Procedure 5 – Additional healthcare: add a beneficiary to your health card (CCAA)

What you need to have to hand

1. Cl@ve PIN/Permanente or certificado digital. Without this you'll be stuck.
2. PDFs of DNI/NIE for titular and beneficiary (front and back).
3. Certificado de empadronamiento colectivo (less than 3 months). This proves you live together.
4. Libro de familia or certificado literal del Registro Civil (birth/marriage/pareja de hecho). If you don't have the Libro, use the certificate.
5. Número de la Seguridad Social of the titular (NAF). It usually appears on your vida laboral or the Import@ss app.

Documentation

• Identity: DNI/NIE of titular and beneficiary.
• Link: Libro de familia or Registro Civil certificates (birth for children, marriage or pareja de hecho for partners).
• Residency: Certificado de empadronamiento colectivo recent.
• Right: Resolución del INSS (if it already exists) or you get it in step 1.
• Authorisation: Some CCAA ask for a consent from the titular to add the beneficiary.
• Foreigners: TIE or certificado de registro de la UE of the beneficiary.

Step by step

1. Request recognition of the right at the INSS: go to the Sede (sede.seg-social.gob.es > Ciudadanos > Asistencia sanitaria > Reconocimiento del derecho). ID with Cl@ve or certificado.
2. Fill it in as titular and tick that you add a beneficiario. Complete details and upload certificado de empadronamiento colectivo, identity docs and vínculo (birth/marriage/pareja de hecho).
3. Send and save the receipt. The resolución usually takes 5–15 working days. Check “Mis notificaciones” on the Sede.
4. With a favourable resolución, go to the portal del Servicio de Salud de tu CCAA and request the Tarjeta Sanitaria Individual (TSI) for the beneficiary. If your CCAA allows it, do it online; if not, print and take it to the centro de salud.
5. Attach the INSS resolución, the empadronamiento and identity documents. Choose centro de salud/médico if asked.
6. Card activation: many CCAA enable a virtual card in their app and post the physical one. If it doesn't arrive, drop by the centro de salud.

Tricks that save you time

• Certificado de empadronamiento colectivo: request it online at your ayuntamiento. If it’s not colectivo, they'll reject you.
• Light PDFs: upload black & white files under 10 MB. The Sede del INSS chokes on huge files.
• Registro Civil online: if you need a birth certificate, request it at sede.mjusticia.gob.es (trámite de certificados del Registro Civil) and you get it by download or post.
• Do it on weekday mornings: the Sede del INSS behaves better then. Fewer 500 errors.
• Use your CCAA app: many have a tarjeta sanitaria virtual. Use that while the physical card arrives.

Common mistakes that can mess up the process

1. Uploading an individual empadronamiento instead of colectivo: it doesn't prove cohabitation and they'll reject you.
2. Out-of-date or missing Libro de familia: use certificados literales from the Registro Civil instead.
3. Going straight to the CCAA without INSS: they'll say the reconocimiento is missing. Order matters: INSS → CCAA.
4. Blurry photos or screenshots: scan documents. If they’re unreadable they'll request them and you'll lose weeks.
5. Not checking notifications: if INSS asks for something and you don't reply, they archive the case. Check the Sede every few days.