By Kathleen Evans
The ease of access and affordability of healthcare should always be one of the top criteria when looking for a place to retire. One never knows when a medical emergency or a need for long-term treatment might crop up, regardless of age. Therefore, having your ducks in a row and being well-informed is a necessity before embarking on any travels.
Malta has a healthcare system backed by an excellent track record of providing public-financed care since 1372. That’s when Malta’s first hospital became operational. When the Knights of St. John came to the country in the early 16th century, they started building hospitals as one of their fundamental objectives.
Today Malta offers some of the best healthcare in the world, despite its size. The World Health Organization, in 2023, ranked Malta #26, and Statista.com puts Malta at #19 – ahead of countries renowned for their healthcare programs, such as Portugal, Korea, UAE, and Costa Rica. Other indexes rank Malta’s healthcare in the top 10. Life expectancy in Malta is high, and the population spends, on average, 90% of their lifespan in good health, longer than any other EU country.
Malta, like most countries, has both a public and private healthcare system. We’ll focus primarily on the private one for much of this article, since third-country nationals (from outside the EU) and digital nomads are required to purchase private healthcare insurance to qualify for a visa or residency.
Even with a policy responsible for only major medical needs, covering smaller health issues out-of-pocket is still relatively affordable compared to what one would pay in the US or Canada through the private system.
Malta’s strong public healthcare system provides free services to all Maltese citizens and European Union residents with a European Health Insurance Card (EHIC). Malta’s public healthcare system is funded via taxes. The islands have eight public hospitals, including one on the island of Gozo, and a network of health clinics and pharmacies that offer preventative, rehabilitative, and curative care. Thanks to Malta’s small size, it’s easy to access a hospital or health clinic when needed, regardless of where you live.
The Mater Dei Hospital (MDH), more famous as Mater Dei, is the main public hospital of Malta, located in Msida. It functions as a specialty facility as well as a training institute. In terms of infrastructure, it has one of the most significant facilities in Europe. Patients are admitted via referrals by a doctor or the emergency department. Expats can utilize this public hospital, but they will have to pay out of pocket. But depending on the policy, they may be eligible for reimbursement through their private insurance.
As more and more residents in Malta purchase private health insurance, the number of private healthcare clinics and hospitals is also on the rise. Most GPs employed with the public healthcare system also work in private practice.
Malta also has three private hospitals on the main island – St. James Hospital, St. Thomas Hospital, and the DaVinci Health Clinics. They offer a broad range of services, from blood tests to diagnostic scans to complex surgery. Having the latest medical technology, such as a 4D ultrasound, a comprehensive digital radiology system, laser-assisted surgery, and MRI and CT spiral scan. As well as 24/7 emergency room and ambulatory services at both St. James and St. Thomas.
Non-EU citizens living in Malta must obtain private healthcare insurance. Naturally, the cost of policies varies depending on your age, health, and deductibles. The price of a private insurance policy is much lower than in the U.S
A growing number of Maltese and EU citizens are purchasing private insurance, despite having access to free public care, which may be a testament to the reasonable cost of private health insurance. Many prefer to have some additional insurance coverage because it allows access to a greater range of physicians and services, and because private care usually offers much shorter wait times.
Most insurance companies, such as Laferla and Bupa, offer a variety of plans to suit individual or family needs. For example, Laferla’s basic “bronze” plan provides limited coverage for private hospital treatment, and full coverage for CT and MRI scans, outpatient doctor visits, and cancer treatment. The top-tier international “gold” plan covers everything, including funeral expenses.
Steve Spada, originally from Austin and now splitting time between Malta and Costa Rica, recently requested a quote from Laferla for himself and his wife. “We are both in our 60s and want an international policy since we are outside of Malta for half of the year. The International Silver plan is €3100 ($3430) for both of us annually, and it covers us for worldwide medical treatment up to €750,000. With it, we also have emergency coverage in the USA and Canada up to €20,000.”
Saul and Gail Klarke, originally from New York, purchased a private insurance policy through Mapfre. “It cost €2300 ($2543) for both of us. They did not raise our rates this year, but they probably will when Saul turns 70. It’s the minimum policy we could buy and qualify for residency.” They are both currently in their 60s. This policy doesn’t cover them outside Malta or for wellness care. “It also doesn’t cover pre-existing conditions. I had breast cancer, which wouldn’t be covered if it returned. But we have kept our Medicare in the US, and I would travel back there for treatments, if needed.”
For expats, purchasing an international or worldwide health insurance policy rather than a local Maltese plan is a good idea. It helps you get access to hospitals and doctors of your preference, and it applies not just to Malta but in other countries where you travel or live part-time.
Which is the best health insurance in Malta is always subjective. Depending on its coverage and your essential needs, it will be different for every expat. Various aspects, like pre-existing medical conditions, age, specific requirements of medical insurance, and the situation in Malta, among other criteria, need to be considered. Yet, you can find insurance plans offered by internationally-known names like Cigna and Allianz. It’s best to research and compare the policies these companies provide to expats in Malta before choosing the best one for you.
Quality of Care
Malta’s private hospitals are known for the excellence of their specialty clinics. Da Vinci Health, for example, has multiple clinics, including a well-respected breast care clinic, a dentistry department, and an orthopedic specialty. St. James Hospital group owns four state-of-the-art clinics and one 80-bed hospital with a renowned eye care clinic. St. Thomas is the newest boutique hospital, stressing comfort and boasting the latest technology.
Besides the three main private hospital groups, nearly 100 smaller private medical clinics specialize in everything from osteopathy to optical.
There are currently no Joint Commission International (JCI)-certified hospitals on the island. An independent, not-for-profit organization, the JCI identifies, measures, and shares best practices in quality and patient safety around the world for medical centers. That said, Malta’s healthcare system is set to gain access to the latest medical technologies and clinical treatments thanks to a deal with Vitals Global Healthcare, in collaboration with Barts and The London School of Medicine and Dentistry and Partners HealthCare International from the US. Vitals will be investing €220 million in revamping Malta’s medical infrastructure following the award of a service concession from the Government of Malta.
The total number of doctors registered in Malta is approximately 1150, serving a population of just over half a million people. Many of the doctors in Malta have studied or worked in the UK or other EU countries. The doctors and staff in Malta speak English, which is a huge advantage for any English-as-a-first-language patient compared to many of the other popular International Living retirement countries showcased.
In Hasmita’s knee injury case, she was very happy with the surgery and the quality of care. “In all I had five visits to the hospital, and I had a pre-surgery consultation where they measured blood pressure and took a blood test. I would definitely recommend the private over the public hospital as treatment was very good and quick other than the initial X-ray. My consultant authorized ten amazing physio sessions, and they have all the rehab equipment to try different exercises.”
While Malta is not especially known as a medical tourism destination, compared to places like Turkey, Mexico, Costa Rica, India, and Thailand, there is the beginnings of an emerging medical tourism sector.
The most common procedures for tourists include:
- Orthopedic Surgery
- Dental Work
- Cosmetic Surgery
- Blood Tests
- Diagnostic Scans
- Laser Hair Removal
- Cardiac Surgery
The following are a few cost comparisons between medical procedures in Malta and equivalent procedures in the United States:
|Procedure||United States||Malta||Average Savings|
|Breast Augmentation||$5,000-$10,000||$3,000||40% – 70%|
|Laser Hair Removal||$ 430||$ 50||88%|
Since Gail Klarke’s Mapfre insurance does not cover wellness, she and Saul pay the affordable out-of-pocket prices. “A visit to a primary care physician at St. James is €85 ($94) - the best private care hospital in the country. The oncologist is about €60 ($66), eye exams are €35 ($39), dermatologist €65 ($72), and a gynecologist visit is €80 ($88). Blood tests are around €280-300 ($309-33). I was due for a mammogram, and 3D imaging only cost €125 ($138) at St. James Hospital.” The average cost for a 3D imaging mammogram in the US starts at $560 without insurance. And blood work can be upwards of $1000.
Dental care is also cheaper than in the US. For example:
|Clean and polish||$55|
Availability of Medications
There are more than 200 pharmacies in the 122 square miles of Malta, with at least one in each village, and a few dozen in each town. Therefore, you’ll find a pharmacy nearby anywhere you live in Malta, just look for the international green cross.
Many medications can be bought over the counter, and GP’s or specialists issue prescriptions if necessary. In most pharmacies, no ID is required. There is no proper customer file, and your prescription is not scanned, as would be the case in many other countries.
You can typically find any medication you are looking for in Malta—or a generic substitute. Most medicine boxes will have information written in English, but you may also find some brands in foreign languages, such as Turkish or Spanish.
You can also go directly to the pharmacy and ask the pharmacistfor advice if you haven’t already seen a doctor. They can provide you with authorized medicine if it doesn’t need a prescription.
Most pharmacies have General Practitioners available for consultation – typically, you will need to make an appointment, but not always. It’s extremely convenient if you need to see a professional about a non-urgent problem and get a prescription.
Steve Spada, a part-time Malta expat, shared, “I needed to have a consultation to see if I should change my blood pressure medication, and I was able to get a doctor’s appointment at a pharmacy the next day. It only cost me €20 out of pocket ($22) for the consultation and check-up. It would probably be 5x that in the States, and double that in Costa Rica with a private GP.”
I checked with the pharmacist at Stella Maris pharmacy in Sliema to get up-to-date prices for some of the most common drugs taken by typical retirees.
Azithromycin antibiotic used for treating pneumonia, ear/nose/throat infections—€12 ($13) for three tablets
Levothyroxine used to treat hypothyroidism—€3 ($3.30) for 28 days
Lisinopril used alone or together with other medicines to treat high blood pressure—€10-20 ($11-22) for a 30-day supply depending on dosage
Metformin used for type 2 diabetes to lower blood sugar levels—€5-9 ($5.50-10) based on dose for a 90-day supply
Omeprazoleused to treat excess stomach acid causing acid reflux, ulcers, etc.—€12 ($13) for a 30-day supply
Simvastatin commonly used to treat high cholesterol and fat levels in the blood to avoid heart attack and stroke—€4-7 ($4.40-8) for a 30-day supply
With a highly-ranked healthcare system, it only makes sense that medical emergency services are available. Like other EU member nations, people across Malta can dial the toll-free number 112 for 24/7 emergency services. Both St. James Hospital and St. Thomas Hospital have full-service emergency rooms and much of the population can get to an emergency room within 20 minutes or less. However, there are reports of long ambulance wait times (30+ minutes), and during high traffic (which is often), the ambulance may be further delayed.
If you’re on the island of Gozo and you have a critical emergency, you may need to be life-flighted to the main island of Malta (there is no bridge, so one must take a ferry). This could be quite costly; meaning it is a good idea to have health insurance to cover those type of situations.
Malta’s Ministry of Health website provides information from the latest news regarding health alerts to formulary lists and a list of resources. The expats who weighed in feel that the high EU standard of health in Malta for the relatively inexpensive cost is one of the reasons this Mediterranean country is a great place to consider for retirement in Europe.