Healthcare in Europe: What to Know Before You Arrive
Understand how healthcare works across European countries, public systems, private insurance and what you need before relocating.
- Published
- 2026-07-09
- Last reviewed
- 2027-07-09
Public healthcare systems
Most European countries offer public healthcare funded through taxation or social security contributions. As a legal resident or worker, you are typically entitled to access, but waiting times and coverage levels vary significantly. In Portugal, the Serviço Nacional de Saúde (SNS) provides universal coverage funded through taxes — consultations are free or low-cost but waiting times for specialists can be long. In Germany, the public health insurance system (Gesetzliche Krankenversicherung) is funded through employer and employee contributions (approximately 14.6% of salary plus an additional average 1.6% supplementary contribution, shared between employer and employee). In Spain, the Sistema Nacional de Salud (SNS) provides universal coverage similar to a National Health Service model. In the Netherlands, all residents are required to purchase private health insurance from regulated insurers (approximately €130-170 per month), with income-based allowances for lower earners. In France, the Assurance Maladie covers approximately 70% of basic costs and most people have complementary mutuelle insurance for the remainder. Research the system for your target country before arriving, as requirements vary by visa route and employment type.
Private health insurance
Some countries require or strongly recommend private insurance, especially for higher earners or self-employed professionals. In Germany, if your income exceeds approximately €69,300 annually (2026 threshold), you may opt for private health insurance (PKV) instead of public (GKV). Private insurance can be significantly cheaper for young, healthy professionals (€200-400/month) compared to public contributions (€400-700/month at higher salaries). In the Netherlands, the mandatory basic health insurance costs approximately €130-170 per month with an excess of €385 per year. In Portugal, private health insurance (e.g., Multicare, AdvanceCare) costs approximately €300-1,000 per year depending on age, coverage level and pre-existing conditions. Many professionals maintain both public access and private top-up insurance for faster specialist access. Research the health insurance obligation for your specific visa route — some visas require proof of comprehensive private insurance before issuance.
EHIC and temporary cover
If you are an EU citizen, the European Health Insurance Card (EHIC) provides access to state healthcare during temporary stays. Non-EU citizens should check bilateral agreements between their home country and the destination. The EHIC covers medically necessary care on the same terms as residents of the country you are visiting — it is not a substitute for travel insurance and does not cover private healthcare or repatriation costs. For non-EU citizens, some countries have bilateral social security agreements that provide limited healthcare coverage. Check with the embassy or consulate of your destination country about any agreements that may apply. Once you become a resident, you will typically transition to the local healthcare system and your EHIC (if applicable) will no longer be your primary coverage.
Registering for healthcare
After obtaining residence, you typically register with a local doctor and receive a health card. Keep your insurance documents accessible and translated if required by local authorities. In Germany, you choose a public health insurance provider (Krankenkasse) and receive a health card that you present at doctor visits. In Portugal, you register at your local health centre (Centro de Saúde) with your residence card and NIF. In Spain, you register at your local social security office (INSS) to receive your health card (tarjeta sanitaria). In the Netherlands, you purchase a basic insurance policy from a private insurer (e.g., Zilveren Kruis, CZ, VGZ) and receive a policy document and digital card. Registering as early as possible after arrival ensures you have access to healthcare when needed.
Emergency services
The European emergency number 112 works in all EU countries. Emergency care is generally provided regardless of insurance status, but follow-up costs may apply depending on your coverage. In public healthcare systems, emergency treatment in state hospitals is typically covered or low-cost for residents. If you have only private insurance, check whether your policy covers emergency care and ambulance services. Keep your health insurance details and emergency contact numbers accessible on your phone and in a physical document in your wallet. In non-life-threatening situations, research whether your country has a non-emergency medical number (e.g., 116117 in Germany for out-of-hours medical assistance) to avoid unnecessary emergency room visits.