If you’re familiar with the UK National Health Service (NHS) you should feel right at home in Malta, as the NHS in Malta have been heavily inspired by the British. These services are both funded by tax revenues as well as contributions to national insurance; this allows offering free health related services to all citizens who are covered by health-care.

Despite the available free health-care, many Maltese locals are now favoring private health care in order to get more options and a better service. This explains why the proportion of public health-care spendings in Malta has decreased to around 65% of the total spendings on health-care, while in the UK this number remains higher at around 83%.

Available social insurance for injured people

To qualify for this social insurance you will have to be at least 16 years of age; you must also have a job, whether as employee under someone else or as an independent worker. This benefit in only applicable to those who are not yet retired, as detailed in section 3 of the Social Security Act.

The general regulations in Malta specify that all workers who earn less than €910 each year are regarded as “self-occupied”, which isn’t the same thing as self-employed. To be regarded as legitimately self-employed, you must be younger than 65 years old and not qualify as “self-occupied” nor as an employee to someone else. This status also implies that you have Maltese residence and don’t get any welfare benefits or any kind of full-time education.

How Contributions to the NHS are Processed

In general terms, contributions to the NHS in Malta will vary according to your income. As a Maltese worker you are expected to pay minimum contributions which cover your health benefits as well as other situations such as maternity leave and unemployment.

Similar to what happens in the UK, your contributions to national insurance and NHS are paid as part of your income taxes. In Malta you will either fall under class 1 or class 2 contributions, depending on your situation. Class 2 is only for those regarded as “self-employed” as well as those who are “self-occupied” but earn over €910 yearly; Class 1 is for everyone else, including students and employers as well as all kinds of employees.

Class 1 contributions will be split evenly between employers and their employees, with every side reserving 10% of payments to social security. These contributions have a minimum value of €850 and a maximum roof of €3,100 per year, to be paid by both employee and employer.
Class 2 contributions are fixed at 15% of all your earnings for any given year; the minimum amount you can be charged is €1,300 per year, and the maximum charge will be €3,100 per year.

If you’re the family member (spouse or underage children) of someone who is covered by health insurance, you also get free coverage. Additionally, anyone who is receiving a pension from the Government automatically qualifies to get free health-care services in Malta.

Anyone who has to deal with chronic illnesses or struggles with low-income may also benefit from social assistance programs which include health-care assistance.

Things to consider if you’re an international applicant

In order to make sure you can benefit from free health-care while spending time in Malta, you should take the time to sign up with the entitlement Unit; all visitors should make sure to do this unless they’re only staying for a short while.

It’s worth noting that free coverage for health related services in Malta doesn’t cover complex surgeries; if your health problems require sophisticated equipment, there’s a chance you may have to be sent abroad to a bigger hospital. In such a case, you would only benefit from free treatment if you were actually a registered Maltese citizen.

Special conditions for Australian citizens

Since there’s a bilateral agreement between the governments of Australia and Malta aiming to cover the unexpected medical needs of Australian natives who are living in Malta, such people will get free health-care coverage for a total of six months from the time they move.

Rules for EU expatriates

All EU residents who are looking to spend time in Malta should make sure to apply for their EHIC (European Health Insurance Card) in their own home country before heading to the island. This card is meant to avail public health-care services free of charge for travelers, who will then have the same privileges as Maltese residents. You will be able to use your EHIC card whenever you run into medical related situations during your time in Malta. Keep in mind this card is meant as a temporary solution, so in case you plan to stay indefinitely we would recommend you to also arrange a private health insurance to be safe.

In specific situations, some EU expats may also get a S1 portable document from their own country; these cards are available to either pensioners or people working on a second job. Using this special card, you can keep paying your social insurance contributions in your original country while getting the same benefits as if you were paying directly to the Maltese government. If you’ve been issued this document, we advise you to also apply to a certificate of entitlement since you will need that document to get all the free public health-care you’re entitled to.

Specific rules for UK expatriates

All people from the UK who are effectively living in Malta will benefit from the RHA (Reciprocal Health Agreement) that was established between the UK and Malta governments. This agreement makes you entitled to receiving certain healthcare services fee of charge. Please keep in mind that your RHA card does not cover free healthcare services that you may get anywhere other than in Malta, neither does it substitute a EHIC card issued by local authorities. It also doesn’t cover NHS services that you may get during your time back in the UK, even if you happen to get a surgery that was unavailable in Malta.

Since the general EU law offers better conditions for expats compared to the UK law, the RHA is not a popular option among UK expats. If you’re a British citizen you may be best suited with a portable S1 document or a EHIC issued by the UK government.