Establish entitlement before applying for the card
Entitlement may arise through Spanish Social Security, beneficiary status, a registered S1 or another recognised public route. A padrón certificate or residence card alone does not prove every person's healthcare entitlement.
Apply through the service where you live
The regional service will specify whether to apply online, at a health centre or through another office. Your address commonly determines the health centre and primary-care team. Procedures can change within the same autonomous community.
Prepare evidence for the regional process
The exact list varies but can include identity, residence documentation, padrón registration and proof of recognised entitlement. Take the originals or certified copies requested by the authority. A general list on an expatriate website cannot replace the regional checklist.
Examples of official regional information
The links below illustrate why the regional step matters. Use the authority for your own address rather than choosing one of these simply because its instructions are in a familiar language.
The card is not an EHIC or GHIC
The regional card identifies you within the Spanish public health service. An EHIC or GHIC is used for qualifying temporary stays. If Spain is your country of residence, establish residence entitlement rather than relying only on a temporary-stay card.