Getting into the local health system, and what it does not cover

Newcomers often assume that holding a residence permit means being in the health system. In most places it does not. Access follows from something else — employment contributions, a registration step, or a qualifying period — and until that is done you are outside.

The routes in

Through employment. The most common. Contributions are deducted and entitlement follows, though frequently after a qualifying period rather than from the first day.

Through self-employment. Usually possible, with the obligation to register and pay contributions falling on you rather than an employer — and it is easy to leave undone.

Voluntarily. Some systems allow residents outside employment to contribute directly.

As a dependant. Family members of an insured person are often covered, but this is rarely automatic and usually requires a separate registration naming them.

Through a reciprocal agreement. Where one exists between your country and your destination, it may cover you for a defined period — worth checking, and worth not relying on beyond its stated scope.

The dependant route is the one where families get caught. The working member is registered and assumes the family is covered by extension, and the omission surfaces when a child needs treatment.

The waiting period

Between arrival and entitlement there is usually a gap, and it needs to be covered:

• Establish the length before arriving, not after
• Hold private cover across it — this is precisely what interim policies exist for
• Register on the first possible day, since entitlement often runs from registration rather than from arrival
• Keep proof of the gap being covered, which matters if cover is a permit condition

The third point is worth acting on immediately. Delay in registering usually delays entitlement by the same amount, so a month of postponement is a month added to the wait.

Registering with a doctor

In many systems this is the gateway to everything — referrals, prescriptions, specialists — and nothing else works until it is done.

• Do it on arrival, while well, not at the first illness
• Practices may be catchment-based, so the address determines the options
• Bring identity, address proof, insurance number and vaccination records
• Ask for a summary of your medical history from your previous doctor before leaving
• Register children separately

The fourth is easy to arrange before departure and difficult afterwards. A history summary and a current medication list prevent the new doctor starting from nothing, which matters most for ongoing conditions.

What public systems commonly do not cover

Even full entitlement rarely means everything is free:

• Dental care, beyond limited treatment
• Optical care and glasses
• Prescription charges, sometimes with exemptions
• Physiotherapy and mental health, often with long waits or partial cover
• Private rooms and elective procedures
• Repatriation — almost never covered by any public system
• Treatment while travelling outside the country

The last two are the reason many residents keep a supplementary policy alongside full public entitlement. Public systems treat you inside the country; they do not bring you home from elsewhere, and for someone living far from family that is often the cover that matters most.

Prescriptions and continuing treatment

For anyone arriving on regular medication, this needs handling in the first weeks rather than when the supply runs low:

• Bring enough for the transition, with documentation
• Take the generic name with you — brand names differ between countries
• Expect substitution; the same molecule may be sold differently
• Book an early appointment to transfer the prescription
• Check availability in advance where a medication is unusual

The last is the one that occasionally forces a real decision. Some medications are simply not available, or not licensed, in a given country, and finding this out before the move allows a planned change of treatment rather than an urgent one.

Frequently asked questions