Start with public entitlement
Workers and autónomos registered with Spanish Social Security, recognised beneficiaries and some people covered through international coordination can have public healthcare. Residence alone is not the test.
Register for public care
Recognition of entitlement and registration with a regional health service are separate steps. Once recognised, the regional service issues the health card and explains local access arrangements.
Other public routes
An EHIC or GHIC supports necessary care during a temporary stay, not ordinary residence. Eligible established residents without another entitlement may instead consider the paid convenio especial.
What private cover changes
Private treatment can be paid directly or through insurance. A policy may offer a different provider network or appointment route, but its contract still controls exclusions, authorisations and payment. A nearby private hospital is not necessarily available through every policy.
Using both systems
People with public entitlement may also hold private insurance. The systems do not automatically share records, referrals or authorisations, so keep copies when moving between public and private professionals.
Which system counts for a visa
The authority is checking acceptable healthcare evidence for a particular route. Do not assume every visa requires private insurance or that any proof of public care will be accepted.
How payment differs
Public treatment is based on recognised entitlement. Private treatment is paid directly or through a contract that defines covered services. Prescription charges, dental care and treatment outside a private network need separate checking.
More public-healthcare situations
Nationality, pension status and family position can change the route. Use the situation-specific pages rather than treating one answer as universal.