Expat guide to countries with best healthcare systems in Europe

Healthcare is one of the biggest considerations when relocating abroad, as it means saying goodbye to the security of the British NHS system. However, there are some wonderful healthcare options throughout Europe.
Expats may need to pay for private medical insurance, have medical insurance included in a relocation package, or qualify for state healthcare depending on residency status. It is important to ensure that appropriate healthcare cover is in place before moving, and to research local healthcare facilities, register with a doctor and dentist and locate the nearest pharmacy.
There are many things to bear in mind, including cost, quality of care, facilities, treatments included, private vs public services, waiting times and more. Here we look at three of the best healthcare systems in Europe for expatriates.


France has always had a fantastic healthcare system, with low waiting times, high national spending and world-class services, facilities and staff. It was improved even further at the start of 2016, with the introduction of the ‘Protection Universelle Maladie’ or PUMA. This gives anyone who lives in France in a ‘stable and regular’ manner access to public healthcare. To qualify, an expat needs to have lived in the country for three consecutive months and be a permanent legal resident, which is defined as living in France for at least 183 days of the year. There are some exclusions for retirees, so if this applies to you, we recommend that you investigate PUMA restrictions for retirees in further depth.
Public healthcare in France is not free, but it is also not expensive, especially in comparison to private healthcare policies. For a monthly payment into the system, residents get a 70% reimbursement of government-fixed fees for visiting the doctor, dentist or other specialist; 80% of fixed hospital fees; and up to a full 100% of the cost of medications. The government tariffs are low anyway so it’s a very cheap way to access healthcare. It’s even possible to have top-up insurance to be able to see a private doctor or specialist to cover the difference in fees from fixed government rates to private rates.


Germany has a reputation for its excellent healthcare system and high doctor-to-patient rate that, coupled with some of the best life expectancy figures in the world, makes it one of the best systems in Europe. All residents in Germany, including expatriates with resident status, are required by law to have health insurance. In order to get a residence permit, it’s essential to show proof of adequate health insurance cover, as well as a certificate of health from a doctor in Germany. There are various licensed insurance providers in Germany who can provide the right level of cover for expats and their family. There is both public health insurance and private health insurance available, which varies in cost. The mandatory government system means paying a fixed basic rate into the system, while the employer also contributes, which gives access to hospital care, out-patient care and dental care. For more comprehensive coverage, private healthcare policies are available and these offer better access to a wider range of services and facilities. There are permanent and time-limited plans (i.e. for temporary contracts up to five years) available to suit the length of stay in Germany.


Another country famed for its healthcare services is Austria. Expats who live in the country and contribute through the tax system can access the public healthcare system. Because of the top-class quality of facilities and services throughout the country, private healthcare insurance isn’t as common as in some other countries, though it may be offered as part of an employment package. Access to basic healthcare is free, which includes hospital treatment, medication, basic dental care. Expats contribute to the health insurance scheme through their wages and employers match the monthly payments. Children are automatically covered, which is good news for those moving with families. Private insurance gives more ‘perks’, such as a smaller wards or a single room, and private doctors and specialists, but the public system is just as efficient and well organised.
Information correct at the time of publication.