Seeing a Doctor in Spain as a Tourist or New Expat: Private Online Doctor vs Public System

Seeing a doctor in Spain as a tourist is simple in an emergency: call 112 or go to hospital urgencias and you will be treated. Routine public care is harder. A public GP needs a Spanish health card or a valid EHIC or GHIC. Without one, your routes are a private clinic or a private online doctor, paid directly.

Is healthcare free in Spain for tourists?

Not automatically. Emergencies are always treated; whether you pay depends on your cover.

• Emergencies: hospitals treat everyone; without valid cover you may get a bill later.
• Visitors with an EHIC, and UK visitors with a GHIC: you get medically necessary public care on the same terms as people insured in Spain. The NHS explains what the GHIC covers.
• Other visitors: you may be billed for public care. Check whether your travel insurance pays and whether it needs approval first.
• Private care: private clinics and private online doctors always charge a fee. The EHIC does not cover private care.

Your situation	Where to go
Life-threatening emergency	112 or hospital urgencias; uninsured visitors may be billed later
Visitor with an EHIC or UK GHIC	Public health centre or hospital, for care that cannot wait until you go home
Tourist without an EHIC, or new expat without a tarjeta sanitaria	Private clinic or private online doctor; pay directly, claim on travel insurance
Advice, a medical note or a medicine review, in English	Private online GP, by video every day, 07:30–20:30 (Spain time)

Why does the tarjeta sanitaria matter so much?

Because routine public care runs on it. Spain's public system, the Sistema Nacional de Salud (SNS), is excellent, but without the tarjeta sanitaria individual (TSI) you have no assigned GP, no cita previa (booked appointment) and no repeat prescriptions at your local centro de salud. Emergency care is different: it is open to everyone.

This affects tourists, new digital nomads and remote workers, non-lucrative visa holders early in their residency, and anyone whose padrón or social security number (NUSS) application is stuck. EHIC holders are covered for medically necessary care but get no regular family doctor.

Many newcomers find this out the hard way: they go to the nearest health centre unwell and are turned away because they cannot show a TSI or an equivalent document. This is not unkindness; it is how the system is built.

How do you get a tarjeta sanitaria, and how long does it take?

Three steps, in order: register your address, have your right to care recognised, then register at a health centre. Together they often take several weeks, sometimes months.

Step 1: Empadronamiento

Almost every path to a TSI starts with empadronamiento: registering your address at the town hall (ayuntamiento). It gives no healthcare rights on its own, but nearly every later step asks for it.

Step 2: Recognition of your right to care

Your right to publicly funded healthcare must then be formally recognised. The usual routes are:

• Social security: you work in Spain, employed or self-employed, and pay contributions. Details are on the Seguridad Social website.
• Convenio especial: a monthly fee to join public healthcare if you have no other cover.
• No legal residence: foreigners without legal residence have their own procedure under the current royal decree. Once your application is complete, you get a provisional document that gives access to care, and the authorities have up to three months to decide. The Ministerio de Sanidad publishes the rules on sanidad.gob.es.

Step 3: Registering at the centro de salud

Only then can you register at your local health centre. You are given a médico de cabecera (family doctor) and, finally, the card. Before this point, non-urgent appointments are almost never bookable.

Private online GP vs public SNS: how do they compare?

They solve different problems. The SNS is your free, long-term healthcare home once registered. A private online GP is the bridge for common, non-emergency problems while you visit or while your paperwork is pending.

Factor	Public SNS	Private online GP
Upfront cost	Free at the point of use once enrolled	€50 per 15-minute urgent care video visit
Setup required	Empadronamiento, NIE, recognition of right to care, health centre registration	None: choose an available time in the live calendar
Wait for a routine problem	Days to several weeks, depending on region and caseload	Next available slot in the calendar, every day 07:30–20:30
Language	Spanish by default; English not guaranteed, especially outside big cities	English or Spanish throughout
Best for	Ongoing care, chronic conditions, hospital-level needs, residents with full paperwork	Newcomers, travellers, common ailments, repeat prescriptions, certificates, second opinions
Exams, blood tests, imaging	Available on site	Not possible by video; you are referred when needed

How a private online GP visit works

No TSI, empadronamiento or NUSS is needed. You choose a time, pay a flat €50 and join by video from your phone or laptop. You speak with a GP licensed in Spain, in English or Spanish, and leave with clear advice and, if needed, a referral letter or a medical certificate.

If clinically indicated after the video assessment, you may receive a private electronic prescription under Spanish law, dispensed at pharmacies in Spain. Treatment and prescriptions are issued solely at the doctor's discretion, where clinically appropriate, following a genuine evaluation. Controlled medicines are not prescribed by video. A video visit cannot replace a physical exam, imaging or on-site lab work; you are referred onward when needed.

When the private online route fits

• You have just arrived and have not completed empadronamiento or social security registration.
• You have a common, non-emergency problem: a suspected infection, an allergy flare, a travel stomach bug, sinus symptoms.
• You need a repeat of a medicine you already take, or a certificate for work, school or travel.
• You prefer to describe your symptoms in English, with no risk of a translation error.

When the SNS or in-person care is the better call

• You are a long-term resident with an assigned GP: use it; it is excellent and free.
• You need a physical exam, a blood draw, imaging or a procedure.
• You have a complex or chronic condition that benefits from continuity with one doctor.
• Your symptoms sound like an emergency (see below).

How long is the wait to see a specialist, private vs SNS?

In the SNS, your médico de cabecera issues a referral (derivación) and the wait runs from a few weeks to several months, depending on the region and the specialty. Private specialist access is measured in days to a couple of weeks.

Factor	Private pathway	Public SNS pathway
Referral wait	Days to 1–2 weeks	Weeks to several months, specialty-dependent
Choice of specialist	You choose the provider	Assigned by catchment area
Cost	Consultation and test fees apply	Free at the point of care once referred
Continuity	Direct contact between referring GP and specialist	Structured, sometimes slower coordination between departments
Best for	Time-sensitive concerns, second opinions, convenience	Ongoing chronic disease, complex multidisciplinary care

Dermatology and orthopaedics in high-demand areas have the longest public waits. Chest pain, sudden neurological symptoms or any sharp deterioration should never wait for a referral: call 112.

How a video GP supports your referral

1. Assessment: a video visit establishes whether specialist input is warranted, avoiding unnecessary referrals.
2. Written referral summary: a structured clinical summary you can present to any specialist, private or public.
3. Guidance on private options: general information on typical private access times for your concern.
4. Documentation for the SNS: a summary to accompany the referral request to your médico de cabecera, who decides after their own assessment.

What is the lowest-cost way to see a doctor without insurance in Spain?

Start at the pharmacy for minor problems, which costs nothing. For anything that needs a doctor, a €50 online GP visit is a low fixed price with a clear invoice. Public urgencias are for emergencies and bill uninsured visitors.

1. Pharmacy (farmacia): pharmacists advise on minor ailments and over-the-counter medicines, free of charge. They tell you when you need a doctor.
2. Private online GP: €50 for 15 minutes, no TSI or registration, itemised invoice for any insurer. Best for infections, rashes, stomach bugs, medicine reviews and certificates while you visit or wait for a card.
3. Private clinic: no TSI needed; fees vary by city and by test, and imaging adds up. Best when you need a face-to-face exam.
4. Public urgencias: emergencies only, no card needed. Without cover you are billed afterwards, and a hospital bill is rarely small.

How to choose a reliable online GP

Check four things: a verifiable Spanish colegiado number; prices shown before you pay; an itemised invoice; and Spanish private electronic prescriptions, never promised in advance. Our checklist on how to choose an online GP in Spain goes deeper.

What to expect during the visit

Have your ID, your medicines and allergies, and a note of your symptoms ready. The doctor asks about the problem, looks at anything visible on camera and explains the likely cause and the plan. You get a written summary and, where indicated, a prescription or certificate, or clear directions to in-person care.

What should you avoid?

• Assuming travel or expat insurance gets you into the public system. It does not. The TSI pathway is separate from private insurance.
• Turning up at a centro de salud without checking first. Call ahead or check online to avoid a wasted trip.
• Expecting the EHIC to cover routine GP visits. It covers medically necessary care during a temporary stay; it does not replace registering with a GP.
• Any service that promises a specific prescription before an assessment. Legitimate doctors, public or private, evaluate first.
• Putting off care while you sort out paperwork. You need not feel unwell for weeks while your file is processed.
• Using telemedicine for anything that sounds like an emergency. Call 112. If unsure, read when to go to the ER and when an online doctor is enough.

Emergencies

Call 112, or go straight to hospital urgencias, for chest pain or pressure, severe trouble breathing, signs of a stroke (a drooping face, a weak arm, slurred speech), heavy bleeding that does not stop, a seizure, loss of consciousness, fever with confusion, or a severe allergic reaction with swelling of the face or throat. 112 is free from any phone and handles calls in English; in several regions, 061 also answers medical emergencies. None of these suits a video visit, and no health card is needed to be treated.

Frequently asked questions