Student Insurance and Health Insurance Card for College Students Living Away from Home

School insurance is a mandatory public insurance plan that you pay for along with your tuition: €1.12 per year if you are under 28 and enrolled in an official degree program. It covers accidents that occur during academic activities, certain specific illnesses, and “family misfortune.” It is not your health insurance card: to see a primary care physician in the city where you are studying, you need to enroll in the public health system, which is a separate process.

This is about administrative procedures, not medical care. If you have an emergency, go to the emergency room or call 112: they'll treat you the same way.

It is governed by a law from 1953 (Law of July 17, 1953, and its Bylaws; Order of August 11, 1953) and is administered by the National Social Security Institute (INSS). It remains in effect.

Who is covered. Spanish and foreign students legally residing in Spain, under the age of 28, enrolled in official academic programs ranging from the 3rd year of ESO through a doctoral degree. If you turn 28 during the academic year, coverage continues until the end of that academic year.

How much does it cost? The total fee is €2.24 per course. You pay €1.12 upon registration, and the Ministry of Education covers the other half. The university handles the registration.

What it covers:

• School-related accident. Injuries sustained during activities related to your studies: classes, internships, sports activities, or school-organized trips. This coverage includes medical and pharmaceutical care and, if a lasting disability results, compensation ranging from €150.25 to €601.01 for permanent disability (an annual pension of €144.24 in cases of severe disability).
• Illness. This is not primary care. It covers specific specialties: general surgery, neuropsychiatry, pulmonary and bone tuberculosis, obstetrics (excluding newborn care), and, under certain conditions, physical therapy, chemotherapy, or radiation therapy. Medications: 100% coverage for inpatient care, 70% for outpatient care.
• Family misfortune. If the head of the household dies or the family faces financial ruin, you’ll receive an annual grant to help you finish your degree: €86.55 (€129.82 for special large families), up to age 28.

The amounts haven't been updated in decades. School insurance is helpful, but don't expect it to cover rent.

Waiting period. For almost everything, you need to have made contributions for one year starting from your first enrollment. School accidents, childbirth, and the death of the head of household are not subject to a waiting period.

How to Apply for Benefits. At a CAISS (INSS office) or through the Social Security online portal, with your DNI or NIE and the enrollment certificate proving that you paid the premium. Deadline: one year from the date of the accident; five years for all other cases. For medical care due to illness, the application must be submitted before receiving treatment, not after.

School insurance doesn't provide you with a primary care physician, emergency care for the flu, or your regular prescriptions. That's what the health card from your autonomous community's public health system is for.

The University of Valencia makes it clear: it warns that people over 28 and those who are already covered by Social Security health insurance cannot use this insurance and must present their own health insurance card.

If you're Spanish and are moving to another region to study, you already have a health card in your home region. You have two options.

Option 1: Temporary displaced person. You do not change your region or your registered address. You ask a health center in your new city to assign you a doctor as a temporary resident. In the Community of Madrid, this is called the Document of Care for Temporarily Relocated Individuals (DAD): you can request it at the health center assigned to your address in Madrid or online through the Digital Account, using your DNI or TIE. Andalusia has an equivalent procedure (Andalusian Health Service, “people who temporarily relocate between autonomous communities”).

Option 2: Change your place of residence entirely. You register as a resident in the city where you’re studying and apply for a health card from that region. In Madrid, for example, you’ll need to provide your national ID card (DNI) or residence permit, a proof of registration issued within the last 90 days, and the INSS document certifying your right to health care.

Which one to choose: the "desplazado" option is faster and doesn't affect your residency registration. Registering as a resident has other consequences, so take your time to think it over. We explain it in how to register as a resident while living in a dorm.

If you move within the same community, it's easier. In Madrid, your card doesn't change: at your new health center, they'll print an updated label for you.

Living in a residence. At StepHouse, you can register as a resident if the residence is your primary residence and the residence provides you with the document required by city hall. It’s not mandatory to live there. Here’s a practical tip: the first free hour you have, stop by your local health center with your ID and your regional health card. It’s better to do this in October than during the first rush in November.

If you’re coming from another EU country, the EEA, Switzerland, or the United Kingdom, the European Health Insurance Card (EHIC) gives you access to Spain’s public healthcare system under the same conditions as someone insured here. You must apply for it in your home country before you come.

It covers medically necessary care during your stay, including emergency care and treatment for chronic conditions. It does not cover private healthcare, scheduled treatments, or medical repatriation. That is why many universities require, in addition to the TSE, private health insurance. UC3M, for example, requires both from its Erasmus+ students.

If you're Spanish and going on Erasmus: The INSS issues the TSE for free through its online portal, by phone, or at a CAISS office. It takes about five days to arrive and is valid for two years. If you’re leaving right away, request the Provisional Replacement Certificate: it’s a PDF that’s valid for 90 days.

If you don't pay for student insurance, you won't be covered. Your coverage comes from the public health system's health card. Some universities require students who don't have student insurance to have their own accident insurance (the University of León, for example). Check with the registrar's office.

Private university. What matters is that the degree is officially recognized, not whether the university is public: with an officially recognized degree from a private university, you pay the same amount. A university-specific degree does not grant that right.

Students from outside the EU. For student insurance, you need a valid NIE and a valid residence permit (as required by the Polytechnic University of Valencia). And to obtain a student visa, you will have already been asked to provide private health insurance with no copayments. We’ll go over this in requirements for international students in Spain.

Exchange students coming to Spain. Typically, the host university will require them to have TSE (if they’re from the EU) or private insurance, and they won’t be covered by school insurance. Check the International Relations website.

If you're looking for a place to live in the city where you're studying, check out the StepHouse residences in Spain and Portugal: once you have your address, you’ll know which health center to go to starting the very first week.

€1.12 per course, which is included in the tuition. The other half (up to €2.24) is provided by the Ministry of Education.

No. It covers people under 28 and remains in effect until the end of the academic year in which you turn 28. After that, your coverage is through the public health insurance card.

No. School insurance covers school-related accidents and certain specific medical conditions, but not primary care. To see a primary care physician, you’ll need your regional health insurance card or registration as a non-resident in the city where you’re studying.

Not always. If you're coming from another region, you can apply for assistance as a temporary resident without changing your registration (in Madrid, the "Document of Assistance for Temporary Residents"). If you want the ID card for the new region, then you will be required to register there.

Yes, if they have legal residency in Spain and meet the other requirements (under 28, official education, fee paid).

Yes, as long as it's in effect, it covers medically necessary care in the public health system. It does not cover private care or repatriation: be sure to supplement it with insurance.