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Research Report

Expat Health Insurance Requirements by Country

A data reference for understanding which countries require private health insurance for residency and how public healthcare access works for expats.

Last updated: 2026-01-26 By John Spencer
John Spencer

John Spencer

John Spencer is the founder of Compare Expat Plans, where he focuses on helping people compare health plans for life abroad.

Summary

This report compiles health insurance requirements for expat residency across 20 popular destination countries. Use this data to understand:

  • Which countries require private health insurance for residency visas
  • Where expats can access public healthcare systems
  • Key differences in how countries handle expat health coverage
  • Specific requirements and exceptions by country

Key Takeaways

  • 12 of 20 countries require private health insurance for at least some residency visa types
  • 11 countries offer full public healthcare access to legal residents
  • Requirements vary by visa type — retirement visas often have stricter insurance requirements than work visas
  • EU countries generally have mandatory health coverage requirements but offer public system access
  • "Required" doesn't always mean expensive — some countries accept affordable local insurance plans

Country Requirements Table

The table below shows health insurance requirements for residency and public healthcare access for expats in each country. Click column headers to sort.

Country Insurance Required? Public System Access Notes
Spain Yes Limited Required for non-lucrative and digital nomad visas. Public access after residency and social security contributions.
Portugal Yes Full Required for D7/D8 visas. SNS (public system) access available to legal residents.
France Depends Full Required for long-stay visa application. PUMA (public coverage) available after 3 months of stable residence.
Italy Yes Full Required for elective residency visa. SSN (public system) access with residency registration.
Germany Yes Full Health insurance mandatory for all residents. Choice of public (gesetzliche) or private coverage.
Netherlands Yes Full Basic health insurance (basisverzekering) legally required for all residents.
Switzerland Yes None Health insurance mandatory within 3 months of arrival. No public system; all coverage is private.
United Kingdom Depends Full NHS access based on residency status. Immigration Health Surcharge required for most visa types.
Ireland No Full No insurance requirement for residency. HSE (public system) access available to residents.
Mexico No Limited No insurance required for temporary or permanent residency. IMSS access available through voluntary enrollment.
Costa Rica Yes Full CAJA (public insurance) enrollment mandatory for all residents. Private insurance accepted for initial visa.
Panama No Limited No insurance required for Pensionado or Friendly Nations visa. Public system access limited for non-citizens.
Colombia Depends Limited Digital nomad visa requires insurance. Retirement visa does not. EPS (public) enrollment available to residents.
Brazil No Full No insurance requirement for most visas. SUS (public system) available to all residents free of charge.
Thailand Yes None Required for O-A, O-X retirement visas and LTR visa. Must meet minimum coverage amounts. No public access for expats.
Vietnam Depends Limited Some work permits require insurance. Public system technically available but limited English-language care.
Japan Yes Full National Health Insurance (NHI) enrollment mandatory for residents staying 3+ months.
South Korea Yes Full National Health Insurance mandatory for residents on long-term visas (6+ months).
Australia Yes Depends OSHC required for student visas. Medicare access depends on visa type and reciprocal agreements.
UAE Yes None Health insurance mandatory in Abu Dhabi and Dubai. No public system; employer-sponsored or private required.

Data current as of 2026-01-26. Requirements may change; verify with official government sources before making decisions.

Methodology

This report compiles health insurance requirements for expat residency across 20 countries. Our research process includes:

Data Collection - Review of official government immigration websites and visa requirement pages - Analysis of embassy and consulate guidance documents - Examination of public health system eligibility rules - Cross-referencing with international health insurance provider documentation

Verification - Each country entry verified against at least two independent official sources - Requirements checked against recent policy changes (within 12 months) - Notes reviewed for accuracy by editorial team

Limitations - Requirements may change without notice; always verify with official sources - Specific visa types may have different requirements than general guidance - Public system access rules vary by region within some countries - This data represents general patterns and may not cover all edge cases

Update Schedule - Full review conducted quarterly - Individual country updates made as policy changes are identified - Last comprehensive review: January 2026

Download Data

Download the complete dataset for your own analysis or reference.

requirements-by-country.csv

Contains 20 countries with columns for insurance requirements, public system access, and detailed notes.

Download CSV

Sources

This report draws from the following source categories. Specific URLs are available in our research documentation.

Government Immigration Sources

  • Official government visa and immigration portals for each country
  • Ministry of Foreign Affairs documentation
  • Immigration authority requirement listings

Embassy and Consulate Guidance

  • US Embassy pages for each destination country
  • UK Foreign Office travel advice
  • Consulate-specific visa requirement documents

Public Health System Portals

  • National health service eligibility information
  • Social security administration documentation
  • Regional health authority guidance

Insurance Provider Documentation

  • Insurer country-specific requirement guides
  • Policy documents referencing local regulations
  • Broker compliance documentation

International Organizations

  • WHO health system profiles
  • OECD health statistics
  • European Commission healthcare information

Additional References

  • Expat community forums and verified experience reports
  • Immigration attorney guidance (for verification)
  • News reporting on policy changes

For more detailed information on specific countries or insurance options:

Looking for health insurance that meets your destination country's requirements? Our comparison tool can help you find plans accepted for visa applications.

Compare expat health plans

Disclaimer: This report is for informational purposes only. Immigration and health insurance requirements change frequently. Always verify requirements with official government sources and consult with immigration professionals before making decisions. We are not immigration attorneys or licensed insurance brokers.