Unfortunately, the Seguridad Social doesn´t inform those insured for public healthcare, if in their opinion, something in your personal circumstances has changed or needs to be re-confirmed, to guarantee continued entitlement but instead the cover of your medical card will be suspended until the situation has been regularised. In most cases you will only notice when you try to make an appointment with a medical professional or try to access your prescription meds at the pharmacy.
Naturally, the reasons can be many, but we outline the most common below.
Change in circumstance that you should NOT have to inform the INSS about is when your situation changes from being a dependant/beneficiario to working on a contract or as autonomo, as your status will be updated by the INSS automatically.