Greece requires compulsory social health insurance through EFKA, with care delivered under EOPYY and accessed via an AMKA identity number, though the system leans more heavily on out-of-pocket payment than most EU peers. Here is what that actually means for an American or Briton living in Greece: what the public system gives you, what it does not, and where private cover fits.
Can you use the public system?
- Working for a local employer: Yes, once you complete residence registration
- Self-employed: Yes, by paying contributions
- Retired or not working: Only in limited cases
An AMKA number (obtained at a KEP citizens’ service centre or an EFKA/IKA office) is only an identity number; actual EOPYY cover needs an active EFKA insurance right through employment, self-employment contributions, a pension, or an S1 certificate. UK state pensioners can register a UK S1 with EFKA/EOPYY for UK-funded parity cover, but there is no equivalent US-Greece arrangement, since the US-Greece Social Security treaty covers pensions only, not healthcare.
Waiting period: No official minimum residence period for AMKA registration itself, but activation is not instant, leaving new arrivals with a real coverage gap. The main non-EU retiree route (the Financially Independent Person permit) requires private health insurance as a continuing condition at both issuance and renewal, not just at entry.
The picture differs for UK citizens
UK State Pensioners can register a UK S1 form with EFKA/EOPYY for UK-funded cover equivalent to a Greek citizen’s; there is no equivalent US-Greece healthcare arrangement.
If you are retiring here
Non-working retirees have no EFKA contribution pathway into public cover. UK state pensioners can register an S1 for UK-funded parity cover, but US retirees have no reciprocal deal and must hold qualifying private insurance simply to obtain and keep the FIP retiree residence permit (income threshold around EUR 3,500/month for the main applicant), with no automatic route into EOPYY absent contributions.
What public cover will not give you
- Adult dental care beyond preventive/under-13 orthodontics is largely private
- Specialist waits reported from about a week up to two months, longer for popular specialists
- Greek-language bureaucracy and forms
- Equipment shortages and overcrowding at some public facilities
- High system-wide out-of-pocket cost share (about 34 percent of total health spend)
So do you need private health insurance?
Legally required for the main non-EU retiree residence route (the FIP permit demands proof of qualifying private cover at application and renewal), and de facto necessary more broadly given wait times and the high out-of-pocket share of the system. Proof of health insurance is also a condition of the main residence routes here, so most expats need a policy in place before they apply.
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General information, not insurance, immigration or medical advice. Rules change and individual situations differ; check the official position before you commit. Researched from official sources, July 2026.