Expat insurance and health insurance in Malta

The Maltese healthcare system is a universal two-branch system: a non-contributory branch, funded by general taxation, which makes care free for the patient once they choose a public provider, and a contributory social security branch (category 1 for employees, category 2 for the self-employed) that determines opening of rights. The reference public hospital is Mater Dei Hospital, in Msida, the country's main acute and emergency care facility; the island of Gozo has its own public hospital, Gozo General Hospital, in Victoria, for secondary care. The private sector supplements the public offering, notably with the Saint James Hospital network (Sliema and Żejtun) and St Thomas Hospital (Qormi). Medicines and devices listed on the official schedules (Government Formulary List) are dispensed free of charge to eligible patients registered with the national pharmacy distribution scheme (POYC, "Pharmacy of Your Choice"), particularly for chronic conditions.

Registration isn't automatic from residence alone: it depends on the person's profile. An employee or self-employed person contributing to Maltese social security (category 1 or 2) is covered from registration. A European retiree has their form S1 registered with the Entitlement Unit (a government agency based in Gwardamangia, also reachable by email or via the "MT Health Entitlement" mobile app) to receive public care free of charge, with no local contribution of their own. An economically inactive EU citizen (non-working student, person of independent means) must, under EU free movement law, show comprehensive health insurance to obtain their residence document (eResidence Document), and must register separately with the Entitlement Unit if they wish to access public care. The residence document itself therefore doesn't on its own prove registration for care.

• EU citizen: no visa required, entry with a valid passport or ID card, under free movement. As Malta is a full member of the Schengen area, no systematic border check is required from another Schengen state.
• Beyond 90 days: an EU citizen must apply, within 3 months of arrival, for the electronic residence document ("eResidence Document") from the government agency Identità; beyond that deadline, a €300 fine is provided for under Maltese regulations.
• Registration for public care: not automatic from residence alone. It depends on the profile: a contributing employee or self-employed person (category 1 or 2), a retiree registered via form S1, or an inactive citizen who must show comprehensive health insurance for their residence document; an employee's contribution is around 10% of weekly gross salary, plus an identical share paid by the employer.
• Without registration or an EHIC: care is billed at private-sector rates, a rate that varies by facility and isn't published uniformly.
• Student: the EHIC is enough for a temporary stay (e.g. Erasmus); beyond that, supplementary student insurance or comprehensive health insurance remains necessary to prove the right of residence of an inactive citizen.
• Seconded employee : up to 24 months (extendable), stays on the French scheme via form A1, exempt from Maltese social security contributions.
• Retiree: form S1 with their French pension fund before departure, for registration with the Entitlement Unit with no new contribution of their own.

No individual fine is provided for failure to register for public care itself (distinct from the fine for failing to register your stay); the risk remains above all financial, limited to the patient bearing the full cost of care, with no help from the French embassy for uncovered costs.

As Malta has been an EU member since 2004, there's no classic bilateral agreement with France: coordination runs through EU regulations 883/2004 and 987/2009, as for other member states.

• Temporary stay: the EHIC (to request from your French fund at least 15 days before departure) grants the same cover as a local insured person at contracted public providers, with no upfront payment; if the card is forgotten or lost, a provisional replacement certificate (PRC), valid for 3 months, grants the same rights. Dental care is only covered in an emergency, and medicines are only reimbursed when prescribed during hospitalisation and the 3 days that follow.
• Secondment: form A1, stay on the French scheme for up to 24 months (extendable), exempt from Maltese social security contributions.
• Long-term move: registration with Maltese social security as an employee (category 1) or self-employed person (category 2); form S1 for a retiree, registered with the Entitlement Unit with no new contribution of their own.
• The EHIC covers neither repatriation, nor planned care, nor a long-term move; on return, a stay not covered in advance may be reimbursed retroactively via form S3125, per Maltese or French rates.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Seconded employee: request form A1 from your French fund before departure.
3. Retiree: request form S1 from your pension fund before departure.
4. Before departure, at least 15 days in advance: request the European Health Insurance Card (EHIC) from your French fund to cover the transition period.
5. Within 3 months of arrival, for a stay over 90 days: apply for the electronic residence document ("eResidence Document") from the Identità agency.
6. Check your registration category (employee or self-employed, category 1 or 2, or inactive citizen) then register, if applicable, with the Entitlement Unit for access to public care.
7. Self-employed: check the category 2 contribution terms with the relevant Maltese authorities.
8. Register with the roll of French nationals living abroad (French embassy in Valletta).