Health insurance requirements for a residence permit in Malta

Health insurance is not an afterthought for Americans moving to Malta. For most non-EU residence routes, proof of private cover is a condition of getting the permit, and for special tax programmes it is a condition of keeping the status. The rules differ by route and are written in different places: Identità's healthcare requirement, the Nomad Residence Permit checklist, and the legal rules for the Global Residence Programme and the Malta Retirement Programme. This guide sets out what each one asks for, and why Medicare does not fill the gap. It does not recommend any insurer or policy.

Identità's healthcare requirement

Identità, the agency that issues residence permits to non-EU nationals, published new healthcare requirements under the Healthcare (Fees) Regulations, Subsidiary Legislation 35.28. They apply to new applications from 1 August 2024.

### Who it covers

New and still-abroad applicants applying for employment purposes, and family members applying under both the regulations and policy, need a health insurance policy.

### What the policy must do

• Minimum coverage of €100,000.
• Cover medical treatment, including hospitalisation, in Malta and, if necessary, in other European countries.
• Be valid for the whole first year of the residence permit.
• Not be revocable during that period.

### Students

Students at the University of Malta, the Malta College of Arts, Science & Technology or the Institute of Tourism Studies are exempt. Students on courses elsewhere need a policy with €100,000 minimum coverage for both new and renewal applications, covering their whole stay.

The Nomad Residence Permit

Residency Malta's checklist for the Nomad Residence Permit requires a fully comprehensive health insurance policy for Malta and internationally, covering the main applicant and all dependants. The policy must:

• cover one full year;
• cover the validity period of the residence card.

The checklist states clearly that a travel insurance policy is not an alternative and will not be accepted. Check that the document you submit is described as health insurance, not travel cover.

Special tax programmes

The legal rules for Malta's special tax programmes contain their own insurance conditions. These are conditions for the tax status, separate from the residence card.

### Global Residence Programme

The Global Residence Programme Rules (Legal Notice 167 of 2013) require the applicant to hold sickness insurance for all risks across the whole of the European Union normally covered for Maltese nationals, for themselves and their dependants. The rules list losing this insurance after the appointed day among the reasons the special tax status ends.

### Malta Retirement Programme

The Malta Retirement Programme Rules (Subsidiary Legislation 123.134) set the same condition: sickness insurance for all risks across the whole EU normally covered for Maltese nationals, for the beneficiary and dependants. Not holding it after the appointed day is a ground for ceasing to hold the special tax status.

### Rule changes

Legal Notice 195 of 2026, the Individual Tax Programme Rules, was published in the Government Gazette on 14 July 2026. If you are applying under one of these programmes, read the current rules for the insurance wording before you buy cover.

Why Medicare does not solve this

Many retirees assume Medicare travels with them. It does not, in most cases.

### Medicare abroad

Medicare.gov states that Medicare usually does not cover health care while you are traveling outside the US. The US for this purpose means the 50 states, the District of Columbia, Puerto Rico, the US Virgin Islands, Guam, the Northern Mariana Islands and American Samoa. Malta is outside.

The exceptions are narrow and mostly tied to being in or living in the US:

• you are in the US when an emergency occurs and a foreign hospital is closer than the nearest US hospital that can treat you;
• you are traveling through Canada by the most direct route between Alaska and another state when an emergency occurs;
• you live in the US and the foreign hospital is closer to your home than the nearest suitable US hospital.

None of these apply to someone living in Malta.

### When the exceptions apply

Even in those rare cases, Medicare.gov says it pays only for services Original Medicare covers. Part A covers hospital care when you are formally admitted as an inpatient to the foreign hospital. Part B covers ambulance and doctor services immediately before and during that covered stay. Ambulance transport to a foreign hospital is covered only with admission for covered inpatient care, and return trips home are generally not paid.

### Vaccines before you go

One thing Medicare does help with before departure: Part D covers vaccines recommended by the Advisory Committee on Immunization Practices without a copayment or deductible. The CDC's Malta page advises being up to date on routine vaccines, says all international travelers should be fully vaccinated against measles with MMR, and suggests considering hepatitis A vaccination for most travelers. Sorting these out in the US, before your Maltese cover begins, avoids paying for them abroad.

### Drugs and supplements

• Part D drug plans do not cover prescription drugs bought outside the US.
• Medigap policies may cover emergency care when you travel outside the US. This is emergency cover during travel, not a residence-grade policy.

### What that means for a permit

Identità's and Residency Malta's requirements are written for cover that pays for treatment in Malta. A Medicare card does not meet them. Whether you keep paying Part B premiums while abroad is a separate choice that affects your cover when you are back in the US.

Checking a policy against the rules

Before you submit a policy, compare its wording with the rule that applies to your route:

1. Amount. Is the limit at least €100,000 where Identità's rule applies?
2. Territory. Does it cover Malta, and Europe or the whole EU where required?
3. Hospitalisation. Is inpatient treatment included?
4. Duration. Does it run for the full first year and the card's validity?
5. Revocability. Can the insurer cancel it mid-term?
6. Dependants. Are all family members named?
7. Type. Is it health insurance, not travel insurance?

Ask the insurer for a certificate that states these points in English. It makes the review easier.

After the permit

The insurance rule for the permit is the starting point. Public healthcare access in Malta depends on your status and contributions. The Ministry for Health describes free public services including acute care at Mater Dei Hospital and primary care, but entitlement is checked separately. Keep your policy in force until you have confirmed your entitlement.

Common questions

How much health insurance does Malta require for a permit? Identità requires at least €100,000 of cover for new employment-purpose applicants and family members, including hospitalisation in Malta and, if needed, other European countries.

Is travel insurance accepted for the nomad permit? No. Residency Malta's checklist says travel insurance is not an alternative and will not be accepted. The policy must be comprehensive health insurance for a full year.

Does Medicare cover me in Malta? In most cases no. Medicare.gov says Medicare usually does not cover care outside the US, and Part D does not cover drugs bought abroad.

Do the GRP and retirement programme require insurance? Yes. Both rules require sickness insurance for all risks across the EU normally covered for Maltese nationals, for you and your dependants.