Who wouldn’t want to retire to Malta? This gorgeous Mediterranean island calls Italy and Tunisia its neighbors and is famous for its beautiful mild climate and rich history, with French, British, Arab, Greek, and Roman influences.
The cost of living is low – think free ferries and .50 cent all-day bus fare. Elegant restaurant meals with fine wine are less than 50 euros, while basic take out lunches are just a few euros at most. Small, simple countryside accommodations start at a few hundred euros, while smart city center flats might start at 600 euros — not exactly dirt cheap but well under the European average. And, perhaps best of all, Malta has a robust, affordable healthcare system that’s user-friendly for expats and retirees.

1. Malta Is A Healthcare Pioneer
A lot of countries claim to have a long history of healthcare innovation but few can compete with Malta. A fully functioning hospital was operating in the country as far back as the year 1372, which some argue makes it the very first “modern” hospital ever. That legacy continues in recent years. In World War I, the entire country was nicknamed the “Nurse of the Mediterranean” because so many wounded soldiers were treated there.

2. It’s Also A Healthcare Superstar
Malta is one of the world’s smallest countries but it ranks a highly impressive fifth overall in the World Health Organization’s list of the world’s most efficient healthcare systems. It beats out healthcare powerhouses like Singapore, the United Kingdom, Canada, and the United States. On the Euro Health Consumer Index, it places a more modest but still respectable 23rd. Poor scores for a lack of smoking prevention programs and patient access to e-records and online appointment booking dragged down the country’s overall score.
3. The Country Has A Two Tiered System
Malta has a well-established public healthcare system, known as the government healthcare service. Care provided through this system is free at the point of delivery. The public system covers just about everything you can imagine, including hospitalization, surgeries, pregnancy, childbirth, and rehabilitation. Private healthcare is also common in the country and many people use a combination of the two systems to get the best possible care.

4. GPs And Hospitals Make A Strong Team
General practitioners are in charge of delivering primary care, while the hospital takes care of secondary and tertiary services, from treating broken bones to providing specialist services. For just about all non-urgent concerns, a GP is the first point of contact for a patient. All residents are assigned a clinic through which they see their GP based on their place of residence.
There are close to 50 local clinics that are staffed by a GP who holds set office hours every week to write prescriptions and take non-urgent appointments, which are done on a first come, first served basis. Additionally, the are CommCare Assessment Units (CAU) staffed by nurses so that those in need of community-based care (such as seniors) get the treatment they require with a focus on independence.
However, it should be noted that waiting times are a common complaint, which prompts many patients (both expats and local residents) to carry private insurance. Private clinics typically have much shorter wait times. As well, many physicians work in both the public and private systems, making it easy to get referrals to consultants in the hospitals if you need to continue your care.

5. It Has One (Huge) Hospital
At first glance, it doesn’t sound all that impressive to say that Malta has just one main hospital. However, given how small the country is, it makes sense. And what a hospital it is! The Mater Dei Hospital is one of the largest medical facilities in Europe and has 825 beds and 25 operating theaters. And, to be fair, there really is more than one hospital in the country. Malta does have several additional smaller facilities in the form of the Gozo General Hospital, plus specialized facilities for oncology, rehabilitation, long-term care, and more.

6. And Lots Of (Tiny) Pharmacies
Just about every village in Malta is home to at least one pharmacy. Pharmacists can provide basic medical advice like a GP would for non-urgent ailments, and they’re a good resource for things like colds, eye infections, and allergies. It’s worth noting that most pharmacies have limited hours on Saturdays and usually close on Sundays (or share opening duties on a rotating schedule with other nearby facilities.)
7. There Are Some Strict Rules For Foreigners
Anyone who is part of the workforce in Malta (including those who are self-employed), contributes to the country’s social security system and it is this system that funds the public healthcare system. It works out to about 10 percent of your gross salary. However, any non-EU citizens living in Malta who aren’t part of social security must carry their own private health insurance. There are no specifications on how ample your policy must be. As such, depending on your risk tolerance and general health, you might opt for a basic package that covers serious emergencies and pay for more everyday costs on your own. It’s worth noting that most private health insurance packages for coverage in Malta don’t extend beyond the country. If you’re planning to make some trips to southern Europe or North Africa as most expats and retirees do (who can resist being so close to Italy!), make sure to review your policy carefully and see what coverage you have in other countries.
Like many rules, sometimes there’s an exception. Expats who are staying in Malta for more than 3 months qualify for free public healthcare if they have the E121 form, which you need to obtain in your own country before you move. Once issued, you must register it with the Malta Health Department Entitlement Unit. From there, you’ll be issued a Certificate of Entitlement. It sounds like a lot of paperwork — and it is — but it’s well worth it if you’re considering staying in Malta for a long period of time.

8. Care Is High But Costs Are Low
In general, out-of-pocket healthcare costs in Malta are a fraction of what they are in the United States. For instance, a basic doctor’s visit is usually under $50 (and may be as low as $25). A round of basic blood work tests in a lab is a similar cost. Frugally minded expats will want to keep an eye out for special packages and promotions. For instance, you might see a discounted bundle on women’s health services which includes routine preventive care like mammograms and bone density scans. These packages are always cheaper than paying for the tests and appointments separately.
9. Healthy Living Is, Well, Complicated
Malta has an excellent healthcare system and, as you might expect, Maltese citizens enjoy a high quality of life and one of the longest life expectancies in the world. But not everyone would describe the Maltese lifestyle as health oriented. For instance, it is one of the world’s most physically inactive countries and less than 1 percent of the population rides a bicycle on a regular basis. (And, it doesn’t help that Malta is one of the most dangerous cycling destinations in Europe). Once a devotee of the Mediterranean diet (a healthy diet with a heavy focus on fish, olive oil, fruits, vegetables, legumes, and nuts), the country now consumes high amounts of cheese, chocolate, pastry, and processed foods. Consumption of alcohol and tobacco is high and Malta has high rates of obesity and heart disease. But, working in Malta’s favor are its healthcare system, extremely low infant mortality rates, and low violent crime rates. And likely Maltese people would say that their warm, supportive communities and families are a big factor, too!