8 Countries with the Best Healthcare for Expats (According to Experts)

Healthcare abroad needn’t be scary nor expensive. Discover eight expert-recommended countries with the best healthcare for expats and at fair prices

Moving abroad comes with both excitement and anxiety – new cultures, new foods, new adventures… and a whole new healthcare system to figure out. As an expat you might have medical needs, children in tow, or just want the guarantee of being covered locally. 

For those global citizens who want excellent care without paying top dollar, what are the countries with the best healthcare for expats?

Healthcare systems worldwide vary in quality, accessibility, and cost. Some countries might offer world-class care at reasonable prices, while others might leave you with eye-watering bills or frustratingly long wait times. The differences don’t just matter for your wallet – but your health, too.

After speaking with healthcare and immigration experts who’ve guided thousands of expats through these decisions, we’ve identified eight countries that consistently outperform when it comes to expat healthcare access. From Germany’s comprehensive public system to Portugal’s increasingly popular SNS, we’ll break down exactly what makes these destinations stand out.

Disclaimer: This guide isn’t about finding “free” healthcare (because it’s never truly free) but about identifying systems that provide quality, accessibility, and peace of mind for foreigners putting down roots abroad.

Let’s dive into what makes healthcare abroad different for expats, then explore eight countries with the best healthcare for expats that our experts recommend: Five in Europe, plus three high-quality healthcare systems elsewhere.

Don’t just pray for your travel safety and health – do the research to ensure you’re covered. Read on if you prioritize affordable and accessible medical care in your relocation plans. 

Regardless of where or how you choose to travel, protect your journey with full coverage tailored to expats. Explore ExpatDen’s recommended travel insurance plans today.

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Healthcare Abroad: What Expats Need to Know Before Moving

When you’re relocating to a new country, healthcare considerations might take a bit of a backseat to housing, employment, and cultural adjustment, especially if you’re in good health. Yet a staggering 84% of male expats need access to healthcare services after moving abroad, with nearly three-quarters expressing concerns about the quality of local medical facilities, according to research from AXA Global Healthcare. 

Two-thirds of men and 59% of women would even travel back home to receive medical treatment. Why not prepare instead and find out where you can expect quality healthcare? 

“Whether you’re concerned about the facilities or treatment options that are available in your new home, trying to navigate an unfamiliar healthcare system or simply being away from your family, it’s vital that anyone who is considering living abroad takes some time to research the local healthcare facilities,” AXA’s Global Head of International Healthcare Andy Edwards advises. 

But before starting off your research into the countries with best healthcare for expats, Edwards advises you should “Consider booking a health check before you relocate to highlight any potential issues to be aware of before you go.” 

Having a good idea of your health needs means you’ll be more effective in researching healthcare options. 

What to Look for in a Public Healthcare System

So what to look for in terms of coverage and healthcare cost when moving abroad? What do the best healthcare systems for expats offer in terms of coverage and healthcare costs? 

First, public healthcare systems should cover existing health conditions. “Many countries have mandatory healthcare systems in one way or another for any resident in those countries (citizens and expats who are registered residents), which automatically covers pre-existing conditions,” Carsten Creutzberg explains, who is an insurance advisor with over two decades of experience and founder of CIC Insurances.

In other words, universal healthcare means you don’t have to worry about what’s covered and what not – as long as your expat status guarantees you access to medical services. And what about affordability? 

Are there any countries with free healthcare for foreigners?

“Many expats, or citizens from outside Europe for that matter, think that ‘best’ healthcare is a type of free healthcare. But, there is no such thing as free healthcare anywhere in the world,” Creutzberg comments. 

Andrew Raming, Senior Manager Business Development for Henley & Partners, agrees and adds: “The idea of free healthcare is often misunderstood, and most countries that offer it do so only for legal residents or citizens, not just anyone who arrives.” 

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In the case of a public healthcare system, Jaruwitt Akaratongskul explains, “It’s not totally ‘free’ because everyone pays through taxes.” The Co-Founder of insurance platform CheckDi adds that “when you do need healthcare, you don’t pay directly.” 

But even after paying taxes or social security, citizens might still face co-payments for certain health services. 

What makes these systems truly universal is their public access and pay-as-you-earn principle, which sometimes makes healthcare free if you earn below a certain threshold. These social principles are core to many European societies.

That’s why Raming suggests that, “In terms of countries offering public healthcare to all legal residents, including expats, most should look towards Europe.”

5 European Countries with the Best Healthcare for Expats

Europe is the premier destination for expats looking for affordable, high-quality healthcare. The continent’s excellent public healthcare boils down to its governments’ spending – countries like 

Germany, France, and Switzerland dedicate over 10% of their GDP to healthcare. 

Those investments pay off: The continent dominates global healthcare rankings. Seven of the top 10 health systems worldwide are located on the continent, as ranked by insurer Expatriate Group after looking at factors ranging from life expectancy and hospital beds to medical costs. 

What makes European healthcare so attractive to expats? It’s the combination of universal access, state-of-the-art facilities, and patient-centered preventive care. And is the medical care 100% free? Depending on which country we’re talking about, public hospitals could charge zero out-of-pocket expenses. 

However, we recommend combining public universal coverage with a private health insurance plan for comprehensive coverage. So does Andrew Raming, who points out that “It never hurts to also have private insurance until you qualify for public coverage, which would cover any additional costs potentially not provided under the public system.” And if you’re a frequent traveler, it makes sense to extend your coverage abroad with international health insurance. 

That said, let’s explore five European countries with the best healthcare for expats, where you can receive world-class treatment without the astronomical costs you might face at home. 

Germany’s Dual Public-Private Healthcare System

Germany’s dual public-private healthcare system is among the world’s finest, with the country allocating 11.7% of its €4.8 trillion GDP to healthcare services. That translates into excellent facilities, cutting-edge treatments, and comprehensive coverage options for residents and expats alike. Germany ranks 3rd on Global Citizen Solutions’ Quality of Life Index, with healthcare quality being a significant contributor to this high position.

Here’s how Germany’s healthcare roughly works. 

The country operates a mandatory health insurance system where residents must have either public (statutory) health insurance (GKV) or private health insurance (PKV). The system especially shines for expats with pre-existing conditions, which automatically fall under public healthcare coverage.

Another thing Germany’s quality medical care stands out for is price transparency. Germany’s healthcare price control system (G-DRG) standardizes pricing for medical services, making healthcare costs predictable for patients. Besides, treatment costs are the same for German citizens and international patients.

Residency Requirements for Expats

Expats relocating to Germany automatically become subject to the country’s compulsory health insurance regulations once they establish residency. EU citizens can temporarily use their European Health Insurance Card (EHIC) before enrolling in the German system. And if you’re not a European citizen? 

“The key is securing employment with a salary between €45,000-€68,000 with a recognized qualification,” Karsten Aichholz, Founder of ExpatDen explains. “This salary range is high enough for a work permit but keeps you under the public insurance threshold where pre-existing conditions must be covered without exclusions or long wait times.”

Healthcare Cost in Germany

While not “free”, Germany offers affordable high-quality care at low cost. Aichholz shares that “Germany offers one of the most accessible comprehensive healthcare systems for expats with pre-existing conditions, though it’s not completely free.” 

Instead, social security contributions are split equally between employer and employee. “While you’ll pay approximately 7.5% of your salary (with employer matching), this gives you immediate access to world-class healthcare with minimal co-pays and no exclusions for pre-existing conditions.” 

Portugal’s Serviço Nacional de Saúde

Life in Portugal isn’t just good for expats – it’s great. 

One of the reasons Portugal is one of the hottest expat and retiree destinations worldwide is the excellent quality-to-cost ratio. That includes its universal healthcare system. International Living recently named Portugal the best place for quality healthcare for American expats.

Portugal has a dual healthcare system that consists of the public Serviço Nacional de Saúde (SNS) and a strong private sector. The SNS provides universal coverage to residents through a network of health centers and public hospitals. And while many citizens rely on public healthcare for primary care, some prefer private hospitals for shorter wait times and additional services. 

Combined, Portugal’s dual healthcare system excels in offering both affordability and quality – with private insurance rates significantly lower than in countries like the United States while maintaining high standards of care.

Residency Requirements for Expats

Portugal offers a variety of paths to expat residency, from citizenship by investment to visas for digital nomads. Legal residents are automatically entitled to public healthcare services. Recent legislative changes have restricted free public healthcare access for undocumented immigrants and non-resident foreigners.

Healthcare Cost in Portugal

The SNS is funded through social security taxation, making services available without any premiums. There may be small co-payments for certain consultations and procedures, but these are generally minimal. As Andrew Raming notes: “Portugal allows residents access to its Serviço Nacional de Saúde (SNS) for free or low-cost treatment.”

For those preferring private healthcare, Terry Coles, an experienced expat and International Living contributor, notes: “Expats can find and see English-speaking doctors within the private medical system – without insurance – for about $65 to $145 per visit. With insurance, this cost is usually knocked down to under $20.” 

Coles’ private insurance in Portugal averages around $140 per month and “is comparable to what my coverage was in the U.S”. Her insurance even covers travel outside of Portugal.

Spain’s Sistema Nacional de Salud

Portugal isn’t the only Iberian country offering high-quality healthcare at low cost. “Spain also provides expats with residency access to the public healthcare system, and it’s often free or very low-cost,” Andrew Raming notes. The country allocates 9.1% of its €1.6 trillion GDP to healthcare, resulting in affordable medical services that contribute to Spain ranking as the world’s healthiest country in Bloomberg’s Global Health Index.

Spain’s healthcare is divided into public and private sectors. The public system, known as the “Sistema Nacional de Salud” (SNS), looks much like Portugal’s similarly named public healthcare system. It provides universal coverage to Spanish citizens and legal residents who contribute to social security. The private sector offers faster and more personalized care, often with English-speaking providers.

Residency Requirements for Expats

Accessing public healthcare isn’t automatic but quite straightforward. Expats need to be obtain legal residency through one of the various expat programs – a Schengen visa won’t do. After obtaining residency in Spain, expats register to the social security system and apply for a public health card called the “tarjeta sanitaria individual.” 

For expats in the process applying for legal residency and without access to public healthcare, private health insurance is a mandatory requirement. Many expats choose to keep their private health insurance for comprehensive coverage.

Healthcare Cost in Spain

Spanish residents visiting the doctor do so without co-pays. Most tests, services, and procedures are also included in the public system. Ambulance usage in case of a non-life threatening service comes, however, with modest fees.

For temporary expats not covered by private insurance or the public health system (non-residents), the average cost of an emergency room visit is €200, and the average cost of a doctor’s visit is €100.

France’s PUMA Healthcare

The French are incredibly proud of their healthcare system – and that’s not just because the French are proud of everything French. The country ranks 10th globally for healthcare and is the 4th best destination worldwide for affordable medical care, according to Internations’ Expat Insider 2024 survey. 

Worried you won’t be able to access France’s healthcare system due to the language barrier? An English-speaking healthcare helpline (0811 36 36 46) assists expats with their medical queries – a thoughtful touch that makes navigating the system much easier for newcomers.

France operates the Protection Universelle Maladie (PUMA) system, which provides universal healthcare coverage to its residents. French law requires everyone to have some form of health insurance, whether through the state system or private providers. 

What makes the French system different from other European countries is the reimbursement model – patients typically pay upfront for services and then get reimbursed, unlike direct payment systems in countries like the NHS in the United Kingdom or Spain’s SNS.

Residency Requirements for Expats

Andrew Raming tells us that “after three months of residency, expats can enroll in the system (Protection Universelle Maladie, or PUMA).” Additionally, expats need to have the intention to spend at least 183 days a year in the country. This requirement applies regardless of whether you’re employed, self-employed, or retired.

The registration process involves several steps: obtaining a residence permit, registering with the local CPAM (Caisse Primaire d’Assurance Maladie) office, providing proof of identity and residence, and receiving a carte Vitale – the French health insurance card used to access services and process reimbursements.

EU citizens can use their European Health Insurance Card (EHIC) during the initial three-month waiting period, but non-EU citizens should arrange private health insurance to cover this gap.

Healthcare Cost in France

Residents typically pay social contributions (around 8% of income above a certain threshold) to access the system. The PUMA system covers about  70% of most healthcare costs, with many French citizens purchasing complementary private insurance to cover the remaining 30%. 

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Cyprus’ GESY system

Apart from being an island nation with history and charm, Cyprus has two great things going for expats. One, it’s tax-friendly and, two, it has high-quality healthcare. It’s no wonder Cyprus is increasingly popular among entrepreneurial expats. 

Carsten Creutzberg specifically highlights Cyprus in his assessment of expat-friendly healthcare systems: “Cyprus is to be mentioned first, because of their relatively low taxes, good health care standard (tax-based) and easy visa access for business owners and freelancers.”

The country has a two-tier healthcare system, locally called GESY, that went through a major reform in 2019 and that provides universal coverage to citizens and legal residents, while a parallel private system offers additional coverage.

Residency Requirements for Expats

Becoming eligible for Cyprus’s public healthcare system requires obtaining legal residency status. For EU citizens, this is as simple as registering for a residence permit after 90 days in the country. 

Non-EU citizens can apply for long-term residency, which typically require proof of income, accommodation, and private health insurance for the initial period. With residency established, expats can register for the GESY system for universal healthcare access. 

Healthcare Cost in Cyprus

Healthcare contribution in Cyprus is very manageable. Employees contribute 2.65% of their earnings, employers contribute 2.90%, and the self-employed contribute 4.00%.

Under GESY, beneficiaries pay the bare minimum of out-of-pocket expenses. A visit to a general practitioner costs just €3, while specialist consultations cost only €6-€10. Prescription medications have a co-payment of €1 per item, and laboratory tests might require small co-payments depending on the specific test. Now that’s affordable.

What Countries Have the Best and Most Affordable Healthcare Outside of Europe?

Europe might dominate global rankings, but good countries with the best healthcare for expats can be found across the globe – often at a fraction of American prices, Medicare or not. Nowadays, many countries in Latin America and the Asia-Pacific region rival any Western healthcare system. 

Below are three expert-recommended countries with the best healthcare for expats.

Costa Rica’s CCSS (Caja)

Costa Rica holds a special place in the heart of expats worldwide – in large part for its natural beauty and Pura Vida lifestyle, but also for its reliable healthcare system. 

Carsten Creutzberg highlights Costa Rica as particularly expat-friendly: “Costa Rica provides public health care through their ‘Caja Costarricense de Seguro Social’ and has low taxes, but quality may not be as high as in Europe with longer waiting times. Visa requirements, especially for retirees, are very welcoming.”

What makes healthcare in Costa Rica for expats so great is its dual-track system: the public Caja Costarricense de Seguro Social (CCSS or “Caja”) topped with a private sector that includes world-class hospitals like CIMA and Clínica Bíblica. 

Costa Rica’s public healthcare system covers pretty much everything from routine checkups to major surgeries and medications, though waiting times can be long. That’s why many expats use private insurance for faster access to specialists and non-emergency procedures.

Residency Requirements for Expats

Since 2010, all permanent residents in Costa Rica must join the Caja system. The process begins with obtaining residency (which takes 18 months) and then registering with your nearest government regional office.

While waiting for residency approval, expats need alternative coverage. Expats can address this by holding private medical insurance so they’re not caught unaware by emergency expenses. 

Healthcare Cost in Costa Rica

Costa Rica’s public healthcare is remarkably affordable. Contributors pay between 7-11% of their declared monthly income to Caja, which covers both the primary policyholder and their family. Most expats don’t pay more than 57,000 CRC, or 100 USD per month, reports InterNations.

Colombia’s EPS Healthcare System

Colombia’s gone through a remarkable change in recent times. Once best avoided, cities like Medellín are becoming tourist hotspots. While Colombia might not yet be one of the safest South American countries, it’s definitely on the rise as an expat destination. One reason for its popularity is that the South American nation has some of the best healthcare on the continent.

At the heart of Colombia’s system is the Entidades Promotoras de Salud (EPS) – a public health insurance framework administered by various providers. Major cities like Bogotá, Medellín, and Cali feature modern facilities with state-of-the-art technology and internationally trained medical professionals.

Residency Requirements for Expats

“Colombia’s public health system ‘Entidades Promotoras de Salud (EPS)’ is accessible for Expats with national ID and provides an interesting low-cost choice among South American countries,” notes Carsten Creutzberg in his assessment of global healthcare options. 

Accessing healthcare requires obtaining a visa, obtaining a cédula (national ID card), and applying for EPS insurance. The visa application typically takes 2-6 weeks, followed by another 2-3 weeks for cédula processing at an immigration office.

Healthcare Cost in Colombia

The EPS system uses a three-tiered copayment structure for procedures, specialist visits, and medications. EPS premiums for retirees amount to 12.5% of declared pension income, with employed individuals paying just 4% (employers cover the remainder). 

Many retired expats report paying $70 to $85 per couple per month for their premiums with EPS public insurance, according to International Living.

Australia’s Medicare System

Australia is another country that tops many travelers’ bucket lists. Expats, too, like spending a few years Down Under. Australia ranks seventh in Bloomberg’s Global Health Index, and its healthcare system is among the world’s best. Is it as affordable as some of the options on this list? Perhaps not – but that’s only because Australia isn’t. And is it as accessible? That depends on where you’re from. 

Australia’s public system, Medicare, provides comprehensive coverage to eligible residents through a network of public hospitals and community-based services. Carsten Creutzberg notes Australia offers a “very high standard, but relatively strong visa requirements and high taxes.” It’s an assessment that reflects both the quality and accessibility challenges expats might face.

Residency Requirements for Expats

Medicare eligibility is restricted to Australian citizens, permanent residents, and those applying for permanent residency. That means you have to meet citizenship or residency requirements.

Those requirements can be hard to meet. Luckily, Australia maintains reciprocal healthcare agreements with eleven countries, including Belgium, Finland, Italy, Malta, the Netherlands, New Zealand, Norway, Ireland, Slovenia, Sweden, and the United Kingdom. Citizens from these nations can access certain Medicare benefits even without permanent residency.

Expats from other nations, including workers and students, have to cover their own healthcare in cash or subscribe to private health insurance. 

Healthcare Cost in Australia

For those with Medicare access, health services are subsidized or free. A standard doctor’s consultation might cost $110 with Medicare covering $42.10, leaving patients with an out-of-pocket expense of $62.90, according to Australian removalist UPMove. Those gap payments seem to be increasing, however, as are waiting times. Many Australian residents opt for supplemental private insurance – both to reduce waiting times and to avoid paying Medicare levies.

What Country Has the Best and Most Affordable Healthcare?

After examining eight countries with the best healthcare for expats, one thing is clear: good medical care doesn’t have to cost a fortune. So what’s the best country to move to for healthcare?

If you’re facing pre-existing conditions and looking for comprehensive coverage with transparent costs, Germany might be your best option. 

For retirees and expats prioritizing quality-to-cost ratio, Portugal takes the crown. European standards and low costs make it attractive for American expats that pay top-dollar for hospital stays in the US. 

Meanwhile, entrepreneurs looking for solid healthcare might prefer tax-efficient Cyprus over Ireland. Wait, does Ireland have universal health coverage? Yes, it does –though it didn’t make our experts’ top recommendations.

In fact, there are many more countries with great healthcare coverage at a fair rate – Japan, Denmark, South Korea, Canada, Taiwan – but none have “free” universal coverage that fits all your health needs. The countries with the best healthcare for expats have great dual systems that, combined, provide comprehensive coverage without high cost or waiting times.

Want to have the peace of mind that your individual health needs are fully covered? For the best healthcare abroad, visit a local clinic and get a health check, pick a healthcare system that covers most of your needs, and let private health insurance take it from there. 
No matter where you choose to travel, ensure your health is protected during your journey with comprehensive coverage designed for expats. Explore ExpatDen’s recommended travel insurance plans today.