75: Healthcare systems in Europe: What Americans need to know
Healthcare Systems in Europe for Americans: What You Need to Know
Healthcare systems in Europe for Americans can be very different from what you’re used to in the U.S. If you move abroad and need medical care, it’s important to understand how to access services, whether you need insurance, and what costs to expect.
In this post, we’re diving into:
- The biggest differences between U.S. healthcare and European systems
- What expats need to understand about public vs. private healthcare
- How much you’ll actually pay for doctor visits, medications, and insurance
U.S. Healthcare vs. The Rest of the World
Why Expats Often Leave the U.S. System Behind
Healthcare in the U.S. is known for its high costs and complexity. Insurance premiums are expensive and often come with high deductibles. Moreover, coverage is usually tied to employment, limiting flexibility. Even insured patients often face surprise medical bills, which adds to the financial strain. In fact, over 100 million Americans carry medical debt. To put it into perspective, in 2021, the average hospital stay cost $13,262.
How European Systems Differ
In contrast, many European countries provide affordable, accessible healthcare. Public healthcare is often free or low-cost, and surprise billing is rare. Additionally, medication prices are significantly lower. While private insurance exists, it’s usually optional rather than necessary. Despite spending less per person on healthcare, many European countries outperform the U.S. in both health outcomes and access to care.
Comparing Healthcare in Top Expat Destinations
Here’s a breakdown of what healthcare looks like in several popular European countries:
| Country | Public Healthcare | Private Insurance Needed? | Monthly Private Insurance Cost | Doctor Visit Cost (No Insurance) | Prescription Costs |
|---|---|---|---|---|---|
| USA | No universal coverage | Usually required | $400–$800 (individual), $1,500+ (family) | $100–$300+ | Often 10–100x more expensive |
| UK 🇬🇧 | Free at point of use (NHS) | Optional for faster access | $50–$150 | Free to ~$100 | Capped around $13 |
| France 🇫🇷 | Public system covers ~70% | Optional mutuelle fills the gap | $50–$200 | ~$30 (70% reimbursed) | Often under $10 |
| Spain 🇪🇸 | Free or low-cost public system | Optional for faster access | $50–$200 | ~$50 | 50–80% cheaper than U.S. |
| Netherlands 🇳🇱 | Mandatory private insurance | Yes, required | ~$120+ | ~$50 | Affordable with insurance |
| Portugal 🇵🇹 | Low-cost public system | Optional, but common | $50–$150 | ~$40–$60 | 60–80% cheaper than U.S. |
| Germany 🇩🇪 | High-quality public care | Public or private options | $110–$500 | ~$30 | Low-cost with insurance |
Why This Matters
Many Americans moving abroad don’t need private insurance. Healthcare costs are drastically lower, even with private plans. Furthermore, medical debt becomes a non-issue in countries with strong public systems. In the U.S., high insurance premiums, deductibles, and out-of-pocket costs are the norm. By contrast, Europe offers a much more affordable and predictable healthcare experience.
What Expats Need to Know About Public vs. Private Healthcare
Why Some Expats Still Choose Private Coverage
While public systems in Europe are excellent, they sometimes involve wait times for specialists or elective procedures. However, private insurance provides quicker access to specialists, English-speaking doctors, and private hospitals. Moreover, certain visa types, such as Portugal’s D7 visa or Spain’s non-lucrative visa, require proof of private insurance.
Key Cost Takeaways
- Doctor visits are a fraction of U.S. prices
- Medications are often subsidized or capped at low prices
- Emergency care is affordable or free
How to Prepare Before You Move
- Confirm whether your visa requires private insurance
- Research the availability and pricing of any medications you rely on
- Learn how to register for public healthcare once you’re eligible
Conclusion: Why Expats Appreciate European Healthcare
Imagine never worrying about a surprise medical bill that could be hundreds of dollars, if not thousands. Think about accessing quality healthcare without being tied to a job. This is the experience for millions of expats living in Europe. It’s not perfect, but for many, it’s a massive improvement over the U.S. system.
Ready to plan your move?
Take my Which European City Should You Move To? quiz.
Have questions about healthcare abroad? DM me on Instagram @jordan.giberson.
