Health Insurance and Healthcare Systems in Europe: Everything You Need to Know

There are over 30 million expats living in different parts of Europe. Starting a new life on a new continent can be stressful and overwhelming. One of the biggest challenges expats face when moving to a European country is healthcare.

Navigating a new healthcare system is confusing and oftentimes intimidating. This is why it’s important to understand how healthcare is regulated in European countries before deciding to settle down in a new country.

How Does Healthcare Work in Europe?

Health systems in Europe mostly work based on national healthcare, where medical expenses are state-covered, and residents are required to only pay small service fees. Some other countries provide private health insurance, which the government heavily regulates.

However, most countries in Europe have a healthcare system based on the following health models:

• The Beveridge model. This is a healthcare model proposed by William Beveridge in the United Kingdom. According to this system, healthcare centres are public (government-owned and operated), and healthcare is funded largely by income tax; in turn, it offers free services to its citizens. Countries that mostly follow this model include Italy, Spain, Denmark, Sweden, Norway, Portugal, etc.
• The Bismarck model. Named after Otto von Bismarck, its founder, under this system, citizens pay a small fee to a fund (either a private or a national fund) which in turn provides healthcare services for them. Countries that mostly follow this model include Germany, Austria, Switzerland, and the Czech Republic.
• A mixture of both models. After many years of reforms and improvements, not one European country follows the same specific mode. Both systems usually present features, with healthcare being offered on the principle of solidarity and equality.

Healthcare Systems in Europe by Country

Here is a comparative overview of healthcare systems within the EU/EFTA member countries:

Is Health Insurance Mandatory in Europe?

Health insurance is mandatory in most European countries. However, there are differences between healthcare administration depending on the country, and not all have mandatory health insurance laws— you must verify this before heading out to your new place of residence. Some EU countries with mandatory health insurance include Germany, Switzerland, and Luxembourg.

How Can Expats Get Health Insurance in Europe?

Expats who move to live long-term in any country in Europe are usually included in the country’s national health insurance scheme and can receive healthcare just like any citizen. Still, most expats prefer to have additional private health insurance when moving to get additional benefits such as access to English-speaking physicians, fewer waiting times, and treatment at private hospitals.

Does Europe Have Universal Healthcare?

Most countries in Europe have universal healthcare, i.e., they offer healthcare to every resident and citizen regardless of their income— here is a list of some of the most expat famous European countries that offer universal healthcare:

• Albania
• Austria
• Belgium
• Bulgaria
• Croatia
• Czech Republic
• Denmark
• Finland
• France
• Georgia
• Germany
• Greece
• Iceland
• Ireland
• Italy
• Luxembourg
• North Macedonia
• Netherlands
• Norway
• Portugal
• Romania
• Serbia
• Spain
• Sweden
• Switzerland
• Turkey
• United Kingdom

Is Healthcare Free in Europe?

Healthcare is mostly free in many European countries. This means that primary and secondary care services are usually free— funded by taxes and regulated by national healthcare— but patients must either pay co-payments or small service fees (for hospitalisation, emergency visit, ambulance, etc.). However, this largely depends on which country in Europe you are living in. Some countries have “free-for-service” systems, where you pay your medical fees out of pocket and then are reimbursed by insurance (most likely a national health insurance fund).

What Is the European Health Insurance Card?

The European Health Insurance Card, or the EHIC, is an insurance card issued to all citizens or residents of the EU countries, which gives them the right to seek healthcare in any EU member state as if they were a citizen of that country. However, the EHIC is not a replacement for health insurance. If you plan to move long-term to another EU country, you must register with that country’s health insurance scheme. You can use your EHIC for short-period stays.

Can Expats Get an EHIC?

Expats who qualify for national health insurance in any EU country receive an insurance card; usually, the back of the card will contain the EHIC. It’s important to remember that if you receive an EHIC, it’s valid for short-term stays and emergencies while you are in another EU country— for long-term stays, you need proper insurance.

Which European Country Has the Best Healthcare System?

Here is how the EU/EFTA countries were ranked in terms of healthcare according to the Euro Health Consumer Index in 2018 based on three main criteria waiting times, results, and generosity. In addition, the table below showcases life expectancy, GDP expenditure, and mortality rates in terms of health for the EU/EFTA countries: