Is Free Healthcare Available to Expats and Travelers?
They say the best things in life are free – but does that include healthcare? The idea of free healthcare seems too good to be true, but in many countries, citizens or residents never receive a bill for medical services. However, "free" doesn’t mean it comes at no cost. Instead of paying for care upfront, residents are likely paying for it in other ways, typically through taxes or other contributions, depending on the country’s system.
If you are traveling or moving to a country with universal healthcare, you might assume that you'll also receive free care. However, it can be difficult for non-residents to access these services, and it's essential to understand how the system works and what fees may still apply. To help you navigate healthcare abroad, this article provides an overview of countries with free healthcare, how their systems function, and what steps you can take to ensure you can access medical care while traveling or living overseas.
They say the best things in life are free – but does that include healthcare? The idea of free healthcare seems too good to be true, but in many countries, citizens or residents never receive a bill for medical services. However, "free" doesn’t mean it comes at no cost. Instead of paying for care upfront, residents are likely paying for it in other ways, typically through taxes or other contributions, depending on the country’s system.
If you are traveling or moving to a country with universal healthcare, you might assume that you'll also receive free care. However, it can be difficult for non-residents to access these services, and it's essential to understand how the system works and what fees may still apply. To help you navigate healthcare abroad, this article provides an overview of countries with free healthcare, how their systems function, and what steps you can take to ensure you can access medical care while traveling or living overseas.
Is "Free" Healthcare Really Free for Foreigners Abroad?
As mentioned, “free” healthcare isn’t actually free. Citizens usually fund healthcare that government agencies provide in one way or another. The country's healthcare budget may come directly from their taxes or payroll taxes, which affect a citizen's take-home pay. Savvy travelers know not to make offhand remarks about how lucky local residents are to have “free” healthcare in their country. You never know when you might get a sarcastic remark about how their tax bill didn’t seem so free!
Furthermore, in many countries with universal healthcare, patients often pay a small fee or deductible each time they visit the hospital or doctor. Sometimes, they must pay in advance and submit reimbursement forms to the government. They may even have to pay for government-mandated insurance. Therefore, while healthcare may appear free, it often does involve some out-of-pocket costs.
Read More: Which Countries Have Reciprocal Healthcare Agreements?
Finally, while citizens or residents may only pay a small fee for healthcare, non-residents often face much higher costs. For example, the United Kingdom's National Health Service (NHS) is famous for providing free care for its citizens. However, as of 2024, non-residents may need to pay between $1,200 and $3,000 per day for a hospital bed, depending on the facility and level of care they need.
These high expenses are a key reason why many travelers and expats choose to buy international health insurance. It covers the cost of medical care, including hospital stays, treatments, and emergencies, which would otherwise be extremely expensive for non-residents.
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What is the Difference Between Free and Universal Healthcare?
It's important to understand that free healthcare and universal healthcare are not the same, even though people tend to use these terms interchangeably.
Free Healthcare means that all citizens receive medical services without having to pay for them directly. However, universal Healthcare refers to a system that provides coverage to a large percentage of the population. Some experts argue that at least 99% of citizens and residents must be covered for a system to be considered universal, while others set the threshold at 90%.
Notably, under the latter definition, the United States might be considered a country with universal healthcare. However, this would be misleading because while the U.S. has programs like Medicare and Medicaid, millions of people remain uninsured or underinsured. As a result, they lack access to comprehensive healthcare coverage.
Both of these systems are usually funded by taxes paid by citizens.
What Does It Mean When a Country Has Universal Healthcare?
According to the World Health Organization (WHO), universal health coverage (UHC) means that "all people have access to the full range of quality health services they need, when and where they need them, without financial hardship." Notably, the WHO aims to provide UHC to as many people as possible worldwide by 2030.
As mentioned, different organizations define UHC in various ways, making it difficult to provide a clear list of countries with universal healthcare. While some definitions require that at least 99% of the population be covered, others consider 90% sufficient.
UHC can also be understood as a system in which the government is responsible for making sure everyone has healthcare coverage. This can occur through a single-payer system, mandatory insurance, a mix of public and private options, or a fully public system.
For our list, we used information from The World Population Review, which uses the 90% coverage number. However, it’s important to note that most of these systems are not truly “free” healthcare, as they are typically funded by taxes from citizens.
Read More: The Best Healthcare in the World: Country Rankings
Which Types of Healthcare Systems Provide Free or Universal Healthcare?
Countries usually use four main types of systems to provide healthcare. While the details can vary, most systems fall into one of the categories below – although the United States has elements of all of them.
Out-of-Pocket
In this system, patients pay service providers directly for care, and little to no insurance is available. Because of this, the system is neither free nor universal. Cambodia, Chad, Nigeria, and Armenia are some of the countries that use this system. Other nations, like Albania, Bhutan, Greece, and Kuwait, have high out-of-pocket costs due to healthcare systems lacking enough staff, management, or funding.
National Health Insurance
When people think of free healthcare, they often think of countries with National Health Insurance, also called a "single-payer" system. In this system, healthcare is usually provided through private facilities, but the government pays the bills. Patients may also have a small copay in some countries that use this system. Countries with National Health Insurance include Canada, Taiwan, South Korea, Australia, Norway, Sweden, New Zealand, France, and Italy.
The Bismarck Model
The German statesman and first Chancellor of the German Empire, Otto von Bismarck, created the Bismarck model in the late 1800s. Like the National Health Insurance model, this features private healthcare facilities, and citizens must buy health insurance. The government regulates this insurance to ensure it covers important services and costs remain low. This insurance is usually non-profit and funded through payroll deductions or taxes. People with low incomes may get government assistance to pay for their insurance. Countries that use the Bismarck model include Germany, France, and Japan.
The Beveridge Model
The Beveridge model is often referred to as "free" healthcare because it is funded by taxes. In this system, the government owns and operates most hospitals and clinics. A well-known example is the UK's National Health Service (NHS), which was designed by William Beveridge. Other countries that use this model include New Zealand, Cuba, Hong Kong, and Spain.
In this system, the government pays for healthcare through taxes, unlike the National Health Insurance or Bismarck models, where people buy insurance. While the Beveridge model aims to provide care for everyone, it doesn’t always guarantee high quality. As a result, many people buy extra insurance to receive faster or better care from private providers.
Hybrid and Struggling Systems
Some countries that provide universal healthcare do not fit neatly into any specific model and are struggling to cover all their citizens affordably. For example, Mexico and Brazil have government-funded healthcare systems, but many citizens buy supplemental insurance to receive faster and higher-quality care from private providers.
Despite these challenges, some countries are still included in lists of nations with universal healthcare. India and Botswana are lower-income countries working hard to achieve full coverage for their citizens. Botswana, for instance, has a largely government-funded healthcare system that offers free primary healthcare, yet it faces challenges in ensuring access and quality, particularly in rural regions.
Meanwhile, countries like Greece and Italy have strong healthcare laws but face issues with funding, implementation, or both. Additionally, in many cases, the healthcare system does not cover foreigners entering these countries or does not provide them with adequate coverage.
What Countries Have Free Healthcare?
According to Hudson’s Global Residence Index, all but 43 countries in the world offer free or universal healthcare to at least 90% of citizens. Notable examples include Afghanistan, Iran, Nigeria, Yemen, and the United States.
Among these, the U.S. stands out as the largest country without a universal healthcare system. Instead, it relies on a combination of private insurance, employer-provided plans, and government programs like Medicaid and Medicare to support vulnerable populations.
Only one country offers healthcare that is free for everyone, Brazil, because the nation's Constitution defines healthcare as a universal right.
However, the standards among these countries can vary widely. The list includes Norway, which is one of the healthiest countries in the world and among the first to introduce free healthcare in 1912. However, it also includes the Central African Republic, which has one of the lowest life expectancies in the world and very few healthcare providers.
Read More: Countries With the Highest and Lowest Life Expectancies in 2025
List of Countries With Universal Healthcare Systems
The countries listed below provide universal healthcare, meaning they provide at least 90% of citizens or residents with some form of health coverage. In many of these countries, both employers and individuals help pay for healthcare through contributions, copays, and other fees. The goal of these programs is to make healthcare as affordable and accessible as possible for the largest number of people.
Albania: All citizens have a constitutional right to health insurance. However, due to a shortage of medical workers, there is an informal system of out-of-pocket payments for services.
Algeria: Algeria uses a National Health Insurance model. Hospital care is free for residents. The CNAS insurance program covers most salaried workers and their families, while CASNOS covers non-salaried workers, and the National Unemployment Insurance Fund covers unemployed individuals.
Argentina: Argentina has a mix of public healthcare, social security, and private insurance that covers most citizens. All residents can access free healthcare at public facilities.
Australia: Australia's Medicare system is based on National Health Insurance. It provides free hospital care for all Australian citizens, New Zealand citizens, and permanent residents enrolled in the program. Read more about the Healthcare System in Australia.
Austria: Austria uses a Bismarck-style healthcare system that offers universal coverage. Health insurance is mandatory for anyone staying in the country for longer than six months.
Bahamas: NHI Bahamas provides free primary and preventive care to all residents, including registered expats. However, many services are still not covered, so expats often need private insurance. Read more about the Healthcare System in the Bahamas.
Bahrain: Bahrain transitioned from a Beveridge model to a more mixed approach that includes elements of National Health Insurance. It offers universal healthcare for citizens with many free services, but expats usually need private health insurance.
Belgium: Belgium also uses the Bismarck model. While it has relatively high healthcare costs compared to other European countries, it provides comprehensive coverage.
Bhutan: Bhutan's constitution mandates free healthcare for all citizens. Tourists can also receive free healthcare at some facilities, but healthcare options are limited.
Botswana: In Botswana, hospital care, lab tests, and medications are free for citizens at public facilities, which make up 98% of the country's healthcare services.
Brazil: Brazil offers free healthcare to all citizens, residents, and visitors through its publicly funded healthcare system, the Sistema Único de Saúde. Read more about the Healthcare System in Brazil.
Brunei: Brunei offers free healthcare to all its citizens and residents. The government mainly funds this healthcare system. It is known for its high quality and includes various services, such as preventive care and specialized treatments, all at no cost to Bruneians.
Bulgaria: Bulgaria's law mandates universal and free health insurance coverage for all citizens and residents. However, challenges with implementation and funding make access difficult for many citizens.
Burkina Faso: Burkina Faso implemented its Universal Health Insurance Scheme in 2023. The implementation is still in progress, and the country is facing several challenges along the way.
Canada: Canada employs a National Health Insurance model in which provinces and territories run healthcare services. Each province must cover certain hospital care, lab tests, and doctor visits, but beyond that, each province or territory differs significantly. Read more about the Canadian Healthcare System.
Chile: Chile's Universal Access with Explicit Guarantees (AUGE) began in 2006 to provide healthcare for all Chileans. This system includes both private and public options. Expats who are legal residents and pay taxes can use the public healthcare system in Chile.
China: China has three insurance programs that, together, cover over 97% of its citizens, but most services require copayments. Read more about the Healthcare System in China.
Colombia: Colombia has a mixed public and private system that covers over 97% of the population and has low out-of-pocket costs. Expats can also access the public system. Read more about the Healthcare System in Colombia.
Costa Rica: All citizens and residents must pay a premium to participate in the Caja Costarricense de Seguro Social (CCSS) insurance program, which provides free healthcare at the point of service. Read more about the Costa Rican Healthcare System.
Croatia: All residents must join the mandatory health insurance program and pay small copays for healthcare services.
Cuba: Cuba provides free healthcare to all citizens at government-run facilities.
Cyprus: The General Healthcare System (GeSY) covers all residents, offering a wide range of medical services funded through taxation. Residents can receive care without significant out-of-pocket costs, including several free annual primary visits.
Czechia: Eligible residents must purchase a health insurance plan, and patients pay a small fee at the time of service.
Denmark: The Danish government automatically enrolls all residents in the national health insurance program, which provides free healthcare.
Egypt: In 2018, Egypt ratified a universal healthcare law and is slowly moving toward full coverage. A new law in 2024 seeks to privatize some public health facilities, which may impact access and affordability. Read more about the Healthcare System in Egypt.
Finland: Finland uses a Beveridge model, where most healthcare is provided by municipalities. All permanent residents can enroll in the healthcare system. Read more about the Healthcare System in Finland.
France: People living in France for over three months must sign up for the healthcare system, which requires limited copays for most services. Read more about the French Healthcare System.
Georgia: In 2013, Georgia began transitioning to universal healthcare with a national health insurance model, but the process is still ongoing, and high out-of-pocket payments remain a challenge.
Germany: As part of the Bismarck model, Germant requires all residents to purchase a non-profit health insurance plan, known as a "sickness fund." Read more about the German Healthcare System (GKV).
Ghana: The National Health Insurance Scheme (NHIS) was launched in 2003 and provides most healthcare services for Ghanaians.
Greece: Greece has moved from a Bismarck model to a National Health Insurance model, but residents still report high out-of-pocket costs. Almost all Greek visas require proof of health insurance. Read more about the Healthcare System in Greece.
Hong Kong: Hong Kong has a public healthcare system based on the Beveridge model alongside a robust private system. Most public healthcare requires copayments.
Iceland: Iceland's healthcare system follows the Beveridge model, with patients paying limited fees at the time of service.
India: India has a mixed healthcare system with a large private sector. The Constitution guarantees universal coverage, which is administered by the states, but quality and access vary. Read more about India's Healthcare System.
Indonesia: In 2014, Indonesia established a national health insurance scheme known as Jaminan Kesehatan Nasional (JKN), which increased coverage from about 56% to over 90% of its population. However, the rollout has been slow, and significant gaps in care still remain. Read more about the Healthcare System in Indonesia.
Ireland: Ireland covers all citizens, but healthcare isn't free for everyone. The country is working toward a fully universal and free health system called Sláintecare, which is expected to be implemented by 2030. Read more about the Healthcare System in Ireland.
Israel: The National Health Insurance Law of 1995 established universal healthcare in Israel, but patients face increasing copays for services. Read more about the Healthcare System in Israel.
Italy: Italy’s SSN provides free primary care visits and hospital care, but all patients must pay copays for specialist visits, tests, and prescription medications. Read more about the Healthcare System in Italy.
Japan: Residents in Japan for more than three months must enroll in a health insurance program assigned by the government. All services require copays. Read more about the Japanese Healthcare System.
Kuwait: Kuwait offers free healthcare for its citizens, but long wait times often lead residents to seek private providers.
Liechtenstein: Liechtenstein provides universal healthcare through a compulsory insurance system, similar to other Bismarck models.
Luxembourg: The government pays some costs directly to the provider, but in many cases, patients must submit their bills for reimbursement and also pay some out-of-pocket costs.
Macau: All citizens and residents receive free healthcare if they have a valid ID.
Malaysia: All citizens and legal residents must pay a small fee to access healthcare services through the public system. Read more about the Healthcare System in Malaysia.
Maldives: The national health insurance program provides free healthcare to all Maldivians.
Mauritius: Mauritius provides free primary care for all residents.
Mexico: The Seguro Popular program, which provided much of Mexico's universal healthcare, was discontinued in 2020, just as the global pandemic hit. It has been gradually replaced by a new system called Insabi, but coverage and access remain challenges. Read more about the Healthcare System in Mexico.
Morocco: Morocco has universal public healthcare, but many patients pay copays for services.
The Netherlands: The Netherlands uses a Bismarck model of mandatory health insurance for all, with copays and deductibles for many services. Read more about the Healthcare in the Netherlands.
New Zealand: New Zealand's Beveridge model requires copays for primary care visits and medications, but hospital care is free. If you are injured in an accident, medical care is free for everyone, including tourists. Read more about New Zealand’s Healthcare System.
North Korea: North Korea claims to provide universal healthcare, but access and quality are limited in practice.
Norway: All Norwegian taxpayers are part of the healthcare system, regardless of their citizenship status. Members pay a maximum of approximately $200 per year, after which the government covers all additional healthcare costs.
Pakistan: Pakistan has a mixed public and private healthcare system, which covers most of the population, but access varies by province and region.
Peru: Peru has a mixed public healthcare system that covers nearly 99% of residents, including foreign residents. However, this fragmented system can lead to inefficiencies and long wait times for services.
The Philippines: All Filipinos are automatically enrolled in the PhilHealth system, which reimburses them for healthcare costs. Expats can also join the system for a fee. Read more about the Healthcare in the Philippines.
Portugal: Portugal's national healthcare system, the SNS, is well-regarded and steadily improving. Most services require copays at the point of service. Read more about the Healthcare System in Portugal.
Romania: Romania has a state-run universal healthcare system that covers all residents, including expats. However, it often ranks low among European countries for healthcare quality and access, especially in rural areas, which face many challenges.
Russia: All Russians have the right to free healthcare and are covered by mandatory health insurance. However, the quality of the government healthcare system is very poor. Major problems include insufficient funding, old equipment, long wait times, and poor organization. Read more about the Healthcare System in Russia.
Rwanda: Although Rwanda is a small country with a difficult recent history, the WHO describes it as "the beacon of Universal Health Coverage in Africa." As of early 2023, over 90% of the population was covered, and access to primary care has improved significantly.
Saudi Arabia: The government provides free universal healthcare to all citizens. This system includes hospitals and clinics, but some services may have long wait times. Expats usually need private health insurance because they are not covered by the public healthcare system.
Serbia: Serbia requires participation in its national insurance system and allows free healthcare at the point of service for citizens, permanent residents, and some temporary residents.
Seychelles: Primary healthcare is free for all citizens.
Singapore: Citizens and permanent residents must have a medical savings plan and health insurance for major health issues. The government runs many hospitals and controls medicine prices, which keeps out-of-pocket prices relatively low for patients. Read more about Singapore's Healthcare System.
Slovenia: Slovenia’s healthcare system is mainly funded by public health insurance. It offers various medical services, including hospital care and preventive care, with low out-of-pocket expenses.
South Africa: Until recently, South Africa had a mixed public and private healthcare system that covered all citizens and residents, including expats and refugees. In 2024, a new law will end the private sector. This change is controversial, and the effects on healthcare are uncertain. Read more about the Healthcare System in South Africa.
South Korea: With a few exceptions, all residents must pay into the National Health Insurance System. After six months in South Korea, residents are automatically enrolled. They also pay small fees when they receive medical care, but costs are generally low. Read more about the Healthcare System in South Korea.
Spain: Spain's Sistema Nacional de Salud (SNS) is a Beveridge system, similar to the UK's NHS. Legal residents can register for free healthcare, which includes free doctor visits and most tests, services, and procedures at no charge. Read more about the Healthcare System in Spain.
Sri Lanka: Sri Lanka offers free healthcare to all citizens through a government-run system. However, due to economic issues, the public healthcare system struggles with a lack of supplies and resources.
Suriname: A law passed in 2014 guarantees basic healthcare for all citizens. Healthcare is free for citizens under 16 and over 60. While health conditions have improved, Suriname is still developing and has limited resources.
Sweden: Like Spain, New Zealand, and the U.K., Sweden has a Beveridge system with state-run healthcare. However, it is not free at the point of service. Most patients pay fees for doctor visits, hospital care, and other services. They are exempt from further copayments once they reach the maximum out-of-pocket cost for the year. Read more about Sweden’s Healthcare System.
Switzerland: Like Germany, Austria, and other Bismarck-system countries, all Swiss residents must purchase health insurance. They can choose their plans and deductible options and typically pay small fees for most medical services. Read more about Switzerland's Healthcare System.
Taiwan: Taiwan has a robust single-payer healthcare system called National Health Insurance (NHI), which covers nearly all residents. However, it is currently strained by budget cuts and an aging population. Those living in Taiwan for more than six months must enroll in NHI.
Thailand: Thailand has three public health insurance programs that, combined, cover all citizens. Thai citizens get free healthcare at the point of service, but expats must have private insurance. Read more about the Healthcare System in Thailand.
Trinidad and Tobago: Residents of Trinidad and Tobago can receive free primary healthcare at government-run healthcare facilities. However, specialist treatment and prescription medications may require a fee.
Tunisia: Tunisia has a national insurance system that provides coverage for public healthcare and some private facilities to all citizens. For most services, patients usually contribute a 20% copayment, which makes up more than half of the country's total healthcare spending.
Turkey: Turkey provides healthcare to all citizens through a national insurance system. Expats who have lived in Turkey for at least a year can join the national insurance by paying a monthly fee. Read more about the Healthcare System in Turkey.
United Arab Emirates: The UAE has a universal healthcare system, but services vary by emirate. Citizens receive healthcare through public services funded by the government. However, expats must have health insurance and often rely on private providers for access to care. Read about Dubai's Healthcare System.
United Kingdom: The UK's National Health Service (NHS) is famous worldwide for providing free healthcare to residents and citizens. While the NHS has faced significant challenges in recent years, this original Beveridge system remains a model for universal healthcare worldwide. Read more about the Healthcare System in the UK.
Is Healthcare Ever Free for Foreigners or Visitors?
Travelers need to research their destinations because they often won’t have coverage. Just because a country has free healthcare for its citizens doesn’t mean travelers will receive the same benefits. It’s especially important for those moving to another country to understand how and when they can join the public healthcare system.
For example, the healthcare system in Canada can be very costly for uninsured travelers and Canadian citizens who return after being abroad for an extended time. In contrast, visiting a public hospital in Europe might only cost a traveler a promise to return borrowed crutches after receiving treatment for a sprained ankle.
Public hospitals are often mandated to provide emergency care and cannot turn away patients based on their ability to pay. However, these hospitals may have a broad interpretation of what "ability to pay" actually means. They can also decide what counts as a true emergency and what is a serious but non-life-threatening issue.
Travelers should prepare by gaining knowledge and buying comprehensive insurance. Otherwise, they may have to hope their credit card will be accepted and that they have enough credit available to pay for their care.
The Best Global Medical Plans Based on Your Destination
Read our advice on the best global health insurance for expats in specific countries. These guides focus on the top destinations for those living abroad.
Read More: Visitors Insurance Coverage provides International Travel Health Insurance for foreigners visiting a country for a specified period of time, typically ranging from one week to 12 months.
Private Global Health Insurance Plans
If you are planning to live abroad, some of the best international health insurance plans include the following:
Cigna Global Insurance Plan
- The flexibility to tailor a plan to suit your individual needs
- Access to Cigna Global’s trusted network of hospitals and doctors
- The convenience and confidence of 24/7/365 customer service
IMG Global Medical Plan
- Four plan options and additional optional coverages
- Choice of the coverage area to reflect your geographical area of need
- Freedom to choose your health care provider wherever you are in the world
Notably, U.S. citizens planning to move abroad and foreigners looking to move to the U.S. can also apply for the following plan:
Xplorer Worldwide Medical Plan
- Premium Benefits, Coverage and Service
- Define your deductible and prescription benefits
- For Foreigners in the US or US citizens abroad
Read more about the various international health insurance providers and the plans they offer. Start your planning today by requesting a quote for a plan that will cover you worldwide, no matter where you live or where you need care.
Quality and Affordability
All the countries on this list of the best healthcare systems in the world provide free healthcare, including Israel, Qatar, Singapore, France, and Australia.
However, none of these countries offer unlimited healthcare coverage for travelers, and they may not be the most affordable options for out-of-pocket healthcare costs. For travelers willing to consider the advantages and disadvantages of paying for healthcare as needed, it is better to focus on countries with very affordable healthcare rather than those that claim to offer “free” healthcare.
Read More: U.S Health Insurance for Non-Citizens and The U.S. Healthcare System
Free Healthcare in Unexpected Places
Last but not least, travelers can find excellent and affordable healthcare services in unexpected places around the world. For example, public health campaigns may offer free influenza or tetanus vaccines to anyone who attends a community immunization day.
Additionally, international border crossings may have healthcare bureaus that provide free malaria testing and treatment. University-based student health clinics often offer free sexual health services to anyone who requests them. You never know when you might come across an opportunity to improve your health at no extra cost!
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Author: Kamela Hutzley is a Senior Editor at International Citizens Insurance. She is a native New Jerseyite who recently emigrated to Halifax, Nova Scotia. In late 2022, she spent a month each in Ottawa, Montreal, and Quebec City, before deciding on Atlantic Canada for the long haul. She’s traveled to Hawai’i, Jamaica, France, Spain, the UK, Ireland, Greece, Switzerland, Germany and the Netherlands. Kamela writes about International Life Insurance, Travel insurance, and Health topics as well as advice for expats and travelers.