Medical treatment in Europe for foreigners with second citizenship or residency

• Suitable statuses: Caribbean or Malta citizenship; EU residency

• Investments: $100,000+

EU countries provide all types of medical services, from the treatment of oncological diseases and complex operations to pregnancy follow-ups, rehabilitation and care for the elderly.

The cost of treatment depends on the chosen country, clinic, and specific services.

Caribbean citizenship allows you to come to the Schengen countries without a visa and spend up to 90 days out of 180 there. Thus, an investor can go for treatment without delay.

If the treatment requires more time than planned, an extended stay in the country can be requested.

Participation in Caribbean citizenship programs requires at least $100,000 if investments. The application can include a spouse, children, parents, and, sometimes, siblings.

Individual cost calculation for Caribbean citizenship

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An EU residence permit or permanent residence allows you to stay in the country of residence without restrictions. If it is part of the Schengen Area, you can spend up to 90 days out of 180 in other member states.

European residents can undergo complex procedures in one country and go for rehabilitation to another state. An investor can also choose a clinic in the country of residence and undergo a full course of treatment there without extra trips.

Portugal, Greece, Spain, and Malta grant residence permits by investment. Permanent residence programs for investors operate in Malta and Cyprus.

All these countries, except for Cyprus, are part of the Schengen Area; this expands the opportunities for investors to get treatment abroad. An investor doesn’t have to permanently live in the chosen state to maintain a residence permit obtained by investment. The minimum investment amount is €150,000.

Austria, Switzerland, Portugal, and other countries offer residence permits to financially individual persons. It is a non-investment path. A resident must spend at least 6 months a year in the country. Such residence permits are suitable for relocation, not just to get treatment.

A prerequisite for obtaining an EU residence permit is health insurance. It covers the cost of treatment in the clinics of the selected country in part or in full.

Malta citizenship allows you to be treated in the country or other EU states without time limits. Sometimes, investors pay for clinic services at reduced prices or are treated for free.

An investor can get a Maltese passport for exceptional services by direct investment. It is a naturalisation path: investors hold residence permits for one or three years before applying for citizenship.

How to save on treatment. Citizens of the EU states, including Malta, are covered by state healthcare systems. They get access to medical services in their country of residence on special conditions and can save on treatment in other member states.

European residents covered by the state social security system receive EHICs, European Health Insurance Cards. The card is valid when travelling to other EU countries, the UK, Iceland, Liechtenstein, Norway, and Switzerland. The cardholder is provided with emergency medical care on the same terms as the locals: free of charge or at reduced prices.

An EHIC doesn’t replace travel insurance and is not valid if medical treatment is the purpose of the trip.

You can receive reimbursement from the public health insurance fund in your country of residence for treatment abroad. There are two ways to get money back:

1. Fill out the S2 form in advance and get permission.

2. Request a refund after returning home.

In the first case, you can be treated only in public clinics. The latter path allows treatment in public and private clinics.

Some procedures must be approved in advance. The conditions depend on the rules in the country of citizenship; they can be clarified at a national contact centre.

If residents of the country where the investor went for treatment get medical care for a fee, the investor will have to pay for the procedures. The costs will be reimbursed under the rules of the country of treatment.

Individual cost calculation for Maltese citizenship

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• Suitable statuses: Caribbean, Vanuatu or Malta citizenship

• Investments: $100,000+

People go to the UK to have complex operations and cure infertility, oncological and cardiovascular diseases. Medical services for non-residents are quite expensive, but costs can be reduced in the case of emergency medical care.

Treatment in the UK without a medical visa is possible with a passport of Vanuatu, Malta or a Caribbean country like Antigua and Barbuda, Dominica, Grenada, St Lucia, or St Kitts and Nevis. Citizens of these countries spend up to 180 days in the UK without visas.

How to save on treatment. EHICs are valid in the UK. They can be obtained by Maltese and other EU citizens and residents covered by the state social security system.

With an EHIC, you can get medical care during your trip to the UK on preferential terms if:

• there is an emergency;

• help is required due to pregnancy or a chronic illness.

The card does not replace travel insurance. Therefore, it doesn’t cover part of the costs, such as transportation to the country of residence.

You will not be able to use the EHIC if the purpose of the trip is treatment or childbirth in the UK. If there is no card, unscheduled treatment will cost 1.5 times more than for the British.

EU citizens can undergo planned treatment in public clinics in England free of charge. They fill out the S2 form in advance and obtain permission from the insurance institution in the country of citizenship.

Practical Guide

Practical Guide

Comparison of citizenship and residency by investment programs

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1. A Caribbean passport is suitable for trips to the Schengen countries for up to 90 days.

2. An EU residence permit allows for undergoing a long-term course of treatment in the country of residence. EU citizenship allows staying in other member states for more than 90 days.

3. Vanuatu, Malta and Caribbean citizens can visit the UK without visas and spend up to 180 days there. This opportunity can be used if treatment is required in British clinics.

4. EU citizens, including Maltese passport holders, receive European Health Insurance Cards (EHICs). The card allows partial or full coverage of urgent treatment costs in the EU, Norway, Iceland, Liechtenstein, Switzerland, and the UK if medical aid is needed during the trip.

5. EU and British citizens can be treated in public clinics of other EU countries and England on preferential terms. They fill out the S2 form in advance and obtain permission from the public insurance institution in the country of citizenship.