Healthcare when you live or stay long in your home abroad

Buying a home abroad is the easy part of the plan. The harder question is who pays the doctor when you spend three, six or twelve months a year there. The answer depends on one thing above all: whether you are only staying, or have moved your residence. This article explains the main EU tools and what changes outside the EU. It is general information, not legal or insurance advice, and national rules differ, so confirm the details with your own health insurer.

Staying versus living: the key distinction

EU rules treat a temporary stay and a change of residence very differently.

• Temporary stay (holidays, a few months in your second home). You remain insured in the country where you are insured. You use the European Health Insurance Card (EHIC) for medically necessary care.
• Change of residence (you settle in the new country). Your health cover usually moves with you, and the old card stops being the right tool. Who pays depends on your situation: working, pensioner, or neither.

There is no single number of days that switches you from one category to the other. It depends on where your centre of life is, which is the same logic as in our article on tax residency when relocating. Do not assume that the days you count for tax and the days that count for health cover are the same test.

EHIC: what it covers and what it does not

According to the official Your Europe portal, the EHIC gives access to publicly funded healthcare that becomes medically necessary during a temporary stay in another EU country, on the same terms as people insured there. The card is free and issued by your health insurer.

• It does not cover private healthcare.
• It does not cover repatriation or mountain and sea rescue.
• It does not cover planned treatment, meaning travelling in order to be treated.
• It is meant for temporary stays, not for people who have moved.

For someone who spends several months a year in a home abroad, this means the EHIC is a safety net for unexpected illness, not a substitute for a proper arrangement if you stay regularly and for long. The United Kingdom uses its own card, the GHIC, which is a separate scheme for UK-insured people and not something an EU-insured resident uses.

S1: pensioners who move within the EU

If you receive a state pension from one EU country and live in another, you can generally ask your pension institution for a form S1. You register it with the health insurer in the country where you live, and you are then covered there on the same basis as local residents. The country that pays your pension normally bears the cost. This is how many retirees who buy a home in Spain, Portugal, Greece or Italy get public healthcare there. Our guides to retiring in Spain and retiring in Portugal cover the local practicalities. The detailed link between pensions and health cover is in this article on moving a pension abroad.

People who work in the new country are normally insured there. People who are neither working nor receiving a pension are the most complicated group: rules differ by country, and a right of residence beyond the first three months generally depends on having comprehensive health cover. Ask the host-country authority what they accept before you move, not after.

Planned treatment and the cross-border Directive

Separate from the EHIC, EU Directive 2011/24/EU on patients' rights in cross-border healthcare lets an insured person seek treatment in another EU country and be reimbursed by their home system, generally up to the amount the same treatment would have cost at home. Some treatments, such as hospital stays or highly specialised care, can require prior authorisation from your insurer. There is also an older route with a form S2 for authorised planned treatment. Which route applies, and how much you get back, is decided by your insurer. Always ask before you book, and keep invoices.

Outside the EU: private insurance is the rule

The EU instruments do not apply in Turkey, the UAE, Thailand, Georgia or Montenegro (Montenegro is an EU candidate but not a member). You should plan on private international or local health insurance. Residence permits are often linked to it.

• Turkey. Reports and official guidance indicate that applicants for a residence permit generally need health insurance. Verify the current requirement with the migration authority.
• UAE. Health insurance is mandatory for residents in at least Dubai and Abu Dhabi, and a residence visa is usually tied to it. Check the emirate where you will live.
• Thailand. Long-stay visa categories often ask for proof of health insurance. Buying a property does not by itself give a right to stay.
• Georgia. State coverage is for citizens and certain residents, so foreign owners typically buy private insurance.

We have not confirmed the current minimum cover amounts for any of these, so we do not quote them here. Premiums depend on age and pre-existing conditions, and insurers may exclude them. Check what is actually covered, including repatriation, and whether the policy still pays if you spend most of the year in the country.

Practical checklist

• Get the EHIC before the first stay and check the expiry date.
• Ask your insurer in writing what applies if you spend more than a few months a year abroad.
• If you are a pensioner, ask the pension institution about the S1 before you change residence.
• Outside the EU, buy private cover that matches the visa requirement, and keep the policy certificate for the permit application.
• Keep copies of prescriptions and a medical summary in a language the local doctor can read.

FAQ

Can I use the EHIC for six months a year in my home abroad? It is designed for temporary stays and unexpected care. Whether a long repeated stay is still treated as temporary depends on your insurer and the host country, so ask both.

Does owning a home in another EU country give me access to its public healthcare? No. Ownership does not create health cover. Cover comes from your insurance status: employment, pension with S1, or the arrangements of the host country.

Does the S1 work outside the EU? No. It is an EU, EEA and Swiss coordination tool. Outside it you rely on bilateral agreements, where they exist, or private insurance.

Can I be treated abroad on purpose and get the money back? Often yes under the Directive 2011/24/EU, but the amount is usually limited to what the treatment would cost at home and some care needs prior approval. Ask your insurer first.

Is private insurance enough for a residence permit? Frequently it is required, but each country sets its own minimum conditions. Check with the migration authority before buying.

How we help

We are a trilingual platform that finds properties abroad and coordinates independent local lawyers and tax advisers. We do not sell insurance or give medical advice. If you plan to spend long periods in your property, we can help you ask the right questions of the local lawyer and of your insurer before you buy. This text is informational and is not legal, tax or insurance advice. Rules change, so verify current requirements with your health insurer, the Your Europe portal and the authorities of the country concerned. See also relocating abroad with family.