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@linsaywv

You can only get a EHIC if you are resident in Europe, so in your case Spain. Have a read of this.

@linsaywv

If you're living in Canada, an EHIC won't be much use to you. :-)

As @SimCityAT says, it's likely that you're not entitled to an EHIC as you're not resident in Spain (or Europe). Certainly, you're not entitled to a Spanish EHIC merely because you now have a Spanish passport. I don't know the exact rules, but residence and entitlement to health coverage (usually by making social security contributions) are typical. If you decide to move to Spain, now that you're a citizen, I doubt it would be difficult for you meet the requirements and get an EHIC.

You should also note that an EHIC is useful when travelling in the EU, but it's very much a backup in case of accidents and health emergencies. You typically need "proper" health coverage in your main country (e.g. Spain) and perhaps travel insurance when elsewhere. Making the necessary contributions to be entitled to public health coverage is often a prerequisite for an EHIC. The EHIC only works in public hospitals, so there are frequent stories of holidaymakers having a beach/ski accident and confidently seeking treatment as they have an EHIC... only to end up with a huge medical bill from a private facility.

The Spanish EHIC is called a Tarjeta Sanitaria Europea (TSE).

As an example, I have a British passport, but I'm no longer entitled to a UK EHIC (or GHIC) because I'm no longer resident there. Similarly, while I'm a legal Spanish resident, I don't make any social security contributions there, and therefore don't qualify for public health coverage (or a Spanish EHIC). Instead, I make my social security contributions in Bulgaria, as unemployed. This entitles me to public health coverage in Bulgaria and a Bulgarian EHIC for use in Spain (and elsewhere in the EU). As I'm mostly in Bulgaria, this is fine. If I wanted to spend all/most of my time in Spain I would have to change where I make my contributions or purchase private health insurance in Spain.

@linsaywv

Are you a Spanish resident? do you work in Spain? If not, you can't get a health card.

I'm in the same situation. I have a DNI, but am not a resident of Spain and have a US passport also.

When I've inquired they have told me I cannot get a national health insurance card. However, you can buy private insurance and it isn't that costly.

don't take my word, and check it out yourself. Just sharing what I've been told. Good luck.