Healthcare in Malta: the Certificate of Entitlement and the S1 route
The Maltese public system is free at the point of use, with Mater Dei as the main hospital. Pensioners enter it via the CAK and the S1 form, which they have registered at the Entitlement Unit with their biometric receipt, and receive a Certificate of Entitlement. The dentist and the waiting times are the reasons many expats add a private policy alongside.
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Written and checked by Auke on , against the sources at the bottom. Is something no longer right? Report it below and I'll fix it.
Yes, with a Dutch pension you join public healthcare in Malta, on the same terms as a Maltese national. Public healthcare is paid from taxes and free for those entitled to it. You pay the Netherlands a treaty contribution via the CAK instead of a premium.
Two things to know up front:
- You have your S1 (the European form that transfers your healthcare entitlement from the Netherlands to Malta) registered at the Entitlement Unit, next to St Luke's Hospital in Gwardamangia. You bring the biometric receipt you get at your residence registration with Identità. Then you receive the Certificate of Entitlement, the proof of your right to healthcare.
- The trap: the European health insurance card does not count as insurance in Malta if you stay living there.
Route one: with a Dutch pension — the CAK and the S1
Malta is an EU country and therefore a treaty country. Whoever brings a Dutch pension or a statutory benefit registers with the CAK. It assesses the application and sends a letter within four weeks, with an S1 form attached. From the start of your insurance the CAK deducts a healthcare contribution from your pension or benefit every month. So apply for the S1 well before departure.
In Malta it works in two steps:
- First you register your residence with Identità, the Maltese agency for identity and residence. The S1 counts there as proof of health cover, and it does not need to be translated.
- Then you go with your biometric receipt and the S1 to the Entitlement Unit, which issues the Certificate of Entitlement.
You then pass that certificate on to Identità, in person or by email, to complete your registration. You show the certificate at every visit to a hospital or health centre.
| Step | Where | What you bring |
|---|---|---|
| Apply for the S1 | CAK, before departure | your pension or benefit details |
| Register residence | Identità | the S1 as proof of cover |
| Have the S1 registered | Entitlement Unit, St Luke's Hospital, Gwardamangia | biometric receipt and the S1 |
| Complete the registration | Identità | the Certificate of Entitlement |
Route two: with a Maltese job
Whoever works in Malta pays Maltese social contributions through their wages and is thereby covered in the public system. No S1 is needed. Your employer registers you with Jobsplus, Malta's public employment service, and your social security number follows from your employment.
Route three: without a pension and without a job
The European health insurance card is no insurance for those who stay living in Malta. Identità does not accept the EHIC as proof of cover from someone who will live there permanently without paying Maltese contributions and without an S1; the card is for temporary stays. Whoever comes with capital or early retirement and has no right to an S1 shows, at registration, a private policy covering hospital admission and outpatient care in Malta.
Mind the age limits and the cover of existing conditions when you take out such a policy, and include the premium in your monthly budget.
What is the public system — and what is it not?
EURES describes it: the government provides entitled residents with comprehensive healthcare, financed from general taxes. That covers prevention, investigation, treatment and rehabilitation, in health centres and hospitals.
Primary care (the care you can get without a referral) runs through the health centres, with GPs, nursing and clinics for diabetes, eye care and physiotherapy, among others. Mater Dei in Msida is the large public hospital, with 1,140 beds. Gozo has the Gozo General Hospital. Whoever has one of the conditions on a fixed list, such as rheumatoid arthritis, receives free treatment for it, regardless of income.
There are limits too. The Entitlement Unit writes that public dental care is limited: emergency dental treatment is free, but most treatments are private and you pay for them yourself. Many residents also use private GPs and specialists. If you take medicines, bring a referral letter from your GP to Malta.
The order once more
- register with the CAK and apply for the S1 before departure;
- register residence with the S1 as proof;
- take the biometric receipt and the S1 to the Entitlement Unit;
- the certificate back to Identità.
Whoever keeps to that order never stands at a counter uninsured. How the registration itself works is in the e-Residence document and the eID.
In Vertrekklaar this is phase 2 of 5 of the journey, step 2.1: the same steps, but for your situation — in your order, tickable, and with the deadlines watched. See the whole journey to Malta or go straight to step 2.1 in the open plan.
What this rests on
The facts in this article come from these official pages. Rules change. When in doubt, go by the source, not this article.
- CAK — moving to a treaty country with a pension or benefit — hetcak.nl
- Entitlement Unit — healthcare in Malta, the S1 and the Certificate of Entitlement — s2.eessi.gov.mt
- Identità — the insurance requirement for the economically self-sufficient, and where you get the Certificate of Entitlement — identita.gov.mt
- EURES — living and working in Malta, the healthcare system — eures.europa.eu
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