Healthcare Insurance for Expats by Country
Whether a residency visa requires private cover, when public access kicks in, and what private insurance typically costs are three of the most-asked practical questions for relocating expats. This reference summarises the position across 21 major destination countries.
Last reviewed: 2026-04-26. Coverage requirements change with visa rules; always verify with the destination country's immigration and health authority before purchasing.
| Country | Public access | Visa requires private | Private cost (per adult) |
|---|---|---|---|
| Australia | Medicare for Australian citizens, PR holders, and reciprocal-agreement countries (UK, Ireland, NZ, Belgium, Italy, Sweden, Slovenia, Malta, Norway, Finland, Netherlands) Free at point of use for many GP and hospital services; Medicare Levy 2% of taxable income | Yes for non-reciprocal-country visa holders (Overseas Visitors Health Cover OVHC mandatory for 482, 491, 189, 190 visas etc.) | $60-180 per adult (OVHC); $200+ comprehensive Bupa, Medibank, NIB, HCF. Lifetime Health Cover loading applies if private cover taken after age 31. |
| Canada | Provincial health insurance (OHIP, RAMQ, MSP, etc.) after 3-month waiting period (most provinces); BC, Manitoba, Quebec waiting periods vary Free at point of use for medically necessary services; prescriptions, dental, vision require private | Yes for the 3-month waiting period; recommended for prescription / dental gap | $80-300 per adult Manulife, Sun Life, GreenShield. Most permanent jobs include extended health benefits. Quebec RAMQ has special enrolment rules. |
| Costa Rica | Caja Costarricense de Seguro Social (CCSS) — mandatory enrolment for residents at ~7-11% of income; covers all care $50-300/month per adult depending on income | Yes for visa application; once CCSS enrolment, often substituted | $80-200 per adult (BlueCross / INS Costa Rica / Cigna) Public CCSS quality is good but waiting times long for elective care; most expats keep private cover for specialists. |
| France | PUMA (Protection Universelle Maladie) after 3 months of stable residency; full coverage 30% co-pay typical; mutuelle (top-up insurance) covers the rest | Yes for first 3 months — €30k+ private cover for visa application | $60-180 per adult (mutuelle); $200+ international MGEN, Harmonie Mutuelle, Allianz Care. After PUMA enrolment, mutuelle is the standard top-up for the 30% gap. |
| Germany | Statutory health insurance (gesetzliche Krankenversicherung, GKV) mandatory for employees earning under €69k/year; voluntary private (PKV) above the threshold ~14.6% of gross salary (split with employer); ~€450-650/month for self-employed | Yes for visa application — must be 'comparable' to German statutory cover | $300-700 per adult (PKV); $500+ international TK, AOK, Barmer for GKV. Allianz, AXA, DKV for PKV. Switching from PKV back to GKV later is restricted. |
| Greece | EOPYY (National Organisation for Healthcare Services) on residence permit + AMKA (social security number) Free at point of use; co-pays for prescriptions | Yes for Golden Visa, Retirement; private coverage for visa duration | $50-150 per adult Many retirees retain private cover for English-speaking specialist access. Generali, Interamerican, Allianz Care. |
| Ireland | HSE (Health Service Executive) public system; Ordinarily Resident status grants access (typically after 1 year of intent to remain) Free at point of use for hospital care; €80 emergency-room visit; GP fees €50-65 | Yes for Critical Skills, Stamp 4 Investor; private cover for visa duration | $100-300 per adult (VHI, Laya, Irish Life); $250+ international Long HSE waiting lists drive most expats to maintain private cover even after public eligibility. |
| Israel | Universal coverage via 4 Kupot Holim funds (Clalit, Maccabi, Meuhedet, Leumit) for citizens and residents ~5% Health Tax + Bituach Leumi premium (~NIS 200/month for non-employed); free at point of use | No requirement post-Aliyah — Kupat Holim enrolment automatic | Most expats covered by Kupat Holim; supplemental insurance NIS 100-300/month for Maccabi Sheli, Clalit Mushlam, etc. Olim get free Kupat Holim enrolment from day 1 with absorption registration. Supplemental cover common for private specialist access and some elective procedures. |
| Italy | SSN (Servizio Sanitario Nazionale) after Permesso di Soggiorno + Anagrafe registration; non-residents may register via voluntary contribution Free at point of use; small co-pays for some specialist visits | Yes for Elective Residence; €30k+ coverage required | $80-180 per adult UnipolSai, Generali, Allianz Care. Private supplements common to bypass SSN waiting times for elective procedures. |
| Japan | Mandatory enrolment in National Health Insurance (国民健康保険) or Employees' Health Insurance (健康保険) within 14 days of residency registration 30% co-pay; premiums income-based (~¥20,000-100,000/month for self-employed) | No — public is mandatory | Public covers most needs; supplemental cover ~$50-150 per adult AIG, Cigna Global. Public coverage is comprehensive; supplements typically for English-speaking facility access. |
| Mexico | IMSS (employed), INSABI (low-income), or private; Temporary / Permanent Residents may enrol in IMSS voluntarily IMSS voluntary enrolment ~$500/year per adult; uninsured private rates very low ($40 GP visit) | No specific requirement; financial-self-sufficiency proof typical | $80-250 per adult GNP, AXA Mexico, Bupa, Allianz Care. Many US expats fly home for major procedures; Cancun/Playa del Carmen have growing medical-tourism infrastructure. |
| Netherlands | Mandatory Dutch basic health insurance (basisverzekering) within 4 months of residency for everyone covered by Dutch social security ~€140/month per adult (premium) + ~€385 deductible | Yes for visa pre-enrolment; basisverzekering substitutes once enrolled | $150-200 per adult (basisverzekering); supplemental varies Zilveren Kruis, CZ, VGZ are major insurers. Dental coverage requires supplemental cover. |
| New Zealand | Te Whatu Ora (formerly DHBs) for Australians, residents, work-visa holders 2+ years, and reciprocal-agreement countries (UK, Australia) Free at point of use; subsidised GP visits (~$50-65 NZD) | Recommended for visa applicants; mandatory for some long-stay categories | $80-200 per adult Southern Cross, NIB, Accuro. ACC (Accident Compensation Corporation) covers all accidents regardless of visa status. |
| Portugal | After 90 days of residency registration; SNS (Serviço Nacional de Saúde) access on residence card + NIF Free at point of use; small co-pays for some services | Yes (D7, D8, Golden Visa) — €30k+ coverage required for visa | $60-200 per adult Médis, Multicare, Allianz Care, Cigna Global widely used. Private coverage often retained even after SNS enrolment for shorter wait times. |
| Singapore | MediSave / MediShield Life for citizens and PRs; expatriate workers require employer-sponsored or self-funded private cover Public not generally available to non-citizens at subsidised rates | Yes — mandatory for Employment Pass / S Pass holders | $150-500 per adult AIA, Prudential, Great Eastern. International schools often require comprehensive cover including dental. |
| South Korea | National Health Insurance (NHI) mandatory enrolment within 6 months of residency 30% co-pay; premiums ~7% of income (split with employer for employees) | No — NHI is mandatory | Public covers most needs; supplemental ~$50-200 per adult Samsung Life, Korean Re. Generally Korea has very low private-cover need relative to other OECD. |
| Spain | Public Sistema Nacional de Salud after Padrón registration + Sistema sanitario público enrolment; some categories (DNV, Non-Lucrative) require private cover for visa duration Free at point of use; small co-pays for prescriptions | Yes for Non-Lucrative + Digital Nomad — must be no-co-pay coverage in Spain | $50-150 per adult Sanitas, Adeslas, DKV, Mapfre, Allianz Care widely accepted. Beckham-law applicants sometimes use private to access English-speaking specialists. |
| Thailand | Public hospitals available but quality variable; expats typically use private hospitals (Bumrungrad, Bangkok Hospital, Samitivej) Public free at point of use for citizens; foreigners pay nominal rates | Yes for LTR (USD 50k+ coverage), Retirement O (THB 400k inpatient + 40k outpatient) | $80-400 per adult Pacific Cross, AXA, April International, Cigna Global. Bumrungrad and Bangkok Hospital have direct billing with major international insurers. |
| UAE | Public hospitals available to citizens; expatriates require employer-sponsored or self-funded private cover Public not generally available to non-citizens | Yes — mandatory for all residence visa holders in Dubai and Abu Dhabi | $80-400 per adult depending on plan tier Daman, AXA Gulf, Allianz Care, Bupa Arabia. Tiered networks; international coverage common. Employer-sponsored covers the worker but not always family. |
| United Kingdom | NHS access after Immigration Health Surcharge (IHS) payment — paid up-front for visa duration Free at point of use; £9.90 per prescription in England (lower in Wales / NI; free in Scotland) | No private requirement — IHS substitutes | $80-300 per adult (Bupa, AXA, Vitality) IHS is £1,035/year per applicant (£776 for under-18s, students, Youth Mobility). Many expats retain private cover for shorter waits and specialist access. |
| United States | Medicare from age 65 (with sufficient work credits); Medicaid for low-income; ACA marketplace for everyone else Medicare Part A free for eligible; ACA marketplace varies by income (subsidies up to 400% FPL) | Generally yes — most non-immigrant visas implicitly require coverage; HSA-eligible plans common | $400-1,200 per adult depending on age, state, plan ACA marketplace plans (healthcare.gov), employer-sponsored plans, COBRA, GeoBlue international. Costs are the highest in the OECD by a wide margin. |
Major international insurers
- Cigna Global — most widely accepted by visa consulates worldwide; flexible plans, $250-700/month adult.
- Allianz Care — strong European acceptance especially Spain, Italy, Germany; $200-600/month adult.
- Bupa Global — comprehensive international plans with worldwide coverage including US; $400-900/month adult.
- GeoBlue — designed for US persons abroad; works with US-based providers and includes US re-entry coverage.
- April International — specialist in France-related expat plans and Asian destinations.
- SafetyWing — short-term and digital-nomad-focused plans; from $45/month for nomads under 40.
See also: Tax residency matrix · Hospital directory · Apostille by country.