Application form and application procedure are specific to each region; find the right form and instructions for your region.
Servicio Andaluz de Salud's "Convenio Especial Para la Prestacion de Asistencia Sanitaria - Procedimiento - 03/09/2014":
Must satisfy three requirements: resident for one year, on the padron, and not covered by another health system.
Convenio Especial grants a "cartera comun basica", which covers pre-existing conditions, prevention, diagnosis, treatment, rehabilitation,
and urgent transport, to the same levels as the general public gets.
It excludes "cartera comun suplementaria", which also would cover pharmacy, orthoprosthetics, dietetics, and non-urgent transport.
Those things are covered (at various levels) for the general public.
[I think neither plan covers dental (does cover check-ups and tooth extractions ?) or vision or hearing-aids.]
You apply at an administrative health center (probably not your local Centro de Salud).
You supply three documents: ID, document showing residency for one year, and padron.
In case of an EU citizen or Swiss citizen or citizen of a country with a bilateral Social Security treaty with Spain,
you also provide certification that your home-country health system is not covering you.
When you apply, your documents are reviewed. If some are lacking, you still can submit the application, and must
submit the fixed documents within 10 days.
After application and all documents are verified, the health service will respond within 30 days.
If they don't respond, it is understood that you have been accepted, and the agreement is in effect.
After you have been approved, you have to sign a form accepting the agreement. Then within 3 months,
you must start paying the monthly fee, and send them a copy of the payment form for the first month.
If you don't start paying, the agreement is terminated. [And I read somewhere: then you have to wait a year
before you can re-apply.]
Monthly fee is €60 if under 65 years old, or €157 if 65 years or older.
The monthly fee is paid to a special health service bank account (IBAN is given in document).
Your name must be specified with each payment.
Health coverage starts from the day you make the first payment, not the day you signed.
[From another document: the agreement is terminated if you fail to pay the first month,
if you fail to pay any two months in a row, or if you fail to pay any three months alternating (miss 3 out of 6).
And I read somewhere: then you have to wait a year before you can re-apply.]
Went to local health center with convenio especial application form and instructions
(from CAB (PDF)
Asked (in my broken Spanish) what kind of document is needed to satisfy the
"Documento que acredite la residencia efectiva en España por un periodo continuado de un año"
requirement in the instructions. They didn't really know
what document would satisfy this requirement.
So I asked will they accept a simple written statement by me, or accept a copy of my residency card showing
it started more than a year ago ? The "copy of residency card" idea seemed to get a good reception.
I think I'll go back later with my Spanish-speaking partner and ask again.
But: 1-year renewal of my residency card is taking months
(3.5 and counting).
I don't think I can apply for Convenio Especial until I have the new card.
Finally decided to try applying while residency card is being renewed.
Doesn't seem to be a way to get a cita without first having a TSI, so I'll go to office without a cita.
Filled out the application form
from CAB (PDF)
Made copies of my residency card and padron and the form showing that my residency card is in renewal (renovacion).
Printed a PDF from INSS stating my Spanish Social Security number.
Wrote a little one-page letter in Spanish saying "I have resided in Spain since [date]." ("He residido en España desde el 15 de [date].")
to satisfy the "Documento que acredite la residencia ..." requirement on the form (section 5).
1/17: went to local Centro Salud, handed my stack of documents to the guy.
He seemed to focus mostly on my Social Security number document, and passport.
Typed into the computer for a while.
Then said a bunch of stuff along the lines of "you're not alta on Social Security, you have to go to INSS,
Convenio Especial is for EU people only, you have to stay on private insurance, etc". I think he's
wrong about most of that, but I'll try going to INSS and see what they say.
1/25: went to INSS office with cita. First official didn't know what convenio especial is, another knew a
little about convenio especial, said it was not for Americans, but we have to go to TGSS
anyway, it's not an INSS thing.
So, off to TGSS. Man there tried to say it wasn't
for Americans, consulted with someone else, then I showed him the royal decree number (576/2013) listed on
a Salud form. He printed out the decree, and highlighted a part which says we have to
apply at Salud, not TGSS. We've been there already, a week ago, and Salud said I have
to get "alta" with INSS or TGSS first, and anyway convenio especial is not for Americans.
But they're all wrong about that; the decree he just printed shows it's for anyone
who is resident, on padron, and not covered by another SS system. I satisfy all three requirements.
And the decree says nothing about what country you're from.
This man also says you can't apply while your residency card is being renewed (even if you show the renovacion form), and your padron has
to be dated within last 3 months.
Back to Centro de Salud. Lady there again tried to say it's not for me, but we showed her
the royal decree. Then she said there's no way to pay for it here. I said fine, we'll pay at TGSS or
something, once I get on it. Then she said I have to go apply at the central hospital, not here.
So I gave up for today, we'll have to go to the central hospital.
Then online I found
Servicio Andaluz de Salud's "Convenio Especial Para la Prestacion de Asistencia Sanitaria - Procedimiento - 03/09/2014".
Which seems to say I have to apply at a special health administrative center, so I guess the lady at
the Centro de Salud was right about that. And it says money is paid into a special bank account,
not through INSS or TGSS, so that's why they didn't understand it. Progress !
Called the administrative center at the main hospital, they've heard of Convenio Especial,
aren't too clear on it, think I should go back to TGSS to get a number (SS number ?) and pay there.
4/4: With freshly-renewed residency card and padron in hand, I went to the registry center at the main hospital.
Gave the Convenio Especial application form to the receptionist, and he found someone to handle me.
I speak little Spanish, and she spoke no English. But I had my documents all set, and laid them out in front of her:
- Convenio Especial application form.
- Residency card and photocopy.
- Passport and photocopy of ID page.
- Padron (copy, not original).
- Paper from INSS stating my SS number.
- One-line letter I wrote, saying I've been residing in Spain since date X, about 1.5 years ago.
The first problem was the SS number; she said something like I'm not in the Salud system, but I
pointed to the SS document again and said I'm in the INSS system. She said something like I'm not "alta",
and I said yes, I don't work, so I'm not "alta".
Then a question about whether I'd ever been in their system, did I have insurance, etc.
I showed my private insurance info, but I don't think that answered the question.
Then the resident-for-1-year proof. My letter did not satisfy her, although she kept it with
the bundle of application documents. She seemed to be saying that the Jerez padron did not show one year of residence,
but the padron never shows your starting date anyway. I dredged up an old Barcelona padron application that was
dated and officially stamped, and the two padrons together seemed to suffice. She copied the Barcelona document,
and kept the copy (not original) Jerez padron. At one point she pointed to the stamp on the Jerez padron,
and said something about it being a copy, and I held up the original to show her a real stamp,
but she kept the copy and didn't take the original.
She was working from handwritten instructions, and consulting someone in a back room, so I think
this is not a common procedure. Lots of typing on the computer, too.
Eventually done, and she gave me a stamped copy of the first page of my Convenio Especial application form,
and another stamped page certifying my base data in the Salud system, I think. Mainly it gives an NUSS / NUHSA number.
The application is sent off to Sevilla, and they will respond to me.
4/5: The Jerez office called and spoke to my partner, who speaks Spanish. My proof of being resident for a year is
not sufficient; they want to see some official document stamped March of last year. But I have no such document;
I wasn't moving or renewing residency or anything at that time, I was just living quietly in Barcelona. The back of my
residency card shows that I've passed the 1-year renewal, so should be proof that I've resided in Spain for more
than 1 year, but that's not good enough for them. My partner says
there may be a document called a "padron historical",
but we don't know if I can get it, and I'd have to get
it from Barcelona.
Online, I found there IS a "certificado historico de empadronamiento", and for Barcelona I can request it
I tried doing that online, using a digital certificate,
and found that the page (AFTER entering all the info) requires that latest version of Java be installed.
And I don't think it works with Firefox browser, so I switched to IE.
Multiple updates of Java, and still it insists I need to update.
Wiped out older versions of Java and Java SDK, restarted. Fixed Control Panel problems using a Microsoft utility.
Installed the Java update again, restarted, tried again, no go. Gave up.
But they do give a way to fill out a PDF, print it, and postal-mail it. So I'll do that.
In the form, I put my current address in the address fields. And for "Exposicion de hechos y razones", I put:
Necesito "Certificado Historico de Empadronamiento" anterior en OLDADDRESS, desde STARTINGDATE.
Actualmente empadronado en NEWCITY, empadronado el NEWSTARTINGDATE.
Estoy tramitando la atencion a la Seguridad Social / Salud / Convenio Especial para Asistencia Sanitaria.
Me piden constancia de empadronamiento que certifique que estoy viviendo en Espana mas de 1 año.
Solicito: "Certificado Historico de Empadronamiento" que conste que estuve empadronado en Barcelona
desde STARTINGDATE hasta ENDINGDATE, fecha en que me empadrone en NEWCITY.
Envieme el documento a la direccion actual: NEWADDRESS.
4/6: Mailed the document request to Barcelona, then went to hospital again. They accepted a copy of
my old/first residency card, but weren't interested in anything else I offered. They will wait for
the historical padron document.
5/2: Gave them the padron historico (they wanted the original). They said now everything goes to Sevilla,
and I'll be notified.
5/16: Received certified letter saying I'm approved for Convenio Especial !
5/18: Paid €60 at bank and got a "pago" confirmation. Signed and dated both copies of convenio agreement (5-page
"Convenio Especial para la Prestacion de Asistencia Sanitaria"). Made copies of the pago and agreement.
Certified-mailed the three documents (originals of the pago and agreements) to address specified in first, stamped page of letter.
Next step should be: I get one copy of signed agreement, and a certificado saying I'm covered, in the mail.
Then: Take the certificate, SS number document, and residency card to local health centre. Register with a doctor
and apply for a health card (tarjeta sanitaria individual or TSI). This will be sent to you in the post,
or you will be asked to pick it up personally.
Once you have TSI, log in to
But: 5/25, without having TSI, just using digital certificate, I was able to connect to
and see that I have been assigned to some centro salud, I have to pay 100% of any farmacia costs, I have been
assigned to a family doctor, etc. I think this is just default stuff as my registration is happening.
5/26: Received certfied letter containing signed agreement and a page saying I'm registered
in the system as of 5/24. Went to local health center to register and get a doctor and get a TSI, but
the not-very-friendly guy said I have to go to the salud centro, which is a different health center. Maybe that's the only
place they issue TSIs ? But it's not in the central hospital, where I applied for convenio especial.
5/28: Online, I see that my TSI was "emitida" 5/25, so maybe it's in the mail to me.
I guess I'll wait until I receive it.
5/29: My TSI arrived in the mail !
5/30: Went to the centro salud where I'm registered. They said the way to change centers is to go to
the new center, as I tried. Maybe I was rejected because I didn't have a TSI. They don't know
if or which doctors at their center speak any English.
I'm confused about when to pay for convenio especial each month. I paid on 5/18 to start coverage.
Do I have to pay for the next month on 6/1, or 6/18, or when ? By paying on the 18th to start,
did I stupidly pay a whole month's payment to get coverage for only 12 days ?
I wasn't registered until the 24th. Maybe I paid for a month to get coverage for 1 week.
6/1: My lady called salud in Sevilla, and they said since I started first payment on 18th, my
next payment is due 18th of next month. But it sounds like you can pay ANY time during the month.
Which means I got screwed by starting near the end of a month. Should have tried to start near
the start of a month.
6/16: To the local Centro Salud; I want to change from my initially-assigned center to
this one, which is nearer my home. But they say I have to wait 3 months since starting on the NHS, before I can
change centers. But but: somehow they calculate the end of 3 months to be June 24, a week from now.
That's 1 month since I got onto the NHS.
6/26: Back to the local Centro Salud; I want to change from my initially-assigned center to
this one. Much confusion among the staff. Finally they say that technically I have to wait 3 months since starting on the NHS, before I can
change centers, but the boss will make an exception. So they do the change for me. Nice !
7/5: First appointment with doctor, and he's good. My lady went with me, she speaks Spanish.
Got in right on time, maybe a couple of minutes early.
I handed a three-page document (in Spanish) to the doctor, giving my family history and some procedures
or diagnosis I want. Got an order for laboratory tests. Took it downstairs in the health center,
and scheduled that.
Six months after starting Convenio Especial in Andalucia, I moved to Catalunya:
A couple of people said they were able to get on Convenio Especial healthcare just before their first renewal of residency card (so I guess they
avoided committing to another 6 or 12 months of private insurance):
You can apply for residency renewal up to 90 days after your residency card "expires".
So shortly after their card expired, they were able to show they'd been resident and on padron for a year,
and thus were able to apply for Convenio Especial. They received the approval letter and NHS health card
quickly, and then showed those as proof of medical coverage when applying for residency renewal.