Healthcare in Gibraltar

The public healthcare system in Gibraltar provides low-cost or free access to a range of healthcare services for residents and eligible citizens. Funded through taxation and social security contributions, its wide-ranging coverage means that a large portion of the 33,000 population benefits from low-cost healthcare. Eligibility is determined by residency status, employment and social security contributions.

British expats can benefit from the healthcare system in Gibraltar thanks to the country’s status as a British Overseas Territory. However, EU citizens holding an EHIC can also get free coverage from the Gibraltar Health Authority (GHA). Expats in Gibraltar from further afield may not get immediate access to free healthcare, so it is often best to obtain a private health insurance policy instead.

It should be noted that EHIC and GHIC holders are only covered temporarily. If their stay becomes permanent, registration with the GHA will be necessary unless a private healthcare plan is obtained.

The quality of public healthcare in Gibraltar is considered excellent and shares similarities with many Western European countries. Facilities tend to be of a high quality and are well-equipped, with medical experts who can speak both English and Spanish. Wait times can be long, though, and occasionally delays in care are evident. In some cases, where complex or specialist treatments are required, patients may be referred to hospitals in the UK or Spain.

Registering with the GHA (Gibraltar Health Authority) for access to the public healthcare system can be done in two ways. If you are a resident of Gibraltar and employed in the country, provide proof of your social security contributions and your passport or residence card. You then complete an online application via the government website.

If you do not make Social Security contributions, you can contribute voluntarily by paying £21.12 per week for your household to be eligible for public healthcare. This can be a tricky process as stringent eligibility checks may delay your coverage.

Despite Gibraltar only having one public hospital, there are several private facilities across the Peninsula that expats can benefit from. This is particularly beneficial for those who are ineligible for GHA healthcare, such as non-British residents or those not registered as residents of Gibraltar. Many expats eligible for GHA healthcare choose private healthcare over public services due to shorter waiting times and broader services offered.

The costs for private healthcare in Gibraltar vary depending on the service required and are typically similar to those found in the UK. That being said, there are large differences between the costs of certain medical services. Diagnostics such as ECGs can cost up to £200 in Gibraltar, whereas in the UK they can cost more than £700. Specialist treatments not available on the Peninsula will cost significantly more than normal, as repatriation/evacuation costs also need to be considered.

Despite its size, a variety of private healthcare facilities in Gibraltar are available that expats can benefit from. GibMed International Hospital is the only private hospital in Gibraltar but other private facilities such as MidTown Clinic, Specialist Medical Clinic and College Clinic provide a variety of medical services for those with private healthcare. With only one private hospital available, it is not uncommon for expats to be referred to Spain or the UK for treatments in other private hospitals. Because of this, most expats seek out a comprehensive international health insurance plan that helps them not only benefit from the private facilities on Gibraltar but also abroad too.

Health insurance in Gibraltar is mandatory in practice. If you live in Gibraltar and are employed, you must make social security contributions, which in turn make you eligible for the GHA healthcare. Taking a private plan in place of, or in addition to, public care is not required. If you are a resident but not working or paying social security, you are not covered by GHA and would need a private healthcare plan. This makes health insurance a requirement for your residency permit to remain valid.

Expats have the option of securing a local health insurance plan that offers coverage in Gibraltar only. This type of policy covers a wide range of medical services but has limitations. For example, where treatments can only be carried out overseas, a local plan may not provide suitable coverage for anything other than services provided in Gibraltar. This is why many expats consider an international health insurance plan. With a broader range of services available and the options to receive treatment across the globe, expats can remain confident that the correct treatment is always available.

Even with comprehensive local or international plans, exclusions may apply. In many cases, pre-existing conditions are not covered, and cosmetic procedures are – in most cases – not part of the coverage.

The cost of private healthcare insurance in Gibraltar varies.  Age, medical history, level of coverage and insurance company all influence the cost of a policy. A local health insurance plan can cost around £50-£150 per month, whereas an international plan can easily cost double that amount. You can obtain private health insurance before arriving in Gibraltar through a specialist expat insurance provider or broker, but you can wait until your arrival to see the options local providers offer. If you are relocating to Gibraltar for work, check with your employer if healthcare is included in your employment package. Some employers provide coverage as standard, but it may not be comprehensive.insurance or may be able to use a GHIC/EHIC card if you’re coming from the UK or EU, although that’s only suitable for short-term stays.

English is the main language of Gibraltar, meaning that language barriers for expats are often minimal. In healthcare facilities, most staff will be bilingual, assisting patients in both English and Spanish. If expats living in Gibraltar speak neither English nor Spanish, it is advisable to use private healthcare facilities. GibMed International Hospital, for example, advertises that it provides services for expats. This can extend to translation and interpreter services where required.

Between the two hospitals in Gibraltar, a wide range of services are provided to ensure expats and residents can receive the treatment and care they require. Where St Bernards provides care and assistance for primary through to tertiary care, including maternity, paediatrics, pathology, critical care, emergency care and mental health support, GibMed International offers additional services not found at St Bernards. Home to Gibraltar’s first MRI scanner and private CT scanner, the hospital provides primary care, alongside urology, ENT, ophthalmology, dermatology, diagnostics, and women’s health.

The hospital admission process in Gibraltar mirrors that found in the UK. Patients typically access care through referrals from their GP. In cases where treatment is not available in Gibraltar, the referral will be for treatment at a partner facility located in Spain or the UK.

 If using GibMed International or a private clinic, patients can self-refer and be assessed by a private doctor who will determine the appropriate next steps. If treatment is deemed necessary, patients can be admitted to the hospital or referred externally if a procedure isn’t available in Gibraltar.

In the event of emergency treatment being required, patients with GHA coverage can bypass the referral process and go directly to St Bernard’s A&E. Those with private care can admit themselves directly to GibMed.

The only public hospital in Gibraltar is free at the point of use for those benefitting from GHA coverage. This means that consultations, hospital stays, emergency care, diagnostics and maternity care, among other services, are free to eligible residents. In contrast, GibMed International charges patients prices similar to those in the UK for some services. Face-to-face consultations can cost approximately £60, whereas a surgical procedure can run into several thousands of pounds.

The facilities within both the public and private sectors in Gibraltar are of a good to excellent standard, providing patients with modern, comfortable rooms and facilities. Overall, both the public and private hospitals are seen to mirror standards found in much of Western Europe.  That being said, GibMed International offers patients a more refined and comfort-focused stay than its public sector cousin. With comfortable suites providing hotel-like accommodation, it is a considerable upgrade. St Bernard’s also offers private rooms for patients, but these are limited in number.

GibMed International Hospital accepts international health insurance to cover the costs of treatment. In most cases, you’ll pay upfront and claim back after your hospital stay ends. This varies per provider, so it is wise to check how your coverage works before booking an appointment. In the public sector, elective treatments are not covered by GHA, so you will require an upfront payment with an insurance claim made afterwards if the policy offers coverage for such treatments.

Before relocating to Gibraltar, it is recommended to be up to date with all routine vaccinations such as MMR and DTP. There are currently no health concerns in Gibraltar, and no specific vaccinations are required. That being said, a small number of people may be at risk of bat rabies (Bat Lyssavirus), so a vaccination against this is recommended if exposure to bats is likely.

As healthcare information can change quickly, you should visit your GP 6-8 weeks before your departure to ensure you have the correct vaccinations before travel.

Gibraltar has a generally good standard of healthcare. That being said, expats should remain aware of the risks of sun exposure. Furthermore, whilst rare, mosquito-borne diseases are a possibility. West Nile Virus has been reported in Southern Spain, meaning the chances of the virus being found in Gibraltar are higher than in some other areas.

As long as expats protect themselves from prolonged sun exposure during warm months and take appropriate measures against mosquito bites, they should not have any health concerns during their time in Gibraltar.