Spain has a public health system that provides health care almost for free, as long as one is registered within the social welfare system. Some health services, however, are not free, such as psychology or dentistry (on referral if the problem is really serious).

Nationals must merely register in order to receive a health care card and full access to the public health system. Migrant sex workers without papers, orthose in a position where they cannot say where they live, have great difficulties in fulfilling the require-ments for ‘civil registration’, which is the minimum requirement for receiving a health care card.

Every migrants, must have a address for  civil registration to have the health care card

 After successfully completing the civil registration, migrants must also provide a passport number before they receive a health care card.

National drug-using sex workers with insurance may access harm reduction programmes and treatment. Uninsured national and migrant sex workers can get access through NGOs and using the health care card.

The only way undocumented drug-using sex workers can access harm reduction programmes is through NGOs or other associations. Their only other option for health care coverage is to pay for private health insurance.