The state health insurance system is governed by the Ministry of Health and financed by taxes. As an expat, you will need to register first with the Ministry for the Interior to set your residency in motion, and then sign up for state medical insurance. You will then receive a health insurance card. The Ministry will put you into one of three sections:

• those who are entitled to free healthcare
• those who need to pay a small fee
• those who need to pay the full cost of treatment

This categorization depends on your income, any pre-existing conditions, and whether or not you have children.

If you are working for a company based in Cyprus, your employer should sort out your insurance for you. Cyprus is currently overhauling its health insurance system, having decided as far back as 2001 to establish a National Health Service (Gesy). This has been supported by the IMF and the EU, among others, but it is resulting in substantial changes to the system.

Under the new rules wage earners and retirees will have to pay a compulsory fee into the system in order to be eligible for healthcare. This was due to start in March 2019 but has not yet come into play. The percentage will rise again in 2020, when it is hoped that the system will be fully operational.

The Euro Health Index has previously ranked Cyprus in a low position among European health providers, stating that it did not have a proper national healthcare system, and it is this kind of criticism that Gesy has been established to address. However, the new system has not been without problems, including the sacking of its CEO in June 2019, and it is taking a long time to be implemented.

Under the new system, group plans are likely to change the most, because if your company offers employees a group plan, but those employees are obliged to make mandatory contributions, they may choose to opt out and go entirely private, particularly if they already have a private plan.

If people do opt out, then the insurer may have to increase premiums for the rest. Eurolife are looking at adding some coverage for treatments such as physiotherapy which will not be covered under the new system.

There are some small charges for basic healthcare appointments and procedures. A visit to a doctor will usually cost around €3, while prescriptions cost around €0.50. If you do not have a health card then you will be charged more — up to €15 for a routine doctor’s appointment.

Not every doctor speaks English. The standard of medical professionalism among personnel here is considered to be very high.

You will be eligible for free healthcare at the point of delivery under the state insurance scheme in the southern part of the island if you are a EU citizen. Emergency care will be also free to both expats and citizens, but you may have to pay a small fee for in-patient care. If you are an employee, you will need to be paying into the system in order to benefit from it.

If you are from a EU member state, your EHIC card will entitle you to treatment, but it is not intended as a substitute for comprehensive health insurance. You will not be able to use your EHIC in the Turkish part of the island.

Your employer should do this for you, but if you are self-employed, retired or not working, contact the Ministry of Health or a District Labour Office.

The Cypriot state health insurance scheme covers:

• basic medical care
• specialist care
• hospitalisation
• laboratory work
• maternity care
• mammograms
• appliances
• transportation
• some prescriptions

You may need to pay a small cost for your medication, but check that you can still get your usual medications in Cyprus: the pharmacies will not accept foreign prescriptions, so you will need to discuss this with your GP when you get here.

Unless you are a pensioner, you will need to pay around €10 for an emergency room visit.

You can buy ‘stamps’ for costs for lab tests and medicines. These are vouchers ranging from €.50 up to €10.00, which are then attached to your test forms or your prescription. You can get these from hospitals, medical centres or the post office.

You will be covered under the national insurance scheme if you are a retired expat from another EU nation. If you are a British expat, you will be eligible if you in receipt of:

• an exportable UK State Pension
• a contribution-based Employment Support Allowance
• another exportable benefit

You will need to fill in an S1 form to demonstrate receipt of one of these benefits.

If you are not from the EU, you will need to take out private health cover.

Many policies stop when you reach the age of 70, so you need to read the small print to make sure you are still covered. This varies depending on the insurer, however; some will allow cover to continue if you take it out when you are under 70.

If you are an international student, you will need to take out private cover. Premiums range from around €90 – €185 per month.

Your dependents will be covered under the national scheme.

Basic dental treatment is covered under the state health insurance scheme and is free. Dentures are not covered.

Your employer will make the necessary deductions, but given that Gesy is undergoing changes, you should speak to your employer, or to the Ministry of Health if you are self-employed, as to how much this is likely to be.

Contributions to cover both outpatient and inpatient care will shortly be increasing to:

• 2.65% for employees and pensioners
• 2.90% for employers
• 4.70% for the government
• 4% for the self-employed

The above changes are expected to take effect from 1st March 2020.

State health cover is based on income, and residents who earn more than €37,590 have to pay the full cost of treatment. Higher earning expats often take out private medical insurance.

As with other private schemes, taking out private cover can allow you quicker access into the treatment system: Cyprus’ public health system, as in most other European nations, sometimes has long waiting lists. You can either choose international cover – perhaps extending existing healthcare plans from your home country – or go with a local private provider, which is likely to be cheaper. In addition to speed and comfort, private insurance will cover you for treatments such as:

• cosmetic surgery
• advanced dental treatment
• IVF

You may still need to pay for treatment upfront, and then be reimbursed. You do not necessarily need to tell your insurer beforehand that you are going in for treatment.

Check what the terms and conditions are: will your policy cover your medical costs directly, for example, or does it operate on a reimbursement scheme? Note any excess fees, as comparison sites warn that these can be quite high.

This will depend on a number of factors: your age and any pre-existing conditions, for example, but also whether you choose an international or a local provider, and the kind of packages that are available. As with all private care, the more extensive the coverage, the more expensive the package.

For those seeking international private medical insurance (iPMI) cover for multiple countries including Cyprus, numerous variables can have an impact on the cost.

The most important variables are:

• age (the higher the more expensive)
• area of cover (i.e. in addition to Cyprus, which other areas is coverage required in? If those other areas include any of the US, the Caribbean, Singapore, China, Hong Kong or Dubai this can significantly increase the overall price)
• product choice (higher end insurance products are more expensive)

Other variables include:

• deductibles
• co-insurance
• payment frequency
• gender
• nationality
• country of residence

As so many variables have an effect on the cost of international private medical insurance in Cyprus it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.

The main international providers operate in Cyprus, including:

• Allianz
• Atlantic Insurance
• Bupa Global
• Cigna Global
• Foyer Global
• Pacific Prime
• Universal Life

Always request quotes for health insurance from as many companies as possible before choosing a provider.

Έχω ένα ΕΚΑΠ (Écho éna EKAP) - I have an EHIC

Έχω ιδιωτική ασφάλιση υγείας (Écho idiotikí asfálisi ygeías) - I have private health insurance

Χρειάζομαι ασφάλιση υγείας (Chreiázomai asfálisi ygeías) - I need health insurance