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Ranked

What healthcare costs Americans abroad, country by country

Ranked by what private cover typically costs a month, cheapest first, with how each system is organised.

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All 15 countries on this site are ranked. The measure: Typical monthly private insurance premium, US dollars. Reviewed September 4, 2026.

Sweden leads on this measure at $58/mo. Access follows population registration, not citizenship. Once the Migration Agency grants you a residence permit for a stay of one year or more, you register the move with Skatteverket, attend an in-person identity check at a service centre, and receive a personnummer. That number is what gets you into the healthcare system at resident patient fees, plus Forsakringskassan coverage for sick pay and parental leave. Until the personnummer arrives you can be billed at full cost, and permits for employment of one year or less now require you to hold comprehensive private health insurance covering urgent care, hospitalisation, emergency dental care and medical repatriation. Budget for private cover for the first few months in any case, because registration can take several weeks to a few months. Read the Sweden guide for the figures behind it and the source beside each one.

Ordered by the measure named above. Cost indices use a US national average of 100 and money is monthly in US dollars. Every row links to the country guide that carries its sources.
#CountryPrivate coverCentre rentNet salaryWhat it means
1Sweden$58/mo$1,206$3,475Access follows population registration, not citizenship. Once the Migration Agency grants you a residence permit for a stay of one year or more, you register the move with Skatteverket, attend an in-person identity check at a service centre, and receive a personnummer. That number is what gets you into the healthcare system at resident patient fees, plus Forsakringskassan coverage for sick pay and parental leave. Until the personnummer arrives you can be billed at full cost, and permits for employment of one year or less now require you to hold comprehensive private health insurance covering urgent care, hospitalisation, emergency dental care and medical repatriation. Budget for private cover for the first few months in any case, because registration can take several weeks to a few months.
2Norway$60/mo$1,642$4,912Access follows membership of the National Insurance Scheme, not citizenship or tax status. NAV's rule is that if you live in Norway legally and your stay lasts or is intended to last at least 12 months, you are a member from your date of entry. Employment in Norway also triggers compulsory membership for residents of countries outside the EU/EEA. In practice a US citizen who arrives on a skilled worker or family immigration permit is covered almost immediately and pays only the standard user fees. The trap is family: Helfo states that dependent family members must apply to NAV for their own membership, and without it they get only limited healthcare coverage. Visitors and remote workers on visa-free status get nothing back from the scheme beyond care that is an urgent medical necessity, so travel or expatriate insurance is essential until your permit and membership are in place.
3Portugal$75/mo$1,200$2,077Access follows legal residence, not employment or contributions. Once AIMA issues your residence permit you register in the Registo Nacional de Utentes at your local centro de saúde with your permit, passport, NIF and proof of address, and receive a número de utente that gives you full SNS coverage on the same footing as a Portuguese citizen. Before the permit arrives, a junta de freguesia declaration proving more than 90 days in the country gets you urgent and vital care at SNS expense, but not registration with a family doctor. AIMA requires proof of health cover (private insurance or SNS registration) at the permit appointment, so almost everyone buys a private policy for the first year.
4Spain$90/mo$1,390$2,620Anyone who works in Spain and pays into Seguridad Social, plus their dependants, gets full SNS cover from day one. Non-working residents on a digital nomad or non-lucrative permit generally must hold private insurance until they qualify for the convenio especial, a public buy-in that costs 60 euros a month under 65 and 157 euros a month at 65 and over, requires one year of prior residence plus municipal padron registration, and excludes the pharmacy benefit.
5Canada$95/mo$1,433$3,210Permanent residents qualify for a provincial health card. Work permit holders usually qualify too, but the test is provincial: Ontario requires full-time work for an Ontario employer for at least six months and no longer applies a waiting period, while most other provinces start coverage at the end of the second full month after you establish residence. IRCC advises new arrivals to hold private insurance for up to three months. Visitors and remote workers on visitor status are not covered at all.
6New Zealand$95/mo$1,112$3,392Eligibility for publicly funded health services requires a residence class visa, New Zealand or Australian citizenship, or a work visa that allows you to stay for two years or more (counted from your first day in New Zealand, and able to be met by stacking consecutive visas). A US citizen on a three-year Accredited Employer Work Visa is eligible from arrival; someone on a working holiday visa, a visitor visa or a short work visa is not, and must pay full cost for non-accident care. ACC covers accidental injury regardless of visa status, and emergency and infectious-disease treatment is available to everyone.
7the UK$112/mo$2,370$3,566Anyone in England can register and consult with a GP without charge, and accident and emergency care is free to everyone regardless of immigration status. For hospital and specialist care you need to be ordinarily resident or to have paid the Immigration Health Surcharge, which is £1,035 per person per year on most visas (£776 per year for students, dependants and under-18s) and is charged upfront for the full length of the visa. Overseas visitors who are not exempt are charged 150 percent of the cost of NHS treatment.
8Australia$130/mo$1,675$4,996Permanent visa holders (subclass 189, 190, 186, 858 and partner visas) can enrol in Medicare as soon as they arrive in Australia. US citizens on temporary visas cannot: Australia has reciprocal health care agreements with eleven countries and the United States is not one of them. Working visa applicants, including subclass 482 and 485, are required to hold Overseas Visitors Health Cover for the length of their stay, and student visa holders must hold Overseas Student Health Cover.
9Mexico$150/mo$765$1,010Legal residents can enrol voluntarily in IMSS through the Seguro de Salud para la Familia (Modalidad 33), a single annual premium priced by age. The 2026 schedule runs from MXN 9,300 at ages 0-19 to MXN 22,150 at 80 and over, about USD 550 to USD 1,306 a year at the Banxico FIX rate of 16.956 MXN/USD. The brackets most movers fall into are MXN 12,350 at ages 30-39, MXN 14,350 at 40-49, MXN 14,850 at 50-59 and MXN 20,600 at 60-69, so roughly USD 730 to USD 1,215 a year. IMSS screens for pre-existing conditions and applies waiting periods before some treatments, so confirm the current rules before relying on it. Registered residents with a CURP can also enrol in IMSS-Bienestar. In practice most American residents use private hospitals, paying cash for routine care and carrying a Mexican major-medical policy for catastrophic cover. Medicare does not pay for care in Mexico.
10Japan$160/mo$1,280$1,985Enrollment is mandatory, not optional: anyone registered as a resident with a residence card valid for more than three months must join one of the two systems, and you sign up at the ward or city office when you register your address. There is no waiting period and no pre-existing condition exclusion. The one significant gap is the Digital Nomad status, which does not come with a residence card or resident registration, so those holders cannot join the public system and must carry private medical cover with at least 10 million yen of treatment coverage for the whole stay.
11Thailand$180/mo$475$485The Universal Coverage Scheme is for Thai nationals, so no foreigner joins it by moving here. If you work legally on a Non-Immigrant B and a work permit, your employer enrolls you in the Social Security Scheme and you get its medical benefit at a designated hospital, which is real cover but routes you into the public tier. The authority for that route is the Social Security Office under the Ministry of Labour, not the National Health Security Office, whose Universal Coverage Scheme is restricted to Thai nationals; the official link on this page points at the Social Security Fund benefits pages for that reason. Everyone else, meaning DTV holders, retirees, Privilege Card members and LTR holders, is on private insurance or paying cash. Two long-stay routes make insurance compulsory: the Non-Immigrant O-A requires cover of at least 3,000,000 baht per policy year for the whole stay, and the LTR visa requires health insurance of at least 50,000 dollars, Thai social security membership, or 100,000 dollars held in a bank account for twelve months. Medicare does not pay for care in Thailand, which is the single most expensive assumption an American retiree can bring here. One caveat on the premium figure shown on this page: there is no official Thai statistic for expatriate private insurance premiums, so 180 dollars a month is an editorial planning estimate for a mid-range international policy covering a healthy applicant in their forties, not a quoted rate. Thai and international insurers price individually by age, deductible, hospital network and pre-existing conditions, and premiums rise steeply after 60, so get real quotes before you budget.
12the Netherlands$182/mo$1,640$3,950Access is tied to residence and work, not nationality, and taking out cover is a legal duty rather than a choice. From the day you register with a municipality or start paying Dutch payroll tax you are insurable under the Wlz and legally obliged to take out a basisverzekering, and no insurer may refuse you. Read the insurance figure on this page accordingly: it is the compulsory basic premium every resident must pay, not an optional private policy you can decline, so budget it as a fixed cost of living here. It is also partly refundable. Zorgtoeslag, the healthcare allowance, is worth up to EUR 129 a month for a single person in 2026 and EUR 246 for a couple, tapering to nothing at EUR 41,000 of income for a single person, so lower earners pay well below the headline premium. Cover begins on the day you became insurable rather than the day you sign the contract. If you never sign up, the CAK sends warnings, then two fines, then enrols you with an insurer itself, and you personally carry the cost of any care received while uninsured. Students and non-working residents on a permit that does not create Wlz insurability instead need private or international cover. US Medicare provides no coverage in the Netherlands.
13Ireland$184/mo$2,263$4,059Access is based on residence, not nationality or contributions. Anyone the HSE accepts as ordinarily resident, meaning you have lived in Ireland for at least a year or intend to live there for at least a year, gets either full eligibility (Category 1, medical card) or limited eligibility (Category 2). Category 2 covers free public hospital care and consultant outpatient appointments on GP referral, but not GP visits or most prescriptions. Non-EU nationals must document residence with tenancy agreements, bank statements or utility bills dated within the last 12 months, and dependants must qualify separately. Several immigration permissions, including Stamp 0 retirement, STEP and student permission, require you to hold private medical insurance regardless of HSE eligibility.
14Italy$200/mo$1,200$2,690Non-EU residents holding a permesso di soggiorno for employment, self-employment, family reasons or asylum are enrolled in the SSN automatically and at no extra cost. Holders of an elective residency permit are not in the compulsory category and must either buy private cover or take voluntary SSN enrolment, which since 1 January 2024 costs a minimum of EUR 2,000 per year (about USD 194 per month) under Law 213/2023, reduced to EUR 700 for students and EUR 1,200 for au pairs. Enrolment runs by calendar year and cannot be pro-rated. Every long-stay visa applicant must show private health insurance for the visa itself; the digital nomad visa requires at least EUR 30,000 of medical and repatriation cover.
15Germany$465/mo$645$3,400Health cover is compulsory for everyone resident in Germany and you must show proof of it to get a residence permit. If you take a job, you are enrolled in a statutory fund from your first day and your employer pays about half the premium; there is no waiting period and no exclusion for pre-existing conditions. Employees earning above 77,400 euros gross a year in 2026, the compulsory insurance threshold set by the Ministry of Labour, may opt out into private cover, as may the self-employed and freelancers. US travel or expat policies are usually not accepted as proof for a residence permit unless they meet German minimum-cover rules.
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What this ranking does not settle

A premium is not the whole bill. What matters as much is what the public system admits you to and when — that is on each country’s healthcare page, and the waiting periods differ more than the premiums do.

Nothing on this page is a new figure. Each one is taken from that country's guide, where it sits beside the official source it came from and the date that source was read. If a number here matters to a decision, follow it through to the country page and check the source yourself.

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Top of this ranking

The three countries this list opens on, with the full guide behind each.

Moving to SwedenMoving to NorwayMoving to Portugal