Public healthcare for expats: how foreign residents get covered in 10 European countries

How a newcomer gets regular access to public healthcare depends on how the system is built.

We read the official pages of ten countries on 8 October 2026. Three carry an update date: France (13 May 2026), Austria (31 March 2026) and Portugal (23 June 2026). The others were checked on official pages on 8 October 2026.

The table

Insurance you must buy: Switzerland, the Netherlands and Germany

Switzerland requires anyone settling there to take out health insurance within three months of taking up residence. If you register late, cover only starts on the date you enrol and a surcharge is due unless the delay is justified. Insurers must accept every applicant without exclusions or waiting periods.

The Netherlands requires people who come to live or work there to take out Dutch health insurance no later than four months after arriving. Cover runs from the day of arrival; insure after four months and the gap is not covered. Adults pay a compulsory deductible of €385 in 2026, though visits to the family doctor are exempt.

Germany states that all citizens who reside in the country must have health insurance, either statutory or private.

Cover through residence: France, Portugal, Sweden and Ireland

France covers residents through universal health protection, known as Puma. If you work and your application is accepted, you are enrolled at once. If you do not work, you wait three months after arriving, and your rights stay open if you live in France at least six months a year. A 2026 law adds a financial contribution for some beneficiaries without professional income; the page did not give the amount.

Portugal lets any foreign national with legal residence obtain an SNS user number, which gives access to care in public SNS units. The number alone does not guarantee that the SNS pays: your record must also include an identity document, a Portuguese tax number, a full address and a valid residence permit.

Sweden ties access to the population register. People who plan to stay at least one year must usually register with the Swedish Tax Agency. Once registered, you get medical and dental care on the same terms as other residents and pay the standard patient fee.

Ireland bases access on ordinary residence: living there for at least a year, or intending to. Anyone the HSE accepts as ordinarily resident, regardless of nationality, gets either full eligibility, with a medical card, or limited eligibility.

Pay to join: Spain, Austria and the United Kingdom

Spain offers a special agreement for residents not covered through another route. You must prove one year of continuous residence and be registered with a local council. The fee is €60 a month under 65 and €157 from 65.

Austria lets people with their main residence there buy self-insurance if they are not covered by compulsory insurance. It costs €565.25 a month in 2026. Benefits generally start only after a six-month waiting period, unless you were insured shortly before applying.

The United Kingdom charges most visa applicants an immigration health surcharge of £1,035 per year, and £776 for students, their dependants, Youth Mobility Scheme visas and applicants under 18. Once paid, you can use the NHS free of charge from the date your visa starts.

What the table does not show

• Insurance through work. A job often brings cover, which we did not compare here. The paid routes in Spain and Austria are for people not covered in another way.
• Co-payments. Being covered does not mean everything is free, as the Dutch deductible and the Swedish patient fees show.
• Special cases. Students, pensioners, cross-border workers and EU citizens moving within the EU often follow separate rules.

How to use these figures

1. Check the deadline first. Switzerland and the Netherlands start a clock on arrival. Missing it can leave you uncovered or add a surcharge.
2. Plan for the gap. In France, Spain and Austria, some newcomers wait between three months and a year before public cover starts.

Our checklist for the first 90 days abroad puts health registration in order with the other first steps.

Country profiles: Switzerland, Netherlands, Germany, France, Spain, Portugal, Austria, Sweden, Ireland and United Kingdom.

This article describes the rules as published on official pages on 8 October 2026 and is not legal, medical or financial advice. Check your case with the country's health authority or insurer before you move.