Visa Health Insurance Requirements by Country: 2026 Dataset

Written by Steffan Grund · Insurance specialist (Versicherungsfachmann BWV) · Updated October 28, 2026Facts checked: October 28, 2026

Key facts: visa health insurance rules at a glance

What is the difference between visa-stage and permit-stage insurance?

Visa-stage insurance is what the consulate checks before you travel, and it is often short-term travel cover; permit-stage insurance is what the immigration office checks once you live there, and it is usually health insurance for the whole residence period. In our dataset the two steps often ask for different things, so one policy does not automatically do both jobs.

Portugal is the clearest case. The foreign ministry asks D7 applicants for travel insurance covering medical expenses, urgent care and repatriation, and the UK checklist wants it valid for 6 months from the date of the visa request. Once you are in Portugal, AIMA asks for health insurance or proof that the national health service (SNS) covers you. Greece works the same way: travel insurance at least as long as the national visa, then a private insurance policy for the residence permit. Italy’s elective residence visa checklists in the US and UK do not mention insurance at all, but the Questura asks for a health policy, or voluntary enrolment in the SSN, when you apply for the permit within 8 working days of arrival.

Renewals can add a third rule. Thailand’s O-A accepts a foreign policy with the signed certificate for the first application, but for renewals inside Thailand a 2019 police order asks for a Thai policy of 40,000 THB outpatient and 400,000 THB inpatient, while a later plan for 3,000,000 THB from any insurer has not been confirmed as in force. Costa Rica checks continuous CCSS cover at every renewal, and Spain asks you to have kept your insurance when you renew.

Which visas name a minimum sum insured?

Only a handful do: Thailand’s O-A and LTR, Thailand’s O-X (as outpatient and inpatient minimums) and Italy’s digital nomad visa state a figure, while Spain asks for unlimited cover instead of a number. Everywhere else in our dataset the minimum is NOT FOUND, which is not the same as "any amount will do": consulates can still judge a thin policy as insufficient.

Which visas require a local insurer or public cover?

Four routes in our dataset do: Spain’s non-lucrative and telework visas, Thailand’s O-X and Costa Rica’s Pensionado residence. For these, a foreign long-term policy can be useful extra protection but cannot be the policy that satisfies the rule.

If you are moving to Spain, read our guide to healthcare in Spain for expats before you choose a policy, because the visa wording narrows the choice to insurers authorised there.

Is travel insurance enough for a visa application?

Sometimes for the first step, never for life abroad: Portugal (D7 and D8) and Greece accept travel insurance for the visa, while Spain, France (for UK applicants) and Thailand’s LTR reject it. GOV.UK warns that travel insurance is not intended to cover your healthcare costs if you live abroad permanently.

Where can a UK S1 replace private insurance?

In three EU routes in our dataset: Portugal’s D7, France’s long-stay visitor visa and Spain’s non-lucrative visa accept an S1 from a UK State Pension recipient. The S1 only exists once your State Pension is being paid, so Britons who move before State Pension age (66, rising to 67 between 2026 and 2028) need private cover in the meantime; our S1 form guide explains the steps.

Digital nomad visas: what insurance do they ask for?

Almost all remote-work routes in our dataset require cover, and they are stricter on wording than on amounts. Spain’s telework visa copies the non-lucrative rule (insurer authorised in Spain, no copayment or limits) unless you are in Spanish Social Security. Italy names €30,000 and rejects an insurance card on its own. Costa Rica’s Law 10008 wants a medical policy for the whole stay, with the amount set by the migration authority. Colombia applies its seven-risk wording to the digital nomad V visa too. Portugal’s D8 and Greece’s nomad visa ask for travel insurance at the visa stage. Thailand’s LTR Work-from-Thailand route accepts USD 50,000 of health insurance, Thai social security or a USD 100,000 deposit; for the DTV we found no insurance rule. Our digital nomad visas by country comparison covers income, fees and stay length.

How do you check a policy against a visa rule?

Put the visa rule and the policy certificate side by side and tick off each item below before you pay; if one line does not match, ask the insurer for a written confirmation or choose another route.

• Which stage is this: consulate visa, residence permit or renewal? Read the rule for that stage only.
• Start date: must the policy be valid on the request date, on arrival or only for the permit? Long-term plans that start after you cross the border cannot serve the first two.
• End date: does it run for the whole visa or stay (Thailand, Colombia, Ecuador, Greece) or show enough time left (Thailand LTR: 10 months)?
• Minimum sum per year or per stay, in the currency the rule uses (THB, USD, euro).
• Cover area: does it name the country (Ecuador, Thailand certificate) and include it in your zone?
• Risk list: inpatient, outpatient, repatriation, maternity, death, transport of a body: whatever the rule names.
• Deductibles, copayments, waiting periods and benefit caps: Spain allows none.
• Insurer: does the rule require a local or authorised insurer (Spain, Thailand O-X, Costa Rica CCSS)?
• Paperwork: an official form (Thai Foreign Insurance Certificate, Cyprus "Plan A" certificate) or a plain certificate? An insurance card alone is not enough for Italy.
• Language and family: does every family member need their own certificate (Thailand O-X, Costa Rica nomads)?

Where does Care Expat World fit, and where does it not?

Care Expat World is long-term international health insurance for people whose cover starts by 1 December of the year they turn 64; it can be your everyday cover in every country in this table, but we do not claim that any consulate accepts it for a visa. Its contract terms decide where it can and cannot help with a visa rule.

Where it does fit well is the long stretch after the visa: the years in which your real hospital and doctor bills arrive, wherever you settle. Our Care Expat World plan review lists every benefit, and international health insurance cost shows prices by age. If you have a health condition, read international health insurance with pre-existing conditions before you apply.

Worked example: an American in Colombia and a Briton in Portugal

Linda, 57, from Arizona, plans to retire to Medellín on the Colombian M pensionado visa. Article 77 asks for a policy covering Colombia against accident, illness, maternity, disability, hospitalisation, death and repatriation for her planned stay, and Medicare generally does not pay for care outside the United States. Because the list names maternity, she compares Comfort (pregnancy included after 10 months) rather than Basic. Comfort with a €1,200 deductible costs €505/month at 55–59. Our sources do not say whether the policy must already run on the day she files, so before applying she asks the consulate; if it must, she uses a short policy for the application and starts long-term cover on the 1st of the month after she arrives.

Graham, 61, from Leeds, applies for Portugal’s D7. He has no UK State Pension yet, so no S1. The UK checklist wants travel insurance valid 6 months from his visa request, which a plan that starts only after he crosses the border cannot provide, so he buys travel insurance for the application. After arriving he starts long-term cover for the AIMA permit stage and daily life: Basic with a €3,600 deductible is €325/month at 60–64, Comfort with the same deductible €495/month.

Country-by-country summaries

Short summaries of each country’s rule. The visa pages hold the full requirements, documents and fees.

Thailand

Five routes, five different rules. The O-A needs 3,000,000 THB or USD 100,000 a year with the signed Foreign Insurance Certificate for foreign policies; renewals inside Thailand follow rules that official sources state differently. The O-X needs a Thai insurer; the LTR accepts USD 50,000, Thai social security or a USD 100,000 deposit; the Non-O extension has no legal insurance rule. See the Thailand retirement visa and expat health insurance in Thailand.

Philippines and Panama

Neither the SRRV Classic nor the Pensionado asks for insurance: a medical or health certificate is enough. Details on the Philippines retirement visa and Panama Pensionado visa pages.

Costa Rica

Residents must join the public CCSS and keep it up until each renewal; digital nomads instead show a private medical policy for the whole stay. See the Costa Rica retirement visa.

Mexico

None of the consulate sheets we read list insurance for temporary or permanent residence. See the Mexico retirement visa.

Colombia

The M pensionado and the digital nomad V visa share one wording: cover in Colombia for seven named risks for the planned stay, no minimum sum stated, and the M visa does not let you join Colombian social security. See the Colombia retirement visa.

Ecuador

The jubilado visa takes national or foreign insurance valid for the visa period, if a foreign policy states cover in Ecuador. See retiring in Ecuador.

Uruguay

Permanent residence needs a health certificate and vaccination certificate, not insurance. See the Uruguay retirement visa.

Indonesia and Malaysia

Indonesia’s official E33E page does not mention insurance, although agencies say it is mandatory. Malaysia’s MM2H guide asks applicants aged 60 and below for a policy within 90 days of approval, from a Malaysian or foreign insurer with worldwide coverage, and lists insurance again at renewal. See the Indonesia retirement visa and Malaysia MM2H pages.

Spain

The strictest rule in the table, for retirees and remote workers alike: an insurer authorised in Spain, no copayment, deductible, waiting period or limit. See the Spain non-lucrative visa.

Portugal

Travel insurance for the D7 or D8 visa (UK pensioners may use an S1), then health insurance or SNS cover for the AIMA permit. See the Portugal D7 visa and expat health insurance in Portugal.

France

Health insurance covering the stay; UK applicants need private insurance, not travel insurance, unless they have an S1. See the France long-stay visitor visa.

Greece

Travel insurance at least as long as the visa, then a private policy for the residence permit. See the Greece retirement visa.

Italy

No insurance on the elective residence visa checklists, but a health policy or voluntary SSN enrolment for the permit; the nomad visa names €30,000. See the Italy elective residence visa.

Cyprus

The visitor permit asks for a "Plan A" certificate (inpatient, outpatient, transport of a body); Category F’s official list names no insurance; the investment route asks for inpatient and outpatient cover. See the Cyprus retirement visa.

For incomes, ages and permits side by side, see retirement visas by country; for budgets, the cheapest countries to retire; and for how to pick cover in general, our expat health insurance guide. Whether you can join the local public system is covered in healthcare systems by country.

How we built this dataset (methodology and data date)

We built one dataset from our own country fact sheets only, without new research, so every row matches the visa page it links to. Each fact sheet records the official source, the date read and a confidence label; the sources behind this table were read on 27 October 2026 and the dataset was compiled on 28 October 2026.

Open conflicts we carry: Thailand’s O-A renewal rule; Thailand’s O-X insurer (Rome differs); Portugal’s UK validity (6 vs 4 months); Cyprus Category F; what “worldwide coverage” means for Malaysia’s MM2H; Costa Rica’s nomad minimum. Vietnam is not in the table because it has no retirement visa in the law we checked.

Where these facts come from

• Royal Thai Embassies Washington (O-A, O-X, DTV pages, updated Sep 2026) and London (retirement visas, 4 Apr 2024); Thai Ministry of Public Health O-A insurance guideline; Thai General Insurance Association long-stay portal; Board of Investment LTR document list (6 Nov 2025) and LTR site
• Philippine Retirement Authority: SRRV requirements and Expanded SRRV Program (Aug 2025)
• Panama National Migration Service: Pensionado requirements (Sep 2025)
• Costa Rica: Migration Law 8764 (Arts. 78–80); Law 10008 on remote workers; GOV.UK Living in Costa Rica
• Mexican consulates in Washington, Houston, New York, San Diego and New Brunswick: residence document sheets
• Colombian Ministry of Foreign Affairs: Resolution 5477 of 2022 (Arts. 46 and 77)
• Ecuador Ministry of Foreign Affairs: jubilado temporary residence procedure (updated 13 Aug 2024)
• Uruguay National Migration Directorate: permanent residence requirements (Oct 2020)
• Indonesian Directorate General of Immigration: E33E visa page (read Oct 2026)
• Malaysia: MM2H guidelines (updated 10 Feb 2026); Ministry of Tourism insurer list and Guide Malaysia My Second Home (both December 2025)
• Spanish consulates in Boston, New York, Los Angeles, Washington and London: non-lucrative and telework visa pages (2026)
• Portugal Ministry of Foreign Affairs residency-visa documentation; VFS Global UK D7 checklist; AIMA residence permit requirements
• France: service-public.fr visitor card (F302, 1 Jun 2026); France-Visas FAQ; TLScontact UK notice on long-stay visitor insurance (14 May 2021)
• Greek Ministry of Foreign Affairs: national D visa supporting documents (Aug 2025); Attica decentralised administration permit pages (Nov 2023)
• Italian consulates in Houston, Washington, New York, Los Angeles and London: elective residence checklists; Consulate General in New York: digital nomad visa; Polizia di Stato permit documents (May 2024)
• Cyprus Deputy Ministry of Migration: visitor permit supporting documents (Dec 2025), Category F list (Dec 2025), investment permit criteria (May 2023)
• GOV.UK: moving or retiring abroad guidance; NHS Business Services Authority: S1; Medicare.gov: travel outside the US
• Care Concept: Care Expat World premium table and terms (read 27 Oct 2026)

Full source addresses, dates and confidence labels are kept in our country fact sheets. Rules change; confirm the current wording with the consulate or immigration office handling your case before you buy a policy.