EHIC Card in Spain: What the European Health Insurance Card (EHIC) Covers, the S1 Form and Travel Insurance

The European Health Insurance Card (EHIC) and the S1 form are the two key healthcare documents for Europeans who visit or live in Spain. The EHIC gives you access to Spain's public healthcare system during a temporary stay. The S1 form is for people who live in Spain but whose healthcare is paid for by another country.

This guide explains what each one covers, what it does not, and where a private English-speaking online doctor fits in.

Quick Answer: Does the EHIC Card Work in Spain?

Yes. Spain is a European Union member state, so a valid EHIC card issued by any of the EU countries, Iceland, Liechtenstein, Norway or Switzerland (or a UK GHIC) gives you medically necessary care in Spain's public health system on the same terms as residents. Visits to public doctors and hospitals are free of charge. Prescriptions carry a copayment at the pharmacy. The card does not cover private health clinics, private doctors or repatriation.

Situation	Covered by EHIC in Spain?
GP visit at a public Centro de Salud	Yes, free of charge
Public hospital emergency department (Urgencias)	Yes
Prescription medicines	Partly: you pay a share at the pharmacy
Private clinic or private hospital	No
Private English-speaking GP or online doctor	No: you pay directly and can claim on travel insurance
Flight home or repatriation	No: you need travel insurance

How to Use Your EHIC at a Spanish Health Centre

1. For a problem that is not urgent, go to the nearest public health centre (Centro de Salud). For an urgent one, go to a public hospital emergency department (Urgencias). For a life-threatening emergency, call 112.
2. Show your EHIC card (or UK GHIC) and your passport or national ID at reception.
3. Explain that you are a temporary visitor from another country.
4. Take any prescription you receive to a pharmacy (farmacia). You pay a share of the medicine price.
5. If you go to a private clinic, expect to pay. Private providers do not accept the EHIC.

Not sure which door to use? Our guide on when to go to the ER or see an online doctor in Spain walks you through the options.

EHIC in Spain: What the European Health Insurance Card Actually Covers

The EHIC is issued free of charge by the social security system or national health insurer of the country where you are insured. It is proof that you are insured there.

In Spain, it gives short-term visitors access to medically necessary care in the public healthcare system (Sistema Nacional de Salud, SNS). That includes tourists, business travellers, students and digital nomads on a short stay.

Key points for anyone using the EHIC in Spain:

• Same access as locals: You are treated under the same conditions, and at the same cost, as people insured in Spain.
• Who can get one: Anyone covered by the social security system of an EU country, Iceland, Liechtenstein, Norway or Switzerland. UK residents use the GHIC, or a UK EHIC that has not yet expired.
• What "necessary" means: The card covers medical treatment that cannot wait until you get home. The public healthcare system decides what is necessary in each case.
• Public providers only: The card is accepted at public health centres (Centro de Salud) and public hospitals. It is not valid at private hospitals or private clinics.
• Medicine copayments: Consultations and hospital care in public facilities are free. At the pharmacy, you pay a share of the price of prescription medicines. The share depends on your situation, and it is not refunded.

How to Apply for an EHIC

You apply for a European Health Insurance Card in the country where you are insured, not in Spain. The card is free of charge.

• Insured in another EU or EEA country, or Switzerland: apply to your national health insurer or social security office. Many of them let you apply online.
• UK residents: apply for a GHIC on the official NHS website. It is free, so avoid unofficial sites that charge a fee.
• Insured in Spain: if Spain pays for your healthcare, you apply for a Spanish card (Tarjeta Sanitaria Europea) from the INSS, the Spanish social security institute. If you live in Spain with an S1, your card normally comes from the country that issued the S1.

Apply well before you travel, because the card is sent by post. If you need care before it arrives, ask your insurer for a Provisional Replacement Certificate (see the FAQ below).

S1 Form in Spain: Healthcare for Pensioners and Posted Workers

The EHIC is for temporary stays. If you move to Spain, you need to register in the Spanish system. For most people, that happens through work and social security contributions, or through the S1 form.

The S1 is for people who live in Spain but whose healthcare is paid for by another EU or EEA country, Switzerland or the UK. The most common cases are state pensioners, posted workers, some cross-border workers and their dependants.

You register the S1 with the Spanish social security institute (INSS). The INSS then sends you a Spanish social security number. Take it to your local health centre to register, and you receive a Spanish health card (Tarjeta Sanitaria). From then on, you have public healthcare on the same terms as Spanish residents.

Our comparison of health cover in Spain explains how the EHIC, the GHIC, the S1 and the Convenio Especial fit together.

What the Spain EHIC Card Does Not Cover

• Private healthcare: The card does not cover private clinics, private hospitals or private English-speaking GP consultations, in person or online.
• Repatriation and rescue: A flight home for medical reasons, and search and rescue costs, are not covered. You need travel insurance for these.
• Planned treatment: You cannot use the card to travel to Spain for treatment. For planned treatment abroad, you first ask your own health insurer. For some treatments it must give prior authorisation and issue an S2 form.
• A family doctor and planned appointments: The card does not give you an assigned GP or planned specialist appointments. It is for care that cannot wait until you get home.

Why Expats and Visitors Use an Online GP Alongside Their EHIC Card

Public care with the EHIC is good, but it can involve waiting and a language barrier. A private online GP is a paid extra, not a replacement for the card or for travel insurance. Dr. Pedro Yelamo Vera, a physician licensed in Spain, offers:

1. Video consultations in English or Spanish every day, 07:30–20:30 (Spain time), for urgent, non-emergency problems.
2. Private electronic prescriptions under Spanish law, valid at Spanish pharmacies, but only when a treatment is clinically indicated after the video assessment. A prescription is never guaranteed.
3. Medical certificates and fit-to-fly letters, issued after a video assessment when they are appropriate.
4. Clear advice on the next step: whether you can manage at home, should visit a public health centre, or need to go to hospital.

Read our guide to seeing a doctor in Spain as a tourist or new expat for a side-by-side view of the public and private routes.

Frequently Asked Questions

Can I use my EHIC card at private clinics in Spain?

No. The card is only valid in the public health network (SNS). Private clinics and private doctors do not accept it.

What if I travel without my EHIC?

Contact the social security or health insurance office of your home country and ask for a Provisional Replacement Certificate (PRC). It gives you the same cover as the card. UK residents apply through the NHS Business Services Authority.

How much do prescriptions cost with an EHIC in Spain?

Prescription medicines are not free in Spain. With the EHIC, you pay a share of the price at the pharmacy, as residents do. The share depends on your situation, and it is not refunded. Ask the pharmacy before you pay.

Does EHIC cover private online doctor appointments in Spain?

No. The EHIC covers public state healthcare only. A private telemedicine consultation is paid directly. You receive an itemised invoice, which you can send to your travel insurer. Whether it is reimbursed depends on your policy. Our guide to medical records for a travel insurance claim explains what insurers usually ask for.

Is the E111 Card Still Valid in Spain?

No. The European Health Insurance Card replaced the E111 form on 1 June 2004. The last E111 forms stopped being valid at the end of 2005. An old E111 is not accepted anywhere. UK residents now use the GHIC, or a UK-issued EHIC that is still in date.

EHIC Plus Travel Insurance: Do You Need Both?

Yes, for most trips. The EHIC covers necessary care in public hospitals and health centres. Travel insurance covers what the EHIC does not: private clinics and doctors, repatriation, cancelled flights and lost belongings. Some travel insurers waive your excess if you use your EHIC in a public hospital, so carry both.

Need medical advice in English while you are in Spain? Book a video consultation with an online doctor in Spain. No EHIC is needed. Consultations run every day, 07:30–20:30 (Spain time), for urgent, non-emergency care. For emergencies, call 112.