Access to health care in Malta

One of the most important aspects when making the decision to live in another country is access to health care. This aspect has become very relevant nowadays with the issue of the pandemic caused by the COVID-19 coronavirus, but the truth is that it should always be a point to consider when deciding to start a new life in other latitudes. In this post I am going to tell you how the health services in Malta work, what my experience has been like as a Latin American user of these services and what is good and bad about access to health care in Malta.

What does travel insurance cover me for?

The first aspect to review is the issue of travel health insurance. There are many types of insurance and in fact for Latin Americans it is necessary to have one to be able to enter the Schengen area as a tourist and it must also have a minimum cover of €30,000, as well as emergency hospital care and repatriation expenses for medical reasons. Many credit cards include these insurances when you buy tickets with them, so you should check with your bank if the coverage is sufficient, in some cases you can pay extra to have the necessary coverage.

I will tell you about my experience. On a trip I took as a tourist to Malta in 2016, when I was not yet living here, my wife had otitis and we used the health insurance we had bought. It was from Assist Card, which is quite popular in Latin America, and we bought it to have additional security to that of the credit card. When we needed medical assistance, we called Assist Card and they told us that they did not have an agreement with a specific doctor in Malta and that we should go and see a private doctor, ask for an invoice and then they would reimburse us for the cost, together with the medicines, for which we also had to present the prescription and the receipt. We did indeed do so, and although the refund process took much longer than expected and we had to go through some bad times, we were eventually refunded the cost of the care and medication, some three months after the trip. I have actually used Assist Card for many years, but due to the lousy refund experience I would not recommend it, there are too many similar products to have problems when it comes to using it. It is very important to call the insurance company before you use it to make sure that you are doing the right thing and that there is no way they will refuse to reimburse you. Travel insurance can be used for a maximum of 90 days in the Schengen area, as it is linked to the tourist status and must be purchased for the time you are staying in Malta or the Schengen area in general.

Please note that if you purchase the insurance for one year and then change your immigration status in Malta, the travel insurance will most likely not be of any use to you, as it is a product for tourists. Prices vary widely, so compare several providers (costs and coverage) before purchasing one.

Insurance for long stays (students, workers, etc.)

Another issue to keep in mind about access to health care in Malta is that when applying for a student visa or residency on the island, it is necessary to present a medical insurance that covers at least emergencies. In Malta there are insurance companies that offer these products at very affordable prices (from €120 per year for the cheapest insurances) such as GasanMamo or La Ferla and that offer you the strict minimum necessary to present the documents to Identity Malta, the Maltese migration service. These insurances will only cover you for emergency hospital care, however, you will not be covered for private care with a doctor.

The truth is that this type of insurance is very basic, so most of those who purchase it do so in order to comply with the requirements of Malta's immigration authorities for visas and permits. I know personally the case of a Latin American student who had appendicitis and his insurance covered all his treatment. It took a lot of paperwork, but in the end he had a successful operation and recovery, covered by the insurance. However, if you are looking for insurance to cover medical visits and other non-emergency consultations, there are plenty of options on the expatriate insurance market whose costs depend on the type of cover, but can be found from €50 per month and upwards.

Medical care in pharmacies

Something very unique is that you can get access to healthcare in Malta through low-cost private doctor's care without the need for an appointment, in the private sector. Pharmacies usually have a doctor in consultation (you should check the opening hours at your local pharmacy) and the price of the consultation can range from €10 to €20 depending on your neighbourhood, the pharmacy, etc. You can usually go without an appointment, go into the waiting room and ask who is the last patient waiting and sit down. When the next patient comes in, you tell them that you are the last in the queue and everyone knows after whom it is their turn. I have been to the pharmacy doctor several times in different pharmacies and I have always had very good attention and I have never had to wait more than an hour, which is very reasonable considering that you are coming without an appointment.

The doctor will prescribe medicines which you can buy from the pharmacy. In Malta they use both brand-name and generic medicines when available, so the pharmacist will ask you if you prefer a particular brand and you will be able to choose. Anyone can go to these doctors, regardless of their immigration status in Malta. I went for example when I came as a tourist before, and even when my parents visited me last autumn, we went to my local doctor without any complications. In fact, one of the best doctors I have seen in Malta is Dr. Camilleri who works at the O'Hea Pharmacy in Gzira, which is now my neighbourhood pharmacy.

Medical care in health centres

The other option for accessing health care in Malta is to go to your district health centre. Here you can usually go if you have a European Health Insurance Card or if you are covered by the Maltese social security system. Students working part-time with a JobsPlus employment licence are covered by social security and therefore have access to Maltese social security. This was my case, as I was an MBA student in Malta and had a part-time job, which gave me access to social security. In order to be seen you must bring your resident's card and your last pay slip, which shows your social security contributions. You can go without an appointment and ask to see a doctor. In my experience at the Health Center in Gzira, I have never had to wait more than 30 minutes to see a doctor and the care is free of charge. Medicines prescribed by the doctor must be bought at a pharmacy and are not covered. The doctors at the pharmacies can order laboratory tests, which are taken at the health centre if you have access to social security and are also free of charge. You will receive a summons in the post with the date and time of your appointment and the tests will be carried out. The results will then be posted in your electronic medical record, which you can access using your E-ID (electronic identification for which you must request access once and then it is configured for all state services). These results can be consulted by your doctor without the need for you to go to the doctor's office again.

Medical care in public hospitals

The most important hospital in Malta is Mater Dei. It is a very large hospital which has almost all medical specialties centralised here and to which you usually have to go with a prior medical appointment or referral from a primary care doctor. If you have social security, access will be free, although you must first pass the "billing" collection area to hand in your last payment slip, together with your resident's card, to validate your state-covered care.

Mater Dei is a fairly modern hospital, which has all the facilities for patients and their families, including an Identity Malta office for the registration of newborns, as well as pharmacies and even premises for NGOs working to support patients. There are other hospitals, such as Mount Carmel or Sir Anthony Mamo Cancer Hospital, to which you can be referred if you have specific pathologies.

Medical care in private hospitals

Another way to access health care in Malta is through the private sector, as there are also several private health care centres on the island. The largest private hospital on the island is St James's, which has several locations in Sliema, St Paul's and Zabbar, for example, where you can make an appointment for a consultation with a specialist. There are also other hospitals such as St Thomas' or even private clinics. Some private insurances may reimburse you for care in these hospitals, but you should check with your insurer beforehand.

Medical care for formalities

This is something you will find out when you arrive in Malta, especially if you have to apply for a residence permit or a driving licence, which by the way I invite you to read all the details on how to obtain it, in this postIf you do not have a private sector job, you will have to do the formalities in the private sector. Some procedures are inexpensive, such as the form to be filled out by your doctor for your driving licence. This can be done by a doctor in a pharmacy, or in consultation with a doctor in one of the island's hospitals or private clinics, and usually costs the cost of the consultation. Generally speaking you should not pay more than €20 for this procedure.

Another procedure, which is considerably more expensive, is the health screening for the work permit, as it includes x-rays for some countries or even vaccination certificates or COVID tests, according to the new provisions of Identity Malta. In the case of x-rays you will have to go to a private clinic, by appointment, and the x-ray costs around €70. You will then have to take this x-ray, together with a form, to a private doctor who will also charge you for the consultation (between €10 and €20) to sign and stamp it. This document is what your employer will submit to the health department, who will validate your fitness to work. Sounds complicated? Don't worry! Our premium consultancies include all the support for procedures like this, so you will always have an experienced advisor by your side to help you with everything you need.

My opinion as a user of health services

I must say that, as a frequent user of health services, I am fully satisfied with the access patients in Malta have to quality health services. I am hypertensive and have to take additional pills due to hereditary diseases, which I have kept under control for several years now. Being a user of premium health services in Peru, which I accessed through one of the best private insurances provided by my employer, I can say that the service is much better in Malta. My illnesses are chronic, so I have to take pills every day. Even so, in Peru I had to visit my cardiologist every month to get a one-month prescription. The insurance, one of the best, by the way, covered 90% of the treatments and I had to pay "only" a co-payment of 50 soles per consultation, about 15 euros. The 10% I had to pay for treatments was about 150 soles, or about 40 euros. In total I paid about 55 euros per month out of pocket, and my insurance cost my employer a considerable amount. Similarly, on the days I went to the cardiologist, I had to spend 3 to 4 hours of my time, as I had to arrive at least 30 minutes before the appointment time to pay, then wait to be seen, then queue again at the pharmacy and finally return home or to my place of work.

I did this for several years, with annual check-ups in which I had a couple of additional tests, which also had a co-payment, and biannual blood tests, which also cost me about 30 euros. In all this time, they never changed my medication, it was always exactly the same. Needless to say, the system seemed to me to be poorly designed with the patient in mind, forcing me to travel in the difficult Lima traffic, at considerable out-of-pocket cost. More than once, in the pharmacies of these renowned private clinics, I was told that they did not have my medication and that they would "bring it to me" in the next few days, forcing me to follow up with them because they rarely kept their promise to call me, which obliged me to keep an extra stock of my medicines, "just in case" they were going to run out. In Malta the situation was diametrically opposite. When I first arrived in Malta I brought several boxes of medicines with me from Peru as I did not know what access to medicines would be like before I had a residence permit. I went to a pharmacy doctor and was given a prescription for 6 months, which was already a first change. Without any insurance to cover my medication, I was spending around 50 euros per month for the full price of medication, which was cheaper than in Peru, where I had one of the best health insurances in the country. Then, once I got my resident card and then my Jobs Plus work permit as a student (part-time) and started paying social security contributions, my pharmacy doctor told me that some medicines could be covered by social security. At that time he made an appointment for me to have a blood test and also made an appointment with a cardiologist in the public system to validate my access to the programme. From then on everything was covered by the social security. Two weeks later I received a letter in the post with the date and time of the appointment at the health centre for the blood samples. The next day the results were posted in my medical records online. A few weeks later I received a phone call from the public service cardiologist, as they were not doing live consultations due to COVID issues, and she did a phone interview with me, checking my blood test results from her computer. She finally included me in the state programme for group V diseases, which I suffer from and which are among the most common. All in all, it must have taken me a couple of months to be accepted into the programme, and I only had to pay for my initial appointment with Dr. Camilleri at the O'Hea pharmacy in Gzira. After that, it was all by mail or online and free of charge.

POYC (Pharmacy of your Choice) system: How does it work?

Two days after my online appointment, a yellow paper arrived at my house, indicating the diagnosis and the prescription that they give you for 10 years. Unbelievable! Although the truth is that it makes a lot of sense, given that these are chronic diseases. Then, at your routine check-ups, your GP can modify the prescription, always within the same diagnosis, of course. With this yellow paper you should go to any pharmacy in Malta, the one closest to your home, for example, and apply for registration in the POYC system. You only need to bring your last pay slip, your resident card and the yellow paper. Within two or three working days your registration is registered at the pharmacy you have chosen and from that moment on you will be given your medicines to cover a period of two months and you will be given the date of the next time you have to pick up the next medicines, always at the same pharmacy. Of course, if you move, you can then ask to be transferred to a new pharmacy closer to your new home.

Every two months I go to the pharmacy, just with my yellow sheet, they hand me my medicines and I leave. It doesn't take five minutes and it's completely free. The check-ups and analyses are every six months. The truth is that for me this is a system designed with the patient in mind. Things are easy and access to treatment is automatic and fully covered by social security. Access to healthcare in Malta is easy, free and universal. Having worked in the health sector in Peru, I know very well the main deficiencies and problems we have in terms of infrastructure, financing, among others, however, there are quite simple aspects that can drastically facilitate the patient's life such as an electronic medical record, telephone follow-ups and, of course, free and timely access to quality treatments. In that sense for me the island has a huge plus, as access to health care in Malta is very good and that is an element that we cannot neglect when choosing a new place to live.

In conclusion: access to health care in Malta is very good.

Indeed, access to health care in Malta is very good. It is not only the rankings that tell you that, like this from the prestigious medical journal The LancetThe Malta Health System, which ranked Malta among the 10 best health systems in the world, but not the users. In my case, my experience has been one of the most positive and it is one of the important reasons why I am happy to have chosen Malta as my destination to live.