If the past few years have taught us anything, it’s just how important accessible healthcare is for expats. So, if you’re planning a move, you’ll definitely want to factor health policies into your decision. But healthcare can differ depending on which country you’re living in, and each country has its own policies and financing models that affect how much you get for your money. The task, then, is to find out which countries offer the highest standard of care relative to the cost.
We’ve analysed the healthcare systems in the top 10 most popular countries for expats and found the five most affordable and comprehensive. So, if you’re thinking of making the move abroad for better or cheaper healthcare, then this may help you decide where to base your new home.
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First place: Italy
Italy takes the top spot as one of the most accessible healthcare systems for expats. This country has a universal health service similar to the NHS, called the Servizio Sanitario Nazionale (SSN), which is funded by taxes.
Citizens can expect to contribute around 4.6% of their income to the public health system (similar to the UK) and can get free or subsidised healthcare. For the most part, GP and ER visits are free, and prescription costs are subsidised under state health cover, meaning you’ll only pay a small fee. It’s no wonder Italy has among one of the highest life expectancies in Europe (WHO).
For more information, head over to Italy Property Guides for our guide to understanding the Italian healthcare system.
Second place: Germany and the Netherlands
Both Germany and the Netherlands came in second in our results, but their healthcare systems are very different.
Germany
Germany has a national healthcare system similar to that of the UK and other European countries which is funded by tax — expect to contribute around 7.5% of your salary to the health service. State healthcare is an opt-in system but having some form of health cover is mandatory. Some German citizens may choose to take out private health insurance to supplement or replace public health cover.
As well as being one of the most affordable and comprehensive, Germany has one of the highest rates of equity, which means fewer people reported income-related disparities with their healthcare (Commonwealth Fund).
Germany also has the highest number of hospital beds per 10,000 population, as well as one of the largest university hospitals in Europe. This means the country is best equipped to deal with a surge in emergencies out of all our top 10 expat countries.
The Netherlands
The Dutch healthcare system is very different to what we’re used to in the UK. While you may have to contribute 9.65% of your salary to state healthcare, you’ll have access to one of the highest performing healthcare systems in Europe (Commonwealth Fund).
Health insurance is mandatory in the Netherlands meaning, in most cases, residents are required to take out at least a basic healthcare policy. Luckily, Dutch health insurance premiums are relatively low compared to the rest of Europe, the USA, and the UAE, and you’ll have access to free prescriptions, GP visits, and vaccines.
Third place: Spain and the UAE
Two countries also tied for third place: Spain and the United Arab Emirates. Again, while these countries ranked in our top five, they’re very different from one another.
Spain
According to the World Population Review, Spain is the healthiest country in the world, perhaps thanks to its universal healthcare, which guarantees access to free healthcare for all Spanish nationals. However, each region is responsible for the delivery and standard of care, which means healthcare may differ depending on where you live. The good news is, those who are living and working in Spain can access their state healthcare system, but you will need to check the terms and conditions for your region.
While GP visits are usually free with state health insurance, you will have to pay a proportion of your prescription fees, as well as pay for any ER visits, vaccinations, or any specialist treatment. For this reason, many Spanish citizens pay for private insurance alongside state insurance which will give them access to a wider treatment. For more information visit our guide to the Spanish healthcare system at Spain Property Guides.
The UAE
The UAE has its own state health service which is funded by the government. And, as the UAE doesn’t have income tax, healthcare isn’t funded by statutory contributions. Instead, it is paid for with corporate tax on large businesses.
It’s worth bearing in mind that the UAE has both public and private healthcare facilities, and expats can only access public hospitals and clinics if they have a UAE health card. These can be obtained from the Dubai Health Authority or the Health Authority Abu Dhabi. Emergency care is usually free in state-funded hospitals with a health card, although you may have to pay for a consultation with a private family doctor. That being said, costs are still cheaper than those in Switzerland and the USA.
Methodology
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The top 10 countries were picked based on the most common countries of residence as found by the InterNations Expat Insider 2021 survey. These countries were:
- Germany
- USA
- Netherlands
- Spain
- Switzerland
- UK
- UAE
- France
- Italy
- Canada
Healthcare affordability and accessibility was measured by looking at 10 different ranking factors:
- Public healthcare contribution [1]
- Annual cost of health insurance [2]
- Cost of standard prescriptions
- Cost of a GP visit
- Cost of an ER visit
- Cost of a flu vaccine
- Cost of a medical treatment visa
- Average life expectancy [3]
- Number of hospital beds per 10,000 population [4]
- Number of medical doctors per 10,000 population [5]
The 10 countries were then ranked for each category and assigned a point each time it came top. The countries were organised by their number of points to get a definitive ranking.
In light of the results, Chris Nye, Senior Content Editor at Property Guides, said:
“While the cost of living and quality of life are certainly major reasons to move abroad, healthcare should also be a vital deciding factor. Health can be very unpredictable, and you just never know when you might need help or emergency care. And you certainly don’t want the added stress of footing a hefty bill when you’re already sick.
“Most popular expat countries, aside from the US, have some form of state-funded healthcare, with the option to top up your healthcare with private insurance. Wherever you move to, it’s wise to take out at least the most basic health cover to avoid being left in the lurch.
“After analysing the top 10 most popular expat countries, it seems Italy can offer the most in terms of health cover, with Germany and the Netherlands closely following behind. Spain is very popular with British expats, and it’s affordable and comprehensive healthcare suits many residents, although you may need to take out private insurance to supplement it.
“Healthcare can differ greatly from country to country, so it’s wise to do your research before you decide to make the move. You may need to apply for a health insurance card to get access to state healthcare, or you may need to choose a private health insurance policy to get your cover. In some countries, such as Spain or Canada, healthcare can differ from region to region, so this can be another deciding factor before you commit fully to expat life.”
Moving abroad is a big decision and there are so many factors you need to consider before making the switch. Healthcare can differ all over the world, so it’s vital to do your research and gain a clear understanding of what you’re entitled to and how to access it.
Working out what you need to do and how to do it can be tricky. Luckily, our comprehensive guides here at Property Guides will help you at every step of the way. Our team are experts in buying property and moving to France, Spain, Portugal, Italy, the USA, and Ireland, and can offer their advice to help you make one of the most important (and exciting) decisions of your life.
All currency has been converted to GBP. Where cost was displayed as a range, the average has been calculated. In some cases, health insurance is required by law. In these instances, costs are listed as free where insurance will cover the amount.
[1] Public healthcare contribution costs presented as a percentage of income and based on state-provided healthcare or mandatory public health insurance
[2] Annual health insurance costs based on 2019 individual International Private Medical Insurance cost data: https://www.pacificprime.hk/assets/landing/cohi-2019/COHI-2019-GUIDE.pdf
[3] Average life expectancy based on 2019 life expectancy at birth data from the WHO: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/life-expectancy-at-birth-(years)
[4] Number of hospital beds based on most recent WHO data: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/hospital-beds-(per-10-000-population)
[5] Number of medical doctors based on most recent WHO data: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/medical-doctors-(per-10-000-population)