In short
There are two main models. Insurance countries — the Netherlands, Germany, Switzerland, Belgium, Luxembourg, Austria, France — make cover compulsory through public or regulated insurers, often from your first job or within a few months of arriving. Tax-funded systems — Sweden, Denmark, Finland, Spain, Portugal, Italy, the UK — give access once you are registered as resident or working, sometimes with a buy-in for people who are not working. Retirees and digital nomads usually need private insurance, at least at first. Medicare usually does not cover care abroad.
Healthcare in Europe: key facts
Last verified 27 September 2026| Medicare abroad | Medicare usually does not cover health care outside the US — plan for local or private insurance in Europe# Source: Travel outside the U.S. (Medicare.gov) |
|---|---|
| Health insurance | Mandatory Dutch basic insurance within 4 months of arrival — about €159 a month on average in 2026, with a €385 yearly deductible# Source: Government.nl: Health insurance and residence permit · Consumentenbond: Zorgverzekeringen 2026 · Overstappen.nl: Zorgpremies 2026 bekend |
| Health insurance | Compulsory basic insurance for every resident, taken out within 3 months of registering; cover is backdated to arrival# Source: Newcomers to Switzerland – FAQ (Helsana) |
| Health premiums | Average monthly premium CHF 392.30 in 2026, rising to CHF 412 (+5%) in 2027; adults pay CHF 487.60 on average in 2027# Source: Health insurance premiums set to rise by an average of 5% in 2027 (Swissinfo) |
| Public health insurance | 14.6% + average add-on 2.9% (2026), split with the employer — employees pay about 8.75% plus care insurance# Source: Federal Ministry of Health: contributions 2026 |
| Healthcare cost cap | Visit fees are capped at SEK 1,450 (about €130) in any 12 months, and prescription medicines at SEK 3,800 (2026)# Source: Högkostnadsskydd för öppenvård - 1177 (Stockholm) · Läkemedel på recept - kostnader - 1177 |
| Healthcare | Workers and the self-employed are covered by the public SNS; others can buy in through the Convenio Especial after 1 year on the padrón — €60 a month under 65, €157 from 65# Source: Convenio especial de prestación de asistencia sanitaria (Ministerio de Sanidad) |
| Healthcare | Workers are enrolled in the national health service (SSN) for free; retirees and others not working in Italy pay at least €2,000 a year to join voluntarily (since 2024)# Source: Arletti Partners: voluntary national health service enrolment (€2,000 minimum) |
| Healthcare | Legal residents can use the public SNS with a user number; private hospital plans cost about €13–77 a month at age 40# Source: gov.pt: Pedir o número de utente do SNS · DECO PROteste: Seguros de saúde Multicare, Médis |
| Healthcare surcharge | £1,035 a year per adult (£776 for students), paid with the visa; it gives access to the NHS# Source: Pay for UK healthcare: how much (GOV.UK) |
The Basics
The Two European Models
Compulsory health insurance
You must hold basic insurance — public funds (Germany, Austria, Belgium, France) or regulated private insurers (Netherlands, Switzerland). Workers are covered through payroll; others pay a premium.
Residence-based public care
Care is run by the state or regions and is available once you are registered as resident or working (Nordics, Spain, Portugal, Italy, UK, Ireland). Fees are low and often capped.
Medicare usually does not cover health care outside the US — plan for local or private insurance in Europe.
By Country
How Each Country Covers Newcomers
| Country | How newcomers get covered |
|---|---|
| Netherlands | Mandatory Dutch basic insurance within 4 months of arrival — about €159 a month on average in 2026, with a €385 yearly deductible |
| Switzerland | Compulsory basic insurance for every resident, taken out within 3 months of registering; cover is backdated to arrival. Average monthly premium CHF 392.30 in 2026, rising to CHF 412 (+5%) in 2027; adults pay CHF 487.60 on average in 2027 |
| Germany | 14.6% + average add-on 2.9% (2026), split with the employer — employees pay about 8.75% plus care insurance |
| Austria | 7.65% of salary in total: 3.87% employee, 3.78% employer |
| France | Workers from the start of their job; others after 3 months of stable residence |
| Luxembourg | Workers are insured with the CNS; others can join voluntarily from about €155 a month (2026), with a 3-month wait |
| Sweden | Run by the regions; residents registered in Sweden pay subsidised fees — for example SEK 275 for a primary-care doctor and SEK 400 at the emergency department in Region Stockholm (2026). Visit fees are capped at SEK 1,450 (about €130) in any 12 months, and prescription medicines at SEK 3,800 (2026) |
| Denmark | Free public GP and hospital care once you are registered in the CPR with a Danish address — no waiting period |
| Finland | Run by wellbeing services counties (in Helsinki by the city); needs a Finnish municipality of residence |
| Ireland | Public health services for anyone ordinarily resident (living or planning to live in Ireland for a year); GP visits and prescriptions are paid unless you have a medical card. Private insurance is a permit condition only for Stamp 0 and students |
| United Kingdom | £1,035 a year per adult (£776 for students), paid with the visa; it gives access to the NHS |
| Spain | Workers and the self-employed are covered by the public SNS; others can buy in through the Convenio Especial after 1 year on the padrón — €60 a month under 65, €157 from 65 |
| Portugal | Legal residents can use the public SNS with a user number; private hospital plans cost about €13–77 a month at age 40 |
| Italy | Workers are enrolled in the national health service (SSN) for free; retirees and others not working in Italy pay at least €2,000 a year to join voluntarily (since 2024) |
| Greece | Public cover (EOPYY) comes through Greek social-security (EFKA) contributions; FIP and golden visa holders need private insurance |
| Malta | Free public healthcare for people paying Maltese social security; permit holders on the Nomad, GRP, retirement and MPRP routes need private health insurance |
| Cyprus | For permanent residents and employees; holders of a visitor permit usually need private insurance |
| Croatia | Residents who are not otherwise insured must join HZZO and pay contributions; digital nomads use private insurance |
| Slovenia | Public insurance (ZZZS) comes with employment or self-employment; the old complementary insurance was abolished in 2024 and replaced by the €39.36 monthly health contribution; digital nomads and other non-working foreigners generally need private cover |
| Czechia | Non-employees without permanent residence need comprehensive private insurance (any authorised insurer); employees are in the public system |
| Slovakia | Public health insurance (VšZP, Dôvera or Union) is compulsory for employees, sole traders with a business permit and permanent residents; others need private insurance |
| Poland | Workers and the self-employed are insured with NFZ through ZUS; voluntary NFZ cover costs PLN 835 (≈€190) a month in mid-2026 |
| Hungary | State cover (TAJ) comes with Hungarian work or contributions; others need private insurance or a state agreement (HUF 161,400 a month in 2026) |
| Romania | Employees are covered through the 10% health contribution; other residents can join the public system (CNAS) by paying RON 2,430 for 12 months (2026) |
| Bulgaria | Compulsory for permanent residents and single-permit holders (8% contribution); long-term residents on other grounds usually need private insurance |
| Estonia | Starts through employment (after 14 days) or social tax — not through registration; voluntary cover €272 a month (2026) |
| Latvia | Private health insurance needed; state-funded care covers only people working in Latvia and permanent residents |
| Lithuania | Permit holders join the state health insurance (PSD) only if legally employed or self-employed in Lithuania; others need private insurance (at least €30,000 cover for a visa) |
Every rule comes from the country's key-facts register — follow the country link for sources and details. Belgium is covered on its country page.
Your Situation
What It Means for You
You move for a job
In almost every country you are covered from your first payslip through payroll contributions. This is the simplest case.
You retire or live on savings
Most retirement visas require private insurance with full cover. Some countries let you buy into the public system later — Spain through the Convenio Especial after a year, Italy from €2,000 a year, Luxembourg from about €155 a month. See retirement visas.
You work remotely on a nomad permit
Nomad permits almost always require private insurance, and public care usually stays closed unless you contribute locally. See digital nomad visas.
On the Ground
What to Expect
Register first
Public access usually starts with an address registration and an ID number — personnummer in Sweden, CPR in Denmark, NIE/padrón in Spain.
Get a family doctor
In most countries the GP is the gateway to specialists; register with one early.
Keep private cover until public care starts
Waiting periods are common — for example 3 months in Luxembourg's voluntary scheme.
Watch the deadlines
The Netherlands gives you 4 months and Switzerland 3 months to take out basic insurance.
FAQ
Frequently asked questions
Can Americans use public healthcare in Europe?
Yes, once you are a resident who works, contributes or is registered under the country's rules. Tourists and most nomad or retirement-visa holders need private insurance at first.
Does Medicare cover me if I live in Europe?
Usually not. Medicare covers care outside the US only in rare cases, so you need local public cover or private insurance.
Which European country has the cheapest healthcare for retirees?
It depends on the route. Spain lets residents buy in for €60 a month under 65 after a year; Italy's voluntary enrolment starts at €2,000 a year; Portugal's public SNS is open to legal residents.
Is health insurance compulsory in Switzerland and the Netherlands?
Yes. Switzerland requires basic insurance within 3 months (average CHF 412 a month in 2027); the Netherlands within 4 months (about €159 a month in 2026).
Across Europe
Compare all 29 countries by topic
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