Which countries  have mandatory health insurance?

Which countries  have mandatory health insurance?

24 August 2022 Insurance

In some countries, expatriates are required to subscribe to a minimum compulsory health insurance  plan as a prerequisite to  residence  and/or employment. Compulsory health insurance  is generally developed by the government to ensure basic health cover and access.

In which countries is healthcare insurance compulsory? Is this type of local public insurance scheme fully adapted to the needs of expatriates? Foyer Global Health offers you some answers!


Germany’s public health insurance system is the oldest in the world. Being affiliated to it is compulsory for all residents and cross-border commuters, including expatriates. Below a certain annual income threshold (€64,350 in 2021), all employees are required to join the Geseztliche Krankenversicherung (GKV) – the public health insurance scheme – and to choose a health insurance fund. Their contribution is deducted directly from their salary. This public health insurance covers GPs visits, hospital healthcare and check-ups. Private Krankenversicherung (PKV) – the German private health insurance system – covers all residents who do not meet the GKV eligibility criteria (including the self-employed) and offers a level of health coverage proportionate to the type of healthcare policy chosen.


Under Swiss Federal Law on Compulsory Health Care (LAMal), all residents and holders of a work permit of more than three months (permit B, L or C) are legally obliged to be insured against risks related to illness and accidents. All residents must be members of a compulsory basic insurance plan and choose their health insurance provider within three months after arrival. Foreigners who live in Switzerland but do not work there must also subscribe to basic mandatory health insurance (KVG). The latter, however, is not compulsory for workers residing in a country bordering Switzerland who are already covered in their country of residence. KVG/LAMal provides basic health coverage for outpatient care, medical consultations, prescription drugs and maternity costs. For additional benefits, it is necessary to get supplementary private health insurance.


The Dutch Zvw (Zorgverzekeringswet) system provides basic health cover for essential medical care, hospital, and emergency care as well as nursing care for residents and workers in the Netherlands. If you live and work in the Netherlands, you must take out basic health insurance (basisverzekering) with private insurers within four months after arrival. Supplementary health insurance is required for coverage of dental care, eye care and alternative medicine.


Health insurance is compulsory in France if you are working and if you wish to complete several administrative procedures. The Caisse nationale d’assurance maladie ensures free access to health services for all residents on French territory and covers most medical consultations and treatment, prescription drugs, some dental  and emergency care. It is compulsory for all self-employed persons, employers, and employees as it is intended to guarantee comprehensive, equitable and universal health coverage for the entire population.


As an expatriate, subscribing to the SNS (Sistema nacional de salud) is compulsory if you reside and/or work in Spain as an employee or an entrepreneur. If you are an employee in Spain and pay social security contributions, you are covered by public health insurance. The SNS ensures that most public health services and treatments are free and accessible, but like most European public health insurance systems, it lacks flexibility and only covers healthcare provided in the public sector.

United Kingdom

Anyone who was a resident in the UK before 31 December 2020 is entitled to free National Health System (NHS) services and can access medical care and consultations in the public sector without charge. Since Brexit, however, expatriates wishing to move to the UK  are required, prior to their arrival, to subscribe to the NHS. In most cases, expatriates will be required to pay an annual fee of £624. NHS affiliation is included in the application for a visa/residence permit. 


Since 2014, health coverage is mandatory for expatriates residing and/or working in Dubai whether they are employees, self-employed or students. To obtain a visa from the UAE authorities, you are required to take out the Minimum Health Coverage through the Dubai Health Authority. This compulsory health cover includes, among other services, medical emergencies, visits with a health practitioner and maternity care. Employers are responsible for providing this basic cover for their employees.

Why international health insurance is the best option for expatriates?

Subscribing to the national health insurance scheme in countries where it is compulsory does not prevent you from taking out a private international health insurance policy for an optimal, flexible, and comprehensive health coverage anywhere in the world.

Foyer Global Health’s health insurance plans allow you to enjoy supplementary health coverage, ensuring you the flexibility, security, and peace of mind you deserve.

Need more information? Contact us!

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