At Expatax, we are helping retirees settle in Malta and Gozo. We talk about tax, residency, property and everyday life, but one topic comes back again and again: health insurance.
In the past months alone, we have met EU couples who were about to sign private policies costing over €3,000 a year even though they were already entitled to public healthcare in Malta.
This guide is here to prevent exactly that.
If you are planning to retire in Malta or Gozo as an EU, EEA, Swiss or eligible UK pensioner, understanding your S1 healthcare entitlement is the key to avoiding unnecessary costs and ensuring a smooth transition.
How Healthcare Works In Malta
Malta runs a public healthcare system financed through taxation and social security contributions. Citizens and insured residents can use state hospitals and clinics without paying insurance premiums. The public network is centred in Msida, Mater Dei Hospital, and Gozo General Hospital together with a network of government health centres around the islands. This system covers inpatient care, emergency treatment, outpatient clinics and a broad range of services for those who are entitled.
Alongside this, Malta has a well developed private sector made up of private hospitals, medical centres and individual specialists. Here, patients usually enjoy shorter waiting times, more comfort and more choice, but they pay through private insurance or directly out of pocket.
For anyone retiring to Malta, the real question is not whether the system works. It is who pays the bill in the background. That is where the S1 and private health insurance become central.
EU, UK and Swiss Retirees: Why The S1 Form Matters So Much
The S1 is a European certificate that allows you to carry your state healthcare rights from your home country to the country where you live. If you receive a state pension from an EU or EEA country, Switzerland or the UK, your pension state may remain responsible for your healthcare costs when you move abroad and can issue an S1.
When you register that S1 in Malta with the Entitlement Unit, you receive a Certificate of Entitlement. This confirms that you are allowed to use Malta’s public healthcare system on the same terms as a Maltese citizen. Malta then recovers the cost of your care from your home country under social security coordination rules. You present your certificate at hospitals and health centres and are treated like any other insured resident.
You are likely to qualify for an S1 if you are an EU, EEA, Swiss or UK citizen, you receive a state pension from your home country, and under that country’s rules it remains responsible for your healthcare costs while you live in Malta. In many cases, your spouse or dependent partner and children can also be covered through your S1, although the exact rules vary from one country to another. When you apply, it is important to ask specifically about dependants.
For retired EU, UK or Swiss citizens, a registered S1 is normally accepted as proof of comprehensive healthcare cover when applying for residence in Malta as an economically self sufficient person. In practice, this means that you do not usually need to buy private health insurance solely to satisfy the residence requirement. Your Certificate of Entitlement takes the place of an insurance policy in your application. This is precisely where many retirees go wrong. They sign private policies costing thousands of euros a year and only later discover that an S1 would have given them full access to the public system without any premium at all.
Step By Step How To Use The S1 in Malta
Below is the S1 process explained in straightforward, easy-to-follow steps, helping you understand exactly what to do from the moment you decide to relocate to Malta.
Step 1: Request the S1 before you move
Contact the body that manages state healthcare or pensions in your home country and ask whether you are entitled to an S1 for retirement in Malta. Explain that you are relocating as a pensioner and ask whether your spouse or dependants can be included on the certificate.
Step 2: Prepare your Malta documentation
Once you arrive in Malta or Gozo, gather your passport or ID, Maltese tax number, proof of address and your original S1 form. Bring any marriage or birth certificates if you are registering dependants.
Step 3: Register your S1 with the Entitlement Unit
Submit your S1 to the Entitlement Unit, which confirms that another state is responsible for your healthcare. They will issue a Certificate of Entitlement, the document that gives you public healthcare access in Malta.
Step 4: Use your S1 in your residence application
When applying for residence as an economically self sufficient EU or similar retiree, your Certificate of Entitlement normally counts as your required health cover. In this way, the S1 replaces the need for private insurance during your application.
Step 5: Register with the public health system
Once your S1 is processed, you can register with a local health centre or family doctor and begin using the public system like any insured Maltese resident.
Step 6: Keep your S1 and organise EU travel cover
Your S1 remains valid as long as you continue to receive your home country pension and reside in Malta. For travel to other EU countries, request an EHIC or UK GHIC from your home authority.
Kennenlernen der EHIC - Europäische Krankenversicherungskarte
What Private Health Insurance In Malta Usually Covers
Private health insurance is optional for S1 holders, but many retirees still choose to take out a small policy for comfort, speed and access to private hospitals. Private plans in Malta typically include a mix of hospital care, specialist consultations and diagnostic tests.
Typical coverage includes:
- Inpatient and day patient hospital treatment
- Surgery and operating theatre fees
- Emergency treatment and ambulance services
- Specialist consultations and diagnostic tests
- Optional outpatient, dental, maternity or optical benefits
Health Insurers To Approach For Optional Private Cover
If you decide to supplement your S1 with private insurance to speed up access to specialists or private hospitals, Malta offers several reputable providers.
Common local options include:
- Atlas Healthcare
- Bupa Malta
- GasanMamo
- MAPFRE Middlesea
- Laferla Insurance
International expat insurers such as Cigna, AXA, Allianz and others also offer plans valid in Malta.
Private insurance for EU retirees is entirely optional and usually chosen for comfort rather than compliance.
How To Compare Quotes Without Getting Lost In Details
For a non EU retiree aged sixty five and over, it is very common to see a spread of several thousand euros between the cheapest and most expensive health insurance quote. It is also common to find that two policies that satisfy residence rules on paper offer very different protection once you look closely.
When you compare, start with the scope of cover. Check whether the policy is inpatient only or whether it also includes outpatient services, and how cancer treatment is handled. Look at any annual limits and whether particular types of treatment are capped. The geographical area of cover also matters. Some policies focus on Malta only, others include Malta and the EU, and some offer worldwide cover, with or without the United States. Many retirees choose to narrow the area of cover to control costs.
Exclusions and limitations deserve careful reading. If you have existing conditions, make sure you understand whether they are excluded entirely, covered with restrictions or covered normally. Excesses and co payments can be confusing too. Find out if the excess applies per claim, per year or per condition, and decide whether the level is realistic for you. Finally, ask how premiums are likely to change over time. Many insurers move you into more expensive age bands as you get older, and some reserve the right to adjust terms based on your claim history. It is better to know this at the outset.
If a quote looks unusually cheap compared to the others, do not sign it simply because it is the lowest number. Take a moment to read the policy wording and check whether it truly meets residence requirements and whether it covers the risks that matter most to you.
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Common Myths And Mistakes We See In Malta
A frequent myth is that all retirees must buy private insurance in Malta. This is not true for EU/EEA/Swiss retirees who hold an S1. Once registered, the S1 satisfies both public healthcare entitlements and residence requirements.
Another misunderstanding is that the EHIC card is enough to live in Malta. It is not. EHIC is for temporary stays. Long-term residents must rely on Maltese social security or the S1. Some retirees also fear that registering an S1 will be complicated. In reality, the process is standard and handled regularly by the Entitlement Unit.
And finally: public healthcare in Malta is strong, not second-rate. Many retirees use it as their main system and only add private insurance for convenience.
Real Life Scenarios From Clients In Malta
A German couple living in Gozo contacted us after receiving private insurance quotes of €2,800 per person per year. They assumed this was mandatory. After speaking to them, we discovered that both were drawing German state pensions. They requested S1 forms, registered them, and used their Certificates of Entitlement for their residence applications, eliminating over €5,000 in yearly expenses.
Another case involved a French pensioner who had taken out private cover for two years before learning about the S1. Once informed, she registered her S1, cancelled her unnecessary policy and saved thousands annually.
What To Keep In Mind As You Plan
If you are an EU, UK or Swiss retiree and suspect you might have S1 rights, your first step should always be to ask your home country authority. If you qualify, request the S1 before relocating, bring it with you to Malta along with your identification, tax number and address details, and register it with the Entitlement Unit. Use the resulting Certificate of Entitlement as proof of healthcare in your residence application, and then decide calmly whether you want any optional private cover on top.
Final Thoughts From The Expatax Team
Retiring in Malta or Gozo is about slow rhythms, familiar faces in the village square and the comfort of living close to the sea. Healthcare is one of the foundations that lets you enjoy that life without constant worry.
For EU, UK and Swiss pensioners, the S1 form is often the most valuable document in the entire relocation process. Used correctly, it can save you thousands of euros in unnecessary private insurance premiums and give you full access to Malta’s public system.
If you are not sure whether you qualify for an S1, which residence route suits your situation, or how to navigate health insurance as a retiree, Expatax can guide you step by step so that your move to Malta or Gozo begins from a place of clarity and confidence, not confusion.
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