The Maltese state uses taxes to fund a percentage of public health insurance. The system is also funded from contributions and if you come to work in the country you will need to pay these in order to be eligible for public healthcare. If you are self-employed, you will also need to make contributions.

This should be around 10% of your income and will be deducted at source from your salary if you are employed.

If you are an EU citizen and have an EHIC card, then this can be used for emergency care, though it is not a substitute for comprehensive health coverage.

Everyone who pays into the national insurance system is eligible to receive the benefits of public healthcare in Malta, including expats.

Both the UK and Australia have a bilateral healthcare agreement with Malta, so if you are from either of these countries, you will be eligible for free medical care including a hospital stay for up to a month if you are from the UK, or six months if you are Australian. The British population in Malta is so high that you can get an RHC (reciprocal health) card from the Maltese government enabling you to access treatment.

Your employer should sort this out for you, but you will need to register yourself if you are self-employed. It is not mandatory, but the pay-as-you-go system can be expensive.

A wide range of care is covered by state health insurance, including:

• visits to the doctor
• hospitalization
• surgery
• maternity care
• other forms of treatment, including some specialist care

You will have to pay for your prescriptions unless you are in a vulnerable category: i.e. if you are pregnant, unemployed or with a low income, or if you have a chronic illness. Check with your doctor whether you are entitled to a reduction in prescriptions or free medication. You might have to be means-tested, but the option is available.

If you:

• are of qualifying age
• receive a state pension from your EU-member home country
• are a resident of Malta

then you will be eligible for coverage under the national health scheme.

You will need to bring an E121 form with you in order to sign up, if you are an EU citizen and planning on staying in Malta for longer than three months. This should be given to the Maltese Health Department Entitlement Unit, who will issue you with the relevant certificate.

The Malta Retirement Programme (MRP) offers residence status in Malta to EU/EEA/Swiss nationals who receive the majority of their income from a pension. In order to qualify for this you will need to:

• have pension income constitute 75% of your annual chargeable income
• not spend more than 183 days in any other jurisdiction
• check the special rules if you are planning to bring dependents or a special carer with you

Under this scheme, retirees pay 15% on foreign income remitted to Malta. The minimum amount payable is €7,500 per annum, plus €500 per dependent.

You will be charged a one-off fee of €2,500 to register.

If you are an international student from the EU, you will be covered by your EHIC card in case of emergencies.

If you are from outside the EU and studying in Malta, you will be entitled to free hospital treatment in the case of emergencies, but not otherwise. The University of Malta advises its students to take out private insurance.

Your family will be covered by the national insurance scheme.

Dental treatment is not covered unless it is an emergency: in this case you will be seen in a public hospital. You will need to pay as you go for routine dental healthcare in private clinics, all of which are licensed by the Public Health Authorities.

This is currently about 10% of your gross salary and is paid by both employers and employees.

The Maltese Ministry of Health recommends that visitors from overseas take out private health insurance as a precaution and for swifter access to treatment. Although the quality of healthcare is good, the public system can be beset by long waiting times for elective surgery and scans (three-hour waits have been reported in A&E, for example). Private clinics have a smaller uptake and this results in a more personalized service.

Maltese residents often opt for a ‘pay as you go’ relationship with their primary healthcare providers rather than choosing private insurance plans. A consultation with a doctor at your local pharmacy, if it has this service, is around €10.

Private healthcare on the island can be cutting-edge and Malta is a destination for medical tourism — the St James hospital offers a very high standard of cosmetic procedures as well as joint replacements, for example.

If you are going to the island for sports-related reasons (diving, for instance, which can involve an element of risk) there is cover that entitles you to repatriation in the event of an accident.

If you are an expat and working, check to see if your employer has a contract with a private provider: many companies offer medical insurance as part of their employment packages.

Otherwise, the cost of the package will depend on how comprehensive a range of coverage you require and this will depend on whether you have any pre-existing conditions, whether you want coverage for your dependents, and so on. Comprehensive plans will probably set you back a few hundred euros per month, but you may be able to get a more limited policy for around €50.

For those seeking international private medical insurance (iPMI) cover for multiple countries including Malta, 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 Malta, 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 Malta 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 big international providers cover Malta including:

• Atlas
• AXA
• Bupa Global
• Cigna Global
• Pacific Prime

You are unlikely to encounter language difficulties in Malta due to the large British population on the island.