Healthcare Reimbursement in Malta: Who Reimburses What Depending on Your Situation

As France and Malta are members of the European Union, their social security schemes are coordinated by Regulation (EC) 883/2004: a worker falls under the legislation of a single country, in principle that of their place of activity. The carte Vitale does not work at a Maltese doctor. Proof of rights is the EHIC (European Health Insurance Card, CEAM in French) for a temporary stay, or the entitlement certificate issued on presentation of a portable form (S1) for a lasting stay. The EHIC entitles you to necessary care in public establishments, on the same terms as Maltese insured people; it covers neither rescue and repatriation, nor care in private establishments, nor planned treatment (europa.eu).

The most frequent situations are the employee on a local contract, the seconded employee, the self-employed person, the retiree and the person without an occupation, to which are added the student, the family, the CFE member, the first-euro policyholder and the tourist. The notions of reimbursement base and out-of-pocket cost help you compare cover. How the care network works is described in the guide to the Maltese healthcare system.

The locally employed worker contributes to Maltese social security: 10% of their basic weekly wage for one share, the same for the employer, with a cap of 55.93 euros a week each for people born in 1962 or later (MTCA, 2026 scale). Public care is fully covered by health insurance; the use of private providers remains entirely at the patient’s expense, unless covered by private insurance (CLEISS, 2023). In the event of sick leave, the daily allowance is 14.92 euros a day in 2023, after three waiting days paid by the employer, who pays the difference with the usual salary. See the glossary entry on the local contract.

The seconded employee sent by a French employer remains attached to French social security, with the A1 form valid for a maximum of 24 months, which the employer obtains before departure (europa.eu). The EHIC guarantees direct access to public providers in the State of secondment; sick leave is sent to the French fund within 48 hours; the family that accompanies the employee requests a portable S1 document (CLEISS). For a longer stay, the Entitlement Unit invites seconded employees to have their S1 registered. Costs advanced can be reimbursed on return with form S3125, at Maltese or French rates. See secondment versus expatriation and the glossary entry on the seconded employee.

The self-employed person settled in Malta contributes in class 2: 36.18 euros a week for annual net income from 910 to 12,543.72 euros, then, for people born in 1962 or later, 15% of income from 12,543.73 to 29,083.35 euros and 83.89 euros a week above (MTCA, 2026). The CLEISS states that residents who contribute because of an occupational activity are insured for healthcare. The scales are detailed in the page on working in Malta.

The retiree who receives only a French pension, settles permanently or for more than six months a year in a State of the Union and carries out no activity there asks their pension fund for the S1 form, then has it registered with the Entitlement Unit to obtain the entitlement certificate. No contribution to the Maltese scheme is withheld; if tax residence is outside France, a health contribution of 3.2% on the basic pension and 4.2% on the supplementary pension is levied on general scheme pensions, and 7.1% on those of self-employed workers (CLEISS). Each dependant, spouse, civil partner (PACS) or minor, has their own S1. See the guide to the S1 form: how to use it and the page on retiring in Malta.

The student on a temporary stay receives necessary care with the EHIC. To register a study stay beyond three months, Identità asks for comprehensive health insurance, an S1 or an entitlement certificate, except for students of the University of Malta, MCAST and ITS, who are exempt from providing insurance. See student insurance abroad.

The spouse and children of a contributor are covered: children up to 16, beyond that on conditions of study, and the dependent spouse (CLEISS, 2023). The family of a retiree or of a seconded employee requests an S1 from the French fund. See expat family insurance.

The person without an occupation who stays for more than three months shows, for the registration of their stay, resources at least equal to the minimum that entitles Maltese nationals to social assistance and comprehensive health insurance in Malta, an S1 or an entitlement certificate. Identità states that the EHIC is not accepted for a lasting move when the person does not contribute in Malta and has neither an S1 nor a certificate. Interim cover protects during the processing of the enrolment.

The CFE member contributes to a voluntary social protection body for French nationals abroad, which offers sickness-maternity-invalidity insurance, work accident insurance and retirement insurance, for expats who are employees, non-working or retired; the CFE states that it covers healthcare costs worldwide, including in France. It is added to the Maltese scheme of an employee or a self-employed person and serves as a backup for stays in France and for the return. Enrolment conditions and waiting periods should be checked with the body. See the guide to CFE reimbursements.

International health insurance with first-euro cover reimburses actual costs within its ceilings, after any deductible, waiting periods and exclusions. It opens access to private providers, which the EHIC does not cover, and may include repatriation; it is useful for dental care, which the public system covers very little.

The tourist presents their EHIC (Il-Karta tal-Assigurazzjoni tas-Saħħa tal-Unjoni Ewropea in Malta): care in public establishments is covered with no charge or advance payment. Dental care is covered only in an emergency at a public centre, and medicines are reimbursed only when they are prescribed during a hospital stay and the three days that follow. If the card is lost, a provisional replacement certificate valid for three months gives the same rights. Costs not covered can be claimed back on return with form S3125 (CLEISS, 2022). Travel insurance that covers hospitalisation, repatriation and rescue usefully complements the EHIC. See long-stay travel insurance.

An expat who returns contacts the health insurance fund they belonged to before leaving to reopen their rights. A retiree holding an S1 can return to be treated in France, for medically necessary care as well as planned care, according to French regulations (CLEISS). CFE members check with the body the conditions for resuming with no waiting period. See the guide to reducing the waiting period and the page on returning to France.

• Consultation: care at public health centres is fully covered; a public sector specialist is seen on referral from the GP, with no co-payment. A private provider is paid in full, with reimbursement depending on the contract for international insurance (CLEISS, 2023).
• Hospital stay: it takes place on the doctor’s prescription, with no patient contribution in a public hospital; emergency care is free for people who are entitled to care (CLEISS; Entitlement Unit).
• Medicines: free for people on low incomes and for certain chronic diseases on an official list; paid in full by other insured people, except during hospital stays and the three days that follow (CLEISS, 2023).
• Dental: most treatment is not covered by the public system; urgent care at the public hospital, care for schoolchildren and care for social assistance recipients are exceptions (CLEISS, 2023).
• Optical: the official sources consulted do not describe general cover of glasses for adults; international contracts set a ceiling per period.
• Maternity: prenatal and postnatal care is free and childbirth in a public hospital is covered for insured women. The 14-week paid leave, at full salary, is paid by the employer, with at least six weeks after the birth; a flat-rate allowance of 192.73 euros a week in 2023 may be added for four weeks at most (CLEISS, 2023).

The reimbursement guide and the page on expat health insurance give benchmarks; Expavy helps you weigh these options against your situation.