How Madrid's health system works
A tax-funded public system run by the Comunidad de Madrid (Servicio Madrileño de Salud, SERMAS): the INSS recognises the right to care, the health card embodies it, and the centro de salud is the front door. Private care, very common, is mainly a way to go faster.
Good to know
- The individual health card is the key to Madrid's public system. It is issued to residents whom the INSS recognises as insured (affiliated employees, benefit recipients) or as an insured person's beneficiaries: spouse and children under 26 living in Spain. Source
- Primary care paediatricians look after children up to age 14, for acute and chronic illness alike, and run the healthy-child check-ups with the nurse, including growth, feeding and vaccines. Source
- Free choice is the rule: family doctor, paediatrician and nurse can be changed at any time without justification, and you also choose the hospital and specialist when referred. You must be registered (empadronado) in the Comunidad de Madrid to use this right. Source
- Nothing to pay upfront and nothing to claim back: public consultations, emergencies and hospital stays are free. Only prescribed medicines carry a co-payment, proportional to income (40 to 60% of the price for working people), with your rate shown in your virtual health card. Source
- Many families add private insurance (Sanitas, Adeslas, Asisa, DKV, Mapfre...) for direct access to specialists and private clinic emergency rooms. Keep the public health card anyway: it gives access to the scheduled vaccines, the major reference hospitals and local paediatrics.