The state covers all citizens for free under a unified system called EFKA. Greek medical insurance is thus two-tiered: comprised of private cover and the state scheme.

Currently, the Greek healthcare system (ESY) operates around 130 hospitals across the country, both for general and specialized medicine. The system is overseen by seven regional health authorities and there are currently around 30 social insurance funds, which provide both private and state cover. Most of these are independent but still fall under the aegis of the Ministry of Labour and Social Affairs.

The ESY guarantees free healthcare to all citizens and residents of the country: if you are an expat, whether an EU citizen or not, you will be eligible. This applies regardless of your employment status.

If you are from an EU member state, you can use your EHIC card. This will not entitle you to treatment in a private hospital or clinic, so you must make sure that you go to a centre which comes under the Greek National Organisation for Healthcare Services Provision (EOPYY).

In addition, you can consult a doctor in one of the newly established PEDY Units (National Primary Healthcare Network) and you can do so free of charge if you have an EHIC. You can also obtain some dental treatment at a PEDY clinic.

If you are working in the country, your employer must, by law, make contributions for you and sign you up with a provider. You will also need a social security number, known as an AMKA.

Greek medical insurance operates on a reimbursement system: there are several different forms of reimbursement; for example, covering only hospitalization, or treatment plus medication, or a pre-arranged fee.

Medical personnel in the public sector are not allowed to work privately, and the reimbursement system itself has not been adequately overhauled, resulting in a large deficit which periodically has to be topped up from government funds.

If you are not signed up by your workplace, you can speak to your local EFKA office. In either case, you will need to provide them with:

• an S1 form
• a photocopy of your passport
• your tax number
• two passport-style photographs
• an AMKA (national insurance) number
• a residence certificate, if you are going to be resident in Greece for more than three months

If you are working, you will need 50 days’ contributions towards EFKA before you are covered. You will then be issued with a health booklet, which serves as proof of your insurance. This must be renewed once a year in September or December.

If you are self-employed, you will need to apply to the local Insurance Organisation for Self-Employed (OAEE) office. To register, you will need:

• proof of your last three months’ insurance payments
• two passport-style photographs
• your passport or Greek ID card

Learn more below about exactly what the state insurance scheme covers.

The state scheme covers:

• general and specialist care
• hospitalisation
• laboratory services
• discounted drugs and medicines
• maternity care
• medical appliances
• transportation

However, check with EFKA regarding the extent of your coverage and make sure you understand the small print. Expats report paying into IKA, the old system, for years and then discovering that they still had to pay for an operation, so check that your own insurance covers you for anything beyond basic doctor’s visits.

As an expat retiree, you will be covered under EFKA if you are making social security contributions. If you are an EU national and unable to afford private insurance, you might still be covered under EFKA: check with the EOPYY.

Pensioners have to make a small contribution to prescriptions but at a lower rate (10%) than other patients.

If you are an international student, you will be able to use your EHIC card if you are a EU citizen.

If you are not from an EU member state, check whether your country has a reciprocal arrangement with Greece. If it does not, you will need to take out private medical insurance.

Your family will be covered by EFKA. Once you have paid enough contributions into the national scheme, your dependents will be issued with a family health booklet which serves as proof of cover. Under Greek law, your dependents include:

• your spouse, if they are unemployed
• your unmarried children if they live with you: up to the age of 18; up to the age of 24 if they are unemployed; or if they are students, for two years following the completion of their studies or once they have reached the age of 26, whichever comes first
• your children who have a disability of more than 67% even if they work or are employed for the purpose of occupational therapy
• your parents (under certain conditions)
• orphans who have lost both parents, grandchildren, brothers and sisters or orphans by one parent if the surviving parent is considered a protected member
• siblings with disabilities exceeding 67% if they are not insured by the same right
• the uninsured divorced spouse (under conditions) if they pay the corresponding contributions to the former spouse\'s institution

Check the current rules regarding the level of contributions required for your dependents to be covered.

The state scheme will cover:

• preventive dental care
• dental treatment
• orthodontic treatment for minors up to 13 years of age
• change of dentures every five years and provision of services in the meantime

Other dental procedures may require private health insurance cover.

Your employer should arrange this for you, but check that they have actually done so; there are some reports of employers not paying their contributions. EFKA contributions are expensive; around 30% of your salary.

A full range of medical treatment is covered under private insurance, but as with other countries, the reasons for taking out private cover may vary. If your only coverage is under the national health insurance system, you will not be able to choose which doctor or hospital you go to, and facilities in the national system can sometimes be rather basic. English-speaking staff may not be widespread. Strikes among medical personnel are not unusual.

There is a general consensus that the actual medical care you are likely to receive will be of a high standard in the state system, but the comfort factor is a significant element if you are considering taking out private cover.

Given the geography of the country, you may also want to investigate the extent to which private cover can offer you ease of transportation, for example if you have to be taken to hospital in Athens from one of the islands.

Since the economic crash, many Greeks take out private cover in addition to public health insurance, as the range of treatment covered by bodies such as EFKA is not as extensive as it used to be, so the private options fill the treatment gap. You may want to investigate a separate policy for dental cover, for example.

Private insurance includes the full range of primary healthcare but also treatment such as:

• specialists’ fees
• treatment in the country’s best hospitals
• advanced dental treatment
• elective cosmetic surgery

If you are retired, avoid any private cover which reserves the right to cancel your policy once you reach a certain age.

Numerous variables can have an impact on the cost of private health insurance in Greece.

The most important variables are:

• Age (the higher the more expensive)
• Area of cover (i.e. just Greece or other areas too? 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 private medical insurance in Greece 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.

• Alico AIGlife
• Allianz
• Bupa Global
• Cigna Global
• Ethniki Asfalistiki
• Generali
• Piraeus Bank

The majority of hospitals which are registered under a foreign insurance scheme are located in Athens or Thessaloniki.

As with all private health insurance, the higher your premium, the more extensive the range of treatment that you will have access to.

Ενιαίος Οργανισμός Παροχών Υπηρεσιών Υγείας – ΕΟΠΥΥ National Organisation for the Provision of Health Services (EOPYY)

έχετε κανονίσει την ασφαλιστική μου πολιτική? - Have you arranged my insurance policy?

ιδιωτική ασφάλιση υγείας - private health insurance

κρατική ασφάλιση υγείας - state health insurance

Πρέπει να συζητήσω την ασφαλιστική μου πολιτική - I need to discuss my insurance policy

παίρνετε κρατική ασφάλιση σε αυτό το νοσοκομείο - do you take state insurance at this hospital?

παίρνετε κρατική ασφάλεια εδώ - do you take state insurance here?

Έχω κάρτα EHIC - I have an EHIC card