Details
Identity document DNI/NIE of the applicant
Digital identification Certificado digital or Cl@ve (for secure online procedures)
Registered address Must match the address registered with the Seguridad Social (Afiliación)
Mobile phone number Optional, for SMS verification if the delivery address within Spain differs

Attention: If your current address does not match the one registered with the Seguridad Social, the card will be sent to the old address. Update it beforehand via the Seguridad Social's "Change of Address" service before applying for the TSE.

Step by step: applying for the TSE online

  1. Go to the Sede Electrónica of the Seguridad Social (sede.seg-social.gob.es) or the "Tu Seguridad Social" portal.
  2. Identify yourself with Certificado digital, Cl@ve or – without a digital certificate – via simplified identification using a few personal details.
  3. Select the "Ciudadanos" section and then "Asistencia Sanitaria".
  4. Click on the service for applying for/renewing the Tarjeta Sanitaria Europea.
  5. Check whether your registered address is up to date; if you want a different delivery address within Spain, you can confirm it via SMS code using your registered phone number.
  6. If needed, provide the Beneficiarios (family members) for whom the card should also be issued.
  7. Submit the application. You will receive proof that the application has been submitted.
  8. The TSE is delivered by post within a maximum of 5 days – never handed over in person.

If you have difficulties with online procedures of the Seguridad Social, our guide on Cita Previa Seguridad Social can help you arrange a personal appointment.

Process: Applying for the Tarjeta Sanitaria Europea online with the Seguridad Social — including the CPS for short-term trips

Alternative ways to apply: phone, CAISS and Certificado Provisional

Not everyone has a Certificado digital or Cl@ve to hand. For queries about the procedure, especially if the reason for travel is an EU exchange programme or an official academic qualification, you can request an appointment by phone at 901 10 65 70 or 91 541 25 30. Alternatively, a personal visit to a CAISS (Centro de Atención e Información de la Seguridad Social) is usually also possible.

If your departure is very short notice or the TSE cannot be issued in time for other reasons, there is the Certificado Provisional Sustitutorio (CPS): a replacement document that you can download online immediately after applying.

Feature TSE Certificado Provisional Sustitutorio (CPS)
Validity period Up to 5 years Maximum 90 days
Delivery By post, approx. 5 days Instant download as PDF
Purpose of use Standard case Short-term trips, TSE not available
Countries Identical to TSE Identical to TSE

Where is the TSE valid – and where isn't it?

The TSE is valid in all 27 EU member states as well as in Iceland, Liechtenstein, Norway, Switzerland and the United Kingdom. It covers medically necessary treatment so that you can continue your stay without having to return to Spain prematurely – for example emergency treatment, GP and specialist care in cases of acute need, as well as ongoing treatment of chronic conditions.

Not covered, however, are planned treatments abroad: if you travel specifically to another country to receive medical treatment there, you instead need a separate form issued by the INSS or the Instituto Social de la Marina (ISM) following a positive report from the health service. Likewise, the TSE is not a valid document if you permanently relocate your residence to another country – in this case a different social security coordination procedure applies.

Note: Andorra is excluded from the TSE. For cover there, a separate certificate (E-AND-111) must be applied for from the Seguridad Social.

Costs, co-payments and reimbursement without a card

The TSE itself is free of charge. In some countries, however – just like a local insured person – you must pay a fixed amount or percentage of the treatment costs yourself; such co-payments are not reimbursed. It's also important to note that using the TSE requires that the conditions which led to its issue continue to apply throughout the entire validity period. If they no longer apply, costs incurred can be reclaimed under Article 76 of Regulation (EC) 883/2004 as an unduly received benefit.

If you were treated abroad without being able to show the TSE, the practice or clinic will often demand immediate payment. In this case, you pay upfront yourself and then apply for reimbursement of the costs from the Spanish Seguridad Social.

For the period before emigrating, or for additional cover beyond the public healthcare system – for example repatriation or treatment in private clinics – it's worth taking a look at our guide on health insurance in Spain as well as a comparison in the Directory of insurance providers in Mallorca.

Applying for the TSE for family members

Beneficiarios – such as children or a non-working spouse – do not receive their own TSE directly, but rather through the application of the eligible person. Simply indicate in the online form that the card should also be issued for your family members. Whether a valid TSE already exists can be checked via the corresponding online service of the Seguridad Social – however, digital identification is also required for this.

Most common mistakes when applying

  • Outdated address: The TSE is sent strictly to the address registered with the Seguridad Social. If, after a move, the Empadronamiento was updated but the Seguridad Social address was not, the card will be sent to the old address.
  • Confusing the TSE with the TSI: Anyone who believes that the travel card also grants access to the Balearic healthcare system will be in for a surprise at their GP appointment.
  • Confusing planned treatment with the TSE: Anyone travelling abroad specifically for an operation needs the INSS/ISM form, not the TSE.
  • Waiting until the last minute: Postal delivery takes around 5 days – for short-notice trips, often only the Certificado Provisional Sustitutorio remains an option.
  • Not listing any Beneficiarios: Anyone who forgets to include family members in the application will later have to go through the entire process again.

What happens next?

Once the TSE has been delivered, keep it together with your other travel documents – ideally with a copy or photo as a backup. Before every trip, it is worth taking a quick look at the expiry date on the card. If it expires or your status changes (for example, the end of employment, see Finiquito & Kündigung), you should initiate the renewal in good time via the same online procedure. Anyone who also needs to prove their tax residency in Spain will find information on this in the guide to the Certificado de Residencia Fiscal.

Checklist: TSE for residents of Spain

  • Address registered with the Seguridad Social is up to date (identical to your residential address)
  • Certificado digital or Cl@ve available, or an alternative checked (phone/CAISS)
  • Beneficiarios (family members) included in the application
  • Application submitted in good time before departure (at least 5–7 days in advance)
  • For short-notice trips: Certificado Provisional Sustitutorio checked as an alternative
  • TSE not confused with the TSI (Balearic health card)
  • Keep an eye on the card's expiry date

Conclusion

The Tarjeta Sanitaria Europea is a free but important travel document within Europe for all Spain-residents entitled to public healthcare. The online application via the Sede Electrónica of the Seguridad Social is completed in just a few steps, as long as your address is up to date and you can identify yourself. It's crucial to understand the limits of the TSE: it does not replace the Balearic Tarjeta Sanitaria Individual or a private supplementary insurance, and it does not apply to planned treatments abroad or in the event of a permanent change of residence. Those who understand these differences travel through Europe with the TSE much more relaxed.

Official sources

Is the Tarjeta Sanitaria Europea the same as the Tarjeta Sanitaria Individual?
No. The TSE is a travel document for temporary stays in other European countries, while the TSI is the Balearic health card for regular access to GPs and clinics in Mallorca.
How long does delivery of the TSE take?
According to Seguridad Social, the card is sent by post to the registered address within a maximum of 5 days and is not handed over in person.
What does the Tarjeta Sanitaria Europea cost?
The TSE is free of charge; only on-site abroad may co-payments for certain services arise in some countries, which are not reimbursed.
How long is the TSE valid?
According to Seguridad Social, the TSE can be valid for up to 5 years; the expiry date stated on the card is what counts.
Can I also apply for the TSE for my children or my spouse?
Yes. As the eligible person, you apply for the card for your co-insured family members (Beneficiarios) in the same process.
What do I do if my trip is short-notice and the TSE doesn't arrive in time?
You can apply for the Certificado Provisional Sustitutorio (CPS), which can be downloaded immediately as a PDF and is valid for up to 90 days.
Is the Tarjeta Sanitaria Europea valid in Andorra?
No, Andorra is excluded. For healthcare there, a separate certificate (E-AND-111) must be applied for from Seguridad Social.
What happens if I am treated abroad and cannot show a TSE?
As a rule, you must first pay for the treatment costs yourself and can then apply for reimbursement from the Spanish Seguridad Social.