Add a beneficiary to your public health card (CCAA)

What you need to have to hand

1. Your Cl@ve or certificado digital (yes, without this you will struggle). 2) The derecho a asistencia sanitaria of the beneficiary recognised in the INSS. 3) Empadronamiento reciente. 4) Family documents proving relationship or pareja. 5) The S1 if coverage comes from another EU country.

Documentation

• DNI/NIE del titular y del beneficiario.
• Volante de empadronamiento individual o colectivo (menos de 3 meses).
• Libro de familia o certificado de nacimiento/matrimonio/pareja de hecho (registro oficial).
• Resolución del INSS de reconocimiento del derecho a asistencia sanitaria del beneficiario (vale PDF descargado de Import@ss).
• Tarjeta sanitaria del titular (TSI/SIP/CIP) o su código.
• Formulario S1 registrado en INSS si procede (UE/EEE/Suiza).
• Certificado de convivencia si es pareja no casada y tu CCAA lo pide.

Step by step

1. Derecho INSS: go to https://importass.seg-social.es and use the Asistencia sanitaria service for the beneficiary. If they don't have recognised right, request it with Cl@ve. Download the resolución PDF.
2. Padrón: get a volante reciente for the beneficiary at your ayuntamiento's sede (e.g. Madrid https://sede.madrid.es, Barcelona https://seu-ajuntament.barcelona.cat). Without an up-to-date padrón, forget it.
3. Your CCAA: go to the tarjeta sanitaria portal and book a cita or process it online. Madrid: https://www.comunidad.madrid/servicios/salud/tarjeta-sanitaria. Catalunya: https://catsalut.gencat.cat/ca/serveis/tsi/. Comunitat Valenciana: https://www.gva.es/es/inicio/procedimientos?id_proc=18038.
4. Application: choose Alta de beneficiario, fill in data and attach DNI/NIE, padrón, libro de familia, resolución INSS and S1 if applies. Use PDF under 5 MB, simple filenames.
5. Sign and register: sign with Cl@ve or certificado. Save the receipt with the registro number (otherwise you won't find anything later).
6. Verification/Originals: if they call you in, take originals. Ask for the assigned médico de familia and health centre.
7. Follow up: check the status on your CCAA sede or by phone. The physical tarjeta can take time; many CCAA activate a digital card in their app.

Tricks that save you time

• Upload the resolución INSS first; if not, they'll ask for corrections and you lose weeks.
• Get the padrón the same day you plan to upload the request so it doesn't expire.
• Try to book the cita very early (07:59) or late; that's when slots appear.
• If the website errors, try Chrome and disable blockers. Yes, it's that sad.
• If there's an S1, register it in INSS before touching anything at the CCAA.

Common mistakes that can mess up your application

• Assuming an old padrón is fine. It expires.
• Not proving parentesco or lacking a registered pareja de hecho. The request gets rejected fast.
• Uploading blurry photos of DNI/NIE. They'll ask for a correction and your place in the queue is lost.
• Moving house and not updating the padrón: you'll be assigned a different centre and your card may be blocked.
• From UE/EEE, forgetting the S1 or not registering it in INSS. Without it the CCAA won't activate anything.