Employees
An employer normally registers an employee with Spanish Social Security. Signing a contract does not by itself complete healthcare registration. Check that the registration has taken effect and obtain the evidence needed by the regional health service.
Self-employed workers
A self-employed person normally registers in the appropriate Social Security regime, commonly called RETA. Registration, contribution status and any international coordination position need checking for the individual case.
Posted and cross-border workers
Some workers remain subject to another country's system under coordination rules. A certificate deciding where contributions are paid does not necessarily prove healthcare entitlement in Spain. An S1 or other healthcare document may also be needed.
Family members and the regional card
A qualifying family member may obtain entitlement as a beneficiary in some circumstances, but the relationship alone does not complete registration. Once entitlement is recognised, each person should complete the process used by the regional health service.