Spain grants public health access to residents without legal papers

Spain’s Royal Decree 180/2026 lets foreigners without legal residence qualify for public healthcare by proving habitual residence and signing a responsible declaration saying they have no other coverage and can’t export healthcare from abroad. The decree took effect March 13 and applies nationwide, with the health system now using a single process instead of regional workarounds.

Applications get provisional access as soon as they’re submitted. Health authorities have three months to decide and if they don’t answer in time, the request is approved by default.

Who can use it

The rule covers long-term residents, expats and some digital nomads who can show they actually live in Spain through empadronamiento, utility bills, rental contracts or school enrollment. Tourists on short stays still rely on emergency care, EHIC or GHIC coverage or private insurance.

Minors and pregnant women are exempt from extra charges on core care. Spaniards abroad can also get temporary access for up to six months a year and people who were already undocumented before the decree can benefit too.

What applicants need to submit

Applicants must file the declaration form, a passport or other ID and proof of residence with a regional health office or the National Institute of Social Security. If their home country has a social-security agreement with Spain, they also need a certificate showing benefits can’t be exported.

The process is designed to work online where possible and includes support for disabilities and multiple languages. For nomad news and related policy changes, check our visa updates and read our full Spain guide for the complete picture.