Living in Greece is a dream for many, but navigating health insurance can be confusing. Between the public EFKA system, private options, and changing requirements for residence and tax status, it’s easy to get lost in translation.
As an accountant who’s helped many expats navigate Greek bureaucracy, I’ve created this guide to explain what you really need to know — and how to avoid costly or time-wasting mistakes. Whether you’re settling in long-term or just starting the journey, this report offers clarity, options, and a way forward.
“Because Greek bureaucracy shouldn’t stand between you and peace of mind.“
Legal Framework and Eligibility
Under Article 1, paragraph 1, of Law 4251/2014 (Government Gazette A’ 80), third-country nationals, including dependent family members, who reside legally and permanently in Greece, may be included in public health coverage through the National Organization for the Provision of Health Services (EOPYY), provided specific conditions are met.
Basic Requirements
- Legal and Permanent Residence – The applicant must hold a valid residence permit of the type “pensioner” (e.g., Law 4399/2019), which proves their legal and permanent residence in Greece. A visa or short-term entry stamp is not sufficient.
- AMKA Registration – enrollment in the national insurance system requires an AMKA (social security number). This is issued through KEP or EFKA with a valid Passport, Residence permit, proof of residence (utility bill or lease contract), a Bank account in Greece, and proof of pension payment from the third country.
- No Other Coverage – The applicant must not be covered by another public health insurance scheme (domestic or foreign).
Application Submission & Insurance Start Procedure
- Document Collection – The applicant must have: a valid passport and residence permit, and AMKA number, and proof of pension income from abroad.
- EFKA Visit – Submit the application at any local EFKA branch (employee or non-employee), explicitly stating it’s for “optional insurance for a third-country national.”
- Application Completion – The application form includes: Personal details, a residence permit info, IBAN bank account, and a declaration of permanent residence and lack of other insurance.
- Document Submission – Submit photocopies of your: Passport and residence permit, AMKA, AFM (if applicable), proof of residence, and proof of pension income
Issuance of Certificate of Insurance Capacity
After the application is approved by the Committee and the payment of the first two months’ contributions is made, an insurance capacity certificate is granted. Monthly contributions are calculated based on the monthly pension amount.
Contribution Calculation
- Contribution Rate – Contributions are calculated at 8.5% of the pension income.
- Monthly Payments – The first installment is paid within 30 days of application. Coverage begins from the first day of the following month. Payments are made via bank account.
- Start of Coverage – Insurance coverage starts with the issuance of the certificate and includes: Hospital care, Diagnostic exams, Primary healthcare, Medicine coverage at 25% co-pay
Renewal & Obligations
- Coverage Renewal – Insurance capacity must be renewed every 12 months or sooner if the residence permit expires.
- Obligation to Inform – Any change in residence permit, housing status, or bank details must be declared within 30 days.
- Residence Abroad or New Status – If the insured permanently leaves Greece or receives foreign coverage (e.g., S1), the cancellation must be declared.
Important Notes
- Form S1: In bilateral agreements with third countries, S1 may provide equivalent coverage without needing this plan.
- Debts to EΦKA: Outstanding debts may hinder renewal.
- Pre-existing conditions: Not excluded unless determined uninsurable.
- Coverage start: The same requirements apply for Greeks and foreigners.
Summary
This optional coverage provides a crucial path for legally residing non-EU retirees to access Greece’s public healthcare. Timely updates and compliance ensure continued access to services and help integrate retirees into the social protection system.
