Health insurance rules for residence and golden visas

The one number that causes most of the confusion

Search for the health-insurance requirement on almost any residence program and you will be told you need cover of at least 30,000 euros. That figure is real, but it belongs to a different thing. It is the minimum for a Schengen uniform short-stay visa, set by Article 15 of the Visa Code, the regulation that governs stays of up to 90 days. It requires travel medical insurance covering emergency treatment, urgent hospital care and medical repatriation, valid across the Schengen area for the duration of the stay.

A residence permit is not a short-stay visa, and the 30,000 euro rule does not carry across to it. Long-stay national visas and residence permits set their own conditions, and those conditions are usually written in words rather than numbers. Quoting the Schengen figure on a golden-visa application is one of the most common mistakes in this area, and it leads people to buy the wrong kind of policy: a thin travel plan for a short trip, when the permit wants standing health cover for the length of residence.

So the first thing to fix is the instinct to look for a euro amount. For most residence programs there is not one. There is a standard of cover, and the job is to meet the standard.

The European standard: cover like a national, for the whole stay

Behind the individual programs sits a piece of EU law that shapes most of them. The Long-Term Residents Directive requires that a third-country national hold sickness insurance covering all the risks normally covered for the host country's own nationals. There is no sum attached. The test is scope, not size: does the policy cover what a local's cover would, and does it last as long as the residence.

Each member state then writes its own version of that test into national law, which is why the detail differs so much from one country to the next. Some spell out an exhaustive specification. Others accept any internationally recognised policy. What they share is the shape: a genuine health policy, from a recognised insurer, valid for the period the permit covers. Travel insurance, built to expire at the end of a trip, does not satisfy it, and several programs say so outright.

Portugal: proof of health protection, no euro minimum

Portugal's residence-by-investment permit, the ARI, still exists in 2026, though it no longer has a real-estate route. Its document checklist asks for proof that the applicant is covered by health protection, and it accepts two forms of it: either a document showing coverage by the Portuguese National Health Service, or an internationally recognised health insurance policy for the period of the legal residence requested, or one that renews automatically. No monetary minimum is stated anywhere in the checklist.

Portugal's income-based routes, the D7 for passive income and the D8 for remote workers, sit slightly differently. Their general documentation asks for valid travel insurance covering necessary medical expenses, including urgent medical assistance and possible repatriation. Again no euro figure is published, and the requirement is waived where a bilateral healthcare agreement applies, as it does for Brazil and for the United Kingdom. Any 30,000 euro number attached to a D7 or D8 is imported from the Schengen rule, not from Portugal's own text.

Spain: the golden visa is gone, the non-lucrative visa is exacting

Spain's investor golden visa was abolished with effect from 3 April 2025 by Organic Law 1/2025. Applications filed before that date are still processed under the old rules and existing permits stay valid to expiry, but the route is closed to new applicants. If a relocation firm is still selling a Spanish golden visa, that is a reason to look elsewhere.

The route that remains for the self-funded is the non-lucrative residence visa, and its insurance requirement is one of the most detailed in Europe. Spain's consular guidance requires a genuine health policy, explicitly not a travel policy, from an insurer authorised to operate in Spain, covering at least the first year of residence from the intended date of entry. The cover must be 100 percent of medical, hospital and outpatient costs through a medical network, with no deductibles, no waiting periods and no coverage caps. This is the program where a cheap policy will not pass, and where the specification is worth reading line by line before buying.

Greece: required at issue and at every renewal

Greece's golden visa requires an insurance contract from a private insurance body covering all health and safety risks. The important detail is timing: it is required both when the permit is first issued and again at every renewal. The scope of benefits is set by a ministerial decision under the governing law, and no euro amount is published in the primary sources, so any specific figure you see for the Greek program should be treated as unverified.

Malta: the strictest on keeping it in force

Malta runs two relevant programs, and both take insurance seriously. Under the Malta Permanent Residence Programme, the applicant must present a health insurance policy covering all risks normally covered for Maltese nationals, within eight months of the letter of approval in principle, and must keep it in force at all times for the entire duration of the residence card. This is the strongest ongoing obligation of any program here: a lapse is not a paperwork nuisance, it is grounds for removal from the scheme. The regulations state no euro amount, so the 30,000 or 100,000 euro figures that circulate for this program are broker estimates, not official minimums.

Malta's Nomad Residence Permit is the one place with a hard number attached. It requires health insurance with minimum coverage of 100,000 euros, covering the European Union including Malta and the United Kingdom, fully pre-paid for one full year and covering the validity of the nomad card. Monthly payment plans are rejected, and travel insurance is explicitly not accepted.

One program has closed. Malta's citizenship-by-investment route was ruled contrary to EU law by the Court of Justice of the European Union in April 2025 and repealed domestically later that year. It is no longer a route, whatever older guides say.

Italy: the obligation attaches later than you think

Italy is a useful case in how requirements move around within a process. The consular checklists for Italy's investor visa and for the elective residence visa, reviewed across several consulates, contain no health-insurance line at all. The cover obligation attaches at the residence-permit stage rather than the visa stage. Once in Italy, a non-EU national who is not compulsorily enrolled in the national health service must either enrol voluntarily or hold a health insurance policy against illness, injury and maternity. So the honest answer for Italy is that the timing and the exact requirement depend on the permit and the consulate, and the frequently repeated 30,000 euro Schengen-wide figure could not be confirmed from any official Italian source.

Mauritius and the UAE: cover required, amounts unpublished

Mauritius asks, for its Premium Visa, for proof of sufficient travel and health insurance for the intended period of stay, and it asks for it both at first application and at renewal. No coverage amount is specified.

The UAE splits the question. The federal golden-visa criteria contain no health-insurance condition; the obligation arises at the level of the individual emirate and at residence-permit issuance. Abu Dhabi requires golden-visa applicants who are not employees to present health insurance for themselves and their family for the whole period they reside in the country, or to sign an undertaking to obtain cover or bear the costs themselves. And from January 2025, employers across the UAE must hold health insurance in order to issue or renew a residency permit for their staff. The widely quoted minimum coverage figure for golden-visa holders comes from insurers rather than an official source, so we do not state it.

The programs that ask for no policy at all

It is just as useful to know where an insurance policy is not required, because buying one you do not need is its own small tax on the process.

The Caribbean citizenship-by-investment programs do not require health insurance. St Kitts and Nevis, Antigua and Barbuda, Dominica and Saint Lucia each ask for a medical certificate or medical questionnaire as part of due diligence, not an insurance policy. Saint Lucia's forms mention insurance only in the sense of registering with its National Insurance Corporation, which is social security, not medical cover. Grenada's official checklist could not be verified from a working source, so we make no claim about it either way.

Several Latin American residencies are the same. Uruguay's legal residence requires a health certificate and a vaccination record, not insurance. Paraguay's permanent residence for investors lists no insurance and no medical certificate at all. Panama's Friendly Nations permit requires a health certificate but no insurance policy. In each of these, the health requirement is a check that you are well, not a contract that you are covered.

What a compliant policy actually has to show

Where cover is required, the programs that specify anything tend to converge on the same handful of features, and it is worth checking a policy against them before you assume it qualifies.

• It runs for the full period of residence. A policy that lapses mid-permit is the problem Malta withdraws cards over. Cover has to match the length of the permit, not the length of a trip.
• It is a health policy, not a travel policy. Spain and Malta's nomad permit both say this in as many words. A trip-based plan that expires at 90 days does not meet a residence standard.
• The insurer is recognised. Spain wants an insurer authorised to operate in Spain; Portugal accepts an internationally recognised policy. Read which one your program means before buying from an insurer it will not accept.
• It is maintained at renewal. Greece and Mauritius re-check at renewal, and Malta checks continuously. The requirement is not a one-time hurdle at the start.
• The scope matches the national standard. Where the rule is qualitative, the benchmark is what a local national would have covered. A policy riddled with exclusions can technically exist and still fail that test.

None of this is tax or immigration advice, and the rules change when governments amend them, so treat this as the map rather than the territory. For the structuring itself, use a specialist. For the insurance layer, the job is narrower and more concrete: meet the standard the program sets, from an insurer it will accept, for as long as the permit runs.