Malta – Elderly Care

How are elderly people regarded and treated in Malta?

Malta is a deeply Catholic, family-oriented society in which older generations have long been held in considerable esteem. The expectation that adult children will assume primary responsibility for the care of ageing parents remains culturally embedded, and this continues to exert a significant influence on how eldercare is structured across the islands. By contrast with Northern European countries, where state-organised residential provision tends to be the default, Malta has historically relied far more heavily on informal family networks as the first line of support.

Public policy in Malta seeks to shift the narrative around ageing — moving away from a model of dependency towards one of active participation, personal autonomy, and dignity in later life, while simultaneously providing community-based services that enable older people to remain in the homes and neighbourhoods where they have spent their lives. This philosophy forms the philosophical backbone of the government’s entire approach to eldercare.

There remains, at a local level, a degree of reluctance around placing elderly relatives in residential care, which many families still view as an option of last resort. Attitudes are nonetheless shifting, particularly in more urbanised areas, as demographic pressures mount and working-age adults face competing demands on their time.

The majority of public expenditure on long-term care is directed towards institutional services provided in kind, with only 15% allocated to home-based care — well below the EU average of 28%. Countries such as the Netherlands and Denmark devote a substantially larger share of long-term care funding to community and domiciliary support. Malta has formally recognised this imbalance and committed to reorientating its approach accordingly.

What state or publicly funded elderly care is available in Malta?

The central government body with responsibility for older persons’ services is Active Ageing and Community Care (AACC), which sits within the Ministry for Health and Active Ageing. It manages a broad and continuously evolving range of community and residential services across both Malta and Gozo. The majority of services can be applied for through the national government portal, servizz.gov.mt.

Services delivered through Active Ageing and Community Care include: Active Ageing Centres, Home Help, Respite at Home, Residential Respite, a Handyman Service, Telecare, Telecare on the Move, Meals on Wheels, a Continence Service, Domiciliary Nursing, Domiciliary Caring, a Dementia Intervention Team, Dementia Activity Centres, Social Work, a Night Shelter, Home Admission, a Community Geriatrician, Podiatry, Physiotherapy, Occupational Therapy, and Psychotherapy.

The Carer at Home Scheme offers government financial assistance to older people who engage a carer of their own choosing to assist with day-to-day needs. Under the 2025 Budget, the annual government contribution through this scheme is set at €8,500. Available in both Malta and Gozo, it is intended to help older individuals remain in their own homes for longer and retain their independence.

Elderly persons still living in their own homes or in certain care settings where they cover the full cost themselves receive an additional grant supplement: as of 2024, those aged 80 and over receive an extra €50 on top of their existing €400 grant, while those aged between 75 and 79 continue to receive €300 per year.

Dementia Activity Centres (DACs) operate across various localities in Malta and Gozo, offering day care programmes tailored to the specific needs of people living with dementia, alongside respite and therapeutic activities. The Dementia Intervention Team (DIT) delivers a community outreach service to people with dementia and their carers, conducting comprehensive assessments in the home setting.

Eligibility for placement in state-run long-term care institutions is broadly available to people aged 60 and above, and/or those with a disability that prevents independent living. Since thresholds and criteria are subject to change, it is advisable to confirm the current requirements directly with the AACC or via the servizz.gov.mt portal.

Residents in state-run homes are not exempt from financial contributions: they are required to contribute between 60% and 80% of their pension income, plus 60% of any additional income. While the state provides a substantial subsidy, residents share in the cost of their care.

What residential, care home, and nursing home options exist in Malta?

Long-term residential care for older people in Malta is provided across three main sectors: the government, the Catholic Church, and the private market. This tripartite structure gives prospective residents and their families a variety of options depending on their needs, means, and personal values.

The only fully government-operated facility providing round-the-clock geriatric medical care is St. Vincent de Paul Residence (SVPR), which serves as the principal public nursing home and is currently the subject of substantial investment and refurbishment. In 2024, construction of a new residential care home in Bormla was commenced, alongside renovation works at the Msida care home.

Altogether, the government controls approximately 2,500 beds across the residential homes it manages directly, in addition to beds procured from private and Church-run establishments. More than 2,500 individuals have at various points been registered on the waiting list for admission to public elderly homes, which illustrates the scale of demand and reinforces the need for advance planning.

The quality and character of care homes in Malta varies widely. Some are designed to replicate a domestic, home-like atmosphere with personalised, round-the-clock attention, while others are more upscale establishments offering a choice of studios, one- or two-bedroom apartments, or penthouse units with terraces. Standard room features typically include en-suite bathrooms, nurse call systems, and emergency response equipment.

Beyond nursing care, many facilities provide dentistry, physiotherapy, and occupational therapy, as well as on-site pharmaceutical services linked to the Pharmacy of Your Choice (POYC) scheme. Social programmes, lifelong learning activities, and organised excursions are common features across much of the sector.

All care facilities — whether publicly or privately operated — are now subject to regulation and inspection by the Older Persons Standards Authority (OPSA). OPSA was established to set, monitor, and enforce quality standards across all services provided to older people, encompassing nursing homes, day centres, and community-based care. During its first full year of operation, OPSA conducted thorough inspections, issued detailed compliance reports, and collaborated with providers to drive improvements. A register of licensed service providers is publicly accessible at opsa.gov.mt.

Since 2017, quality improvements across the long-term care sector have been supported by the Standards of Care Quality Charter. Both the University of Malta and the Malta College of Arts, Science and Technology (MCAST) have developed accredited training programmes for care workers, helping to build a more professionally competent workforce.

How much does elderly care cost in Malta?

Getting a clear picture of elderly care costs in Malta requires distinguishing between the gross cost to the government, what publicly supported residents personally contribute, and what those without access to subsidised care must pay in full.

The government’s cost of maintaining a single bed in a public care home is estimated at between €60 and €70 per day, amounting to approximately €23,700 annually per resident. This is the state’s expenditure before the resident’s own financial contribution is taken into account; as noted above, residents are required to contribute a proportion of their pension and other income towards their placement.

Those who are not admitted to public residential care often find the cost of Church-run or private alternatives a serious financial burden, particularly when set against the level of a standard pension. This is a particularly relevant consideration for expats who may not have accumulated sufficient social security contributions in Malta to qualify for subsidised placement.

For home care, the government’s Carer at Home Scheme provides meaningful financial relief. Under the 2025 Budget, eligible individuals are estimated to pay around €490 per month after the €8,500 annual subsidy is applied, before accounting for any further benefit from pension increases or the Elderly Support Allowance. Actual out-of-pocket costs will depend on the chosen provider and the care package required.

Fees at private nursing homes and assisted living facilities vary considerably according to the provider, location, and level of care. Most private operators do not publish standardised pricing — a facility manager will outline the specific costs associated with a particular placement, which generally encompass 24-hour nursing and emergency care, meals, in-house activities, and housekeeping. Prospective residents and their families should always request a full, itemised breakdown of fees directly from each facility, as pricing is subject to change. The Malta Tax and Customs Authority publishes an annual List of Homes for the Elderly, which may serve as a useful starting point for identifying accredited providers.

Can expats access elderly care in Malta, and are there any restrictions?

Eligibility for publicly funded elderly care in Malta is determined primarily by residency status and social security contribution history, rather than by nationality. The overarching principle is that the more deeply a person has been integrated into the Maltese social security system, the stronger their entitlement to state-supported services.

Expats who are employed legally in Malta make social security contributions, and in doing so acquire the same healthcare entitlements as Maltese citizens. This extends, in principle, to access to state-funded elderly care for those who have accumulated an adequate contribution record.

Malta’s public healthcare system is funded through employment contributions and is administered by the Ministry for Health. It is accessible to all residents regardless of background or income, and expats who work legally, pay taxes, and contribute to the social security system are entitled to benefit from it.

For EU nationals, entry into the public system is relatively uncomplicated. Those travelling from another EU or Schengen state are entitled to free medical treatment during short visits on presentation of a valid European Health Insurance Card; EU nationals intending to remain for more than 90 days are required to obtain an S1 form in their home country and register it with the Maltese Entitlement Unit. EU residents with a sustained history of social security contributions in Malta will generally enjoy the same access to services as Maltese nationals.

For non-EU nationals, entitlement to publicly subsidised care depends more substantially on residency history and contribution record. Health insurance is a mandatory requirement for most non-EU expats seeking residency or work permits. Those who have lived and worked legally in Malta over an extended period and paid into the social security system should in principle qualify for state elderly care services. Retirees who arrived in Malta later in life with limited or no prior contribution history may find their access to subsidised public residential care more constrained. Current eligibility conditions should always be verified directly with the AACC or the Department of Social Security.

What private elderly care and international options are available in Malta?

The private elderly care sector in Malta has expanded significantly in recent years, driven by demand that the public system alone cannot satisfy. Together with the Church and the government, private operators form one of the three pillars of long-term care provision, occupying a distinct position in terms of both cost and accessibility.

Private nursing and care homes in Malta span a wide spectrum, from smaller, family-run residences to well-appointed establishments that actively market themselves to retirees in search of a comfortable, sociable retirement lifestyle. Well-known examples include The Imperial in Sliema, Casa Serena, and St. Elizabeth Residential and Nursing Home. These homes aim to offer residents a secure and pleasant environment encompassing medical support, rehabilitation, daily programming, and meals adapted to various dietary requirements.

Those seeking premium accommodation may find upscale establishments offering studio apartments, one- or two-bedroom units, and even penthouse options with generous terraces and scenic views. Shared facilities at such homes frequently include landscaped gardens, chapels, libraries, swimming pools, and in some cases dedicated cinema rooms or specially designed activity spaces.

Malta’s status as a bilingual country — with both Maltese and English carrying official language status — means that communication barriers are generally far less of an issue than at retirement destinations in other parts of the Mediterranean. Most care staff in both public and private settings are able to communicate in English, which is a notable practical benefit for expats without Maltese language skills. Private facilities tend to offer shorter waiting times, a wider range of services, and more flexible scheduling than their public counterparts, with English spoken confidently by the majority of staff.

Research into family satisfaction with care in Malta indicates that those employing migrant carers privately are generally highly satisfied with the arrangement, though the associated costs place this option beyond the reach of many. For expats who have the necessary personal resources or appropriate insurance coverage, privately arranged care can deliver a highly tailored experience.

What role does health insurance play in covering elderly care in Malta?

Health insurance occupies an important but often misunderstood place in elderly care planning in Malta. The public system is funded through social security contributions, and standard private health insurance — as is typically the case internationally — is designed to address acute medical needs rather than sustained residential or nursing care. Long-term residential placement is generally excluded from standard health insurance policies, making it vital to understand what your coverage actually includes before you need it.

Health insurance is a mandatory requirement for the majority of non-EU nationals applying for residency or work permits in Malta. EU citizens may rely on their EHIC for temporary stays, but should transition into the public system if their residence is to be long-term.

From August 2024, expats applying to reside in Malta are required to hold health insurance providing a minimum coverage of USD 108,202.86, encompassing medical treatment and hospitalisation, in some cases extending to treatment outside Malta. Comprehensive international health insurance is therefore strongly advisable.

Private health insurance represents an alternative for those living in Malta, with the choice falling between locally issued policies and international plans. A local policy will cover treatment at private facilities within Malta, but its geographical scope is limited. International plans offer wider coverage across multiple countries and are typically better suited to expats who travel regularly or may seek treatment in their country of origin.

When evaluating insurance specifically for elderly care purposes, look for policies that include: extended hospitalisation, specialist geriatric consultations, physiotherapy and rehabilitation, home nursing visits, and — where possible — some contribution towards residential care costs. The last of these is rarely covered by standard policies, so bespoke long-term care insurance or robust financial planning may be necessary. Pre-existing and chronic conditions must be explicitly covered, particularly for retirees who relocate to Malta in later life.

What should expats consider when planning for elderly care in Malta?

Preparing for elderly care in another country demands careful attention to legal, financial, and practical matters that may differ considerably from those in your country of origin. Malta’s care system, while broadly well-regarded, operates under capacity pressures and eligibility requirements that make proactive planning essential.

1. Understand your social security contribution record. Your access to subsidised public care is likely to depend on how long and how much you have contributed to the Maltese social security system. If you are arriving in retirement with no prior contribution history in Malta, budget for private care costs.
2. Plan for waiting lists. More than 2,500 people have at times been registered on the waiting list for public elderly homes, so applications for publicly funded residential care should be submitted well ahead of any foreseeable need.
3. Review your health insurance policy carefully. Confirm that your policy covers hospitalisation, specialist geriatric care, and home nursing. Assess whether dedicated long-term care insurance is warranted given your financial position and the availability of family support.
4. Establish a Power of Attorney. Should cognitive or physical deterioration become a concern, arranging for a trusted person to hold legal authority to act on your behalf under Maltese law is critically important — especially for foreign nationals whose close family members live abroad.
5. Consider advance care directives. Malta’s legal framework allows individuals to set out their medical preferences in advance. A local legal adviser can help draft documents that will be legally recognised in Malta and, where relevant, in other jurisdictions.
6. Consult a local financial and legal adviser. The interaction between Maltese inheritance law, means-testing for care home contributions, and foreign pension income can be intricate. A qualified professional with experience advising expats can help you organise your finances in the most effective way.
7. Explore the full range of community services. Active Ageing and Community Care delivers a wide array of services designed to support older people living in the community and delay the need for long-term residential placement. Many expats are unaware of these programmes, which can meaningfully prolong independent living.

What are the best official sources of information on elderly care in Malta?

Because eligibility thresholds, service fees, and provision can change at any time, it is essential to consult authoritative sources before taking any decisions. The following are the key official references:

• Active Ageing and Community Care (AACC): The primary government body for older persons’ services. Visit aacc.gov.mt for service descriptions, application forms, and eligibility criteria.
• Servizz.gov.mt: Malta’s national government services portal, through which the majority of AACC services can be applied for online. The elderly care and services section provides a comprehensive listing.
• Older Persons Standards Authority (OPSA): Responsible for establishing, monitoring, and enforcing quality standards across all public and private services for older people. The register of licensed providers and a feedback mechanism are available at opsa.gov.mt. A dedicated Freephone number, 80002002, is available specifically for receiving feedback on all services licensed by the Authority.
• Ministry for Health and Active Ageing: Visit health.gov.mt for policy updates, strategic documents, and ministerial guidance.
• Department of Social Security: For questions about social insurance contributions, pension entitlements, and means-testing rules, visit socialsecurity.gov.mt.
• Malta Tax and Customs Authority (MTCA): Publishes the annual List of Homes for the Elderly, useful for identifying accredited facilities that qualify for tax deductions.
• Health Entitlement Unit (HEU): The starting point for registering access to Malta’s public health system as a foreign national. Expats must register with the Health Entitlement Unit, presenting residency or employment documentation, in order to access public healthcare.

It is advisable to cross-reference information across multiple official sources and to request written confirmation of any eligibility or cost information you receive, as published guidance does not always reflect the most recently enacted rules.

Frequently Asked Questions About Elderly Care in Malta

Is the standard of elderly care in Malta good enough for expats?

Malta was ranked 18th out of 196 countries in the CEOWORLD Healthcare Index 2024, reflecting the overall strength of its health and care infrastructure. All elderly care facilities — both public and private — are now subject to licensing and inspection by OPSA. Quality differs between providers, and private establishments tend to offer superior comfort and shorter wait times than the public sector, though at substantially higher cost. Visiting facilities in person before making any commitment is strongly advisable.

Will there be a language barrier in Maltese care homes?

Malta’s two official languages are Maltese and English, and English is used widely throughout healthcare and care settings. Staff in most care homes are able to communicate effectively in English, and this is particularly true of private facilities. In public settings, the level of English may vary between staff members, but it rarely presents a serious obstacle. Where a specific language capability is essential — for example, for a resident with dementia who increasingly relies on their mother tongue — this should be raised directly with care providers before any placement is confirmed.

What happens if a family member abroad suddenly needs emergency residential care in Malta?

In an acute emergency, the immediate priority is hospital care, which is available to all residents through Malta’s public hospital network. The Community Geriatrician Service can arrange medical home visits for older people who are unable to travel due to their physical condition, with assessments carried out by professionals from the CommCare Assessment Division. For urgent residential placement beyond the acute phase, the AACC social work team can assist with assessment and expedited referrals where clinically justified. Families should contact AACC without delay and, where the individual holds private insurance, notify the insurer at the earliest opportunity.

Can I use my home country’s pension to help pay for care in Malta?

Pension income received from abroad is generally included when calculating an individual’s financial contribution towards public care home fees in Malta. Residents of state-run homes are required to contribute between 60% and 80% of their pension entitlements, plus 60% of any other income they receive. Foreign pensions must be declared to the relevant authorities. A local financial adviser can help you determine how your overseas pension interacts with Maltese means-testing requirements and whether any applicable double taxation agreements between Malta and your home country are relevant to your situation.

Are there any dementia-specific care facilities in Malta?

Dementia Activity Centres (DACs) operate in multiple localities across both Malta and Gozo, offering specialist day care for individuals living with dementia, including therapeutic programmes and respite support for carers. Palliative care services are also available at the Palliative Care Ward at Sir Anthony Mamo Oncology Centre in Msida. A National Dementia Strategy has been put in place to further develop services, including a 24-hour dementia helpline and community programmes designed to create more dementia-friendly environments.

Do non-EU nationals qualify for public elderly care in Malta?

Expats who are legally employed in Malta and contribute to the social security system are generally entitled to the same healthcare benefits as Maltese nationals. For non-EU retirees who have not worked in Malta and therefore have no contribution record, eligibility for subsidised public care is likely to be more restricted. Such individuals may need to fund their care privately and hold appropriate insurance. Current eligibility requirements should always be confirmed with the AACC and the Department of Social Security, as the rules may be updated.

What are the main waiting list challenges for public care homes in Malta?

More than 2,500 people have at various times been on the waiting list for placement in public elderly homes in Malta. The government allocates priority according to assessed dependency level — distinguishing between high, medium, and lower dependency, as well as those with dementia — with the most dependent individuals given precedence. The wait for a publicly funded placement can be lengthy, making it important to apply early and to pursue community-based support options through AACC in the interim.

What should I look for in a private health insurance policy to cover elderly care in Malta?

Standard health insurance policies rarely include long-term residential care, so careful scrutiny of your policy is essential. Prioritise coverage that encompasses: extended hospitalisation, specialist geriatric consultations, physiotherapy and rehabilitation, home nursing visits, and — ideally — a contribution towards residential care costs. Pre-existing and chronic conditions must be explicitly included within the policy, which is particularly important for retirees relocating to Malta in their later years. International health insurance plans generally offer more comprehensive coverage than locally issued policies. As of August 2024, expats applying to reside in Malta may be required to hold a policy with minimum coverage of USD 108,202.86. Always read the policy terms thoroughly and seek independent financial advice if you are in any doubt before selecting a plan.