Guide to Countries with Free Healthcare in 2026

If you work with a global team or your business is looking to expand globally, you’ve got a lot to think about: communication across time zones, hiring great talent, compliance, and, of course, healthcare and other benefits.

Healthcare is a major consideration for employers and employees. Employees want comprehensive health benefits to support their families and not stress so much about medical costs. Employers want to attract exceptional talent while managing costs. With more countries offering access to essential health services, companies may have the opportunity to provide employees with great healthcare at a lower cost.for 

Offering fair, competitive, and relevant healthcare benefits comes with its challenges, especially when hiring talent in countries that offer free or universal healthcare and those that don’t. Understanding the nuances will help build a better benefits strategy that attracts the talent you need while remaining compliant.

Let’s walk through what countries have free or universal healthcare and why it matters for your company.   

What does "free healthcare" mean? (and how is it different from universal healthcare)

“Free healthcare” isn’t actually free. The “free” part means patients don’t pay out of pocket at the point of service. So, it’s about what they pay. Universal healthcare means everyone in a country has access to health coverage. It's about who's covered.

Legal residents of countries with free healthcare are guaranteed medical coverage, which may include prescription drugs, dental, and vision services. It’s considered “free” because patients don’t pay anything at the time of treatment. The country’s universal healthcare plan covers all expenses. But just because a country has universal healthcare doesn’t always mean every service is free. Some patients may still be responsible for supplemental health insurance and other costs, like prescription drugs.

Not all countries offer universal healthcare, but instead may have:

• Subsidized healthcare. Reduced or low-cost healthcare plans subsidized by the government or an employer. These plans help cover costs like co-pays, deductibles, and premiums, making it easier for subscribers to access necessary healthcare. Countries like the United States offer healthcare subsidies under the  Affordable Care Act (ACA).
• Copay systems. Users pay a set fee (or copay) when they go to the doctor, dentist, or eye specialist. Copay systems are funded through a combination of user premiums and private insurance companies. 

For global employers, knowing the difference between these systems is crucial. In countries with free healthcare, it may reduce the employer’s obligation to provide healthcare insurance, freeing up capital to invest in other business areas, like recruiting great global talent. 

Countries with free or universal healthcare

Below is a list of countries with universal and free healthcare, grouped by region:

Europe

• United Kingdom .The National Health Service (NHS) is funded by general taxation. Employers contribute via National Insurance.
• Germany .Enrolling in health insurance is mandatory, and benefits are offered through employer and employee-funded statutory health insurance or private insurance.
• France . People must enroll in statutory health insurance, which is funded through payroll taxes, a national income tax, and tax levies on specific products. 
• Spain . The national health system is primarily funded through taxes. Enrollment is mandatory.
•   Italy . Public healthcare is primarily funded through tax revenue. 
• Sweden, Norway, Finland, Denmark . Universal healthcare is funded by taxes and some grants given by the central government. Copays are determined regionally.
• Switzerland . A decentralized, universal healthcare system is funded through a combination of enrollee premiums, taxes, and social insurance contributions. Residents must purchase private insurance.

Asia

• Japan . Universal health insurance is funded through taxes and individual payroll contributions.
• South Korea . National health insurance is funded through mandatory employer and employee contributions, government subsidies, and tobacco taxes.
• Taiwan . Single-payer national health insurance is funded through premiums. The government offers subsidies for low-income households and civil servants. 
• Israel .Universal healthcare coverage is provided through  nonprofit health plans funded by taxes and insurance.
• Thailand . The Universal Coverage Schemes are funded through taxes and offer different healthcare benefits depending on income. 

North America

• Canada.  Canadian Medicare is a universal and decentralized system that is publicly funded and administered by the 13 provinces.
• Cuba.  Universal, state-run healthcare is funded through the national budget.
• Costa Rica.  Universal healthcare is funded through a payroll tax that receives contributions from employees, employers, and the state.

South America

• Brazil. Universal healthcare is decentralized and funded through taxes and contributions from state, federal, and municipal governments.
• Argentina.  A combination of publicly funded, social security/union-run, and private health systems makes up Argentina’s universal healthcare.
• Chile. There is government-subsidized, universal healthcare, but many people still pay into private health insurance plans.

Oceania

• Australia.  Citizens are automatically enrolled in universal public health insurance, which is funded through taxes and government levies.
• New Zealand. Universal health coverage is publicly funded through taxes. Copayments are required for some services, but there are no deductibles.

Middle East and Africa (select examples)

• Saudi Arabia. Healthcare is provided through a mix of government and private sectors, which is primarily funded by oil revenues. Saudi Arabia is a Gulf Cooperation Council (GCC) member, which promotes global expansion.
• United Arab Emirates (UAE ). For nationals, the UAE has a universal healthcare system funded by the government. Private health insurance is also available. Expats must be sponsored to get health insurance.
• South Africa. All South African residents have access to universal health coverage, which is funded through taxes and contributions. There are also private health systems funded through private sources and out-of-pocket expenses.

What countries don't have free healthcare?

While many countries offer some form of universal healthcare, many countries don’t have it.

• United States.  Health coverage is provided through a combination of “public and private, and for-profit and nonprofit insurers and health providers ” Government-funded Medicare provides coverage for people over 65, and there are some programs for low-income groups and veterans.  
• India.  All citizens can receive care at government-run facilities, but staff and supply shortages lead most people to pay out of pocket for healthcare.   The government recently started the National Health Protection Scheme for people with lower incomes, which is tax-funded.
• Nigeria. Health systems are primarily funded through tax revenue, health insurance, and external sources. Most people pay out of pocket. Nigeria spends less on healthcare than almost any other country in the world, leaving many Nigerians without coverage.
• Philippines. The  government enacted universal healthcare in 2019, giving all Filipinos access to health coverage. Filipinos are mandated to enroll. 

FAQs

What countries have free healthcare?

Many countries offer free or subsidized healthcare, including Canada, the UK, Japan, Australia, and others listed above. 

What countries don't have free healthcare?

Countries like the U.S. don’t offer free healthcare beyond programs for older adults and low-income people. Low- and middle-income nations often lack full universal coverage or have limited public healthcare options.

What does free healthcare mean?

Free or universal healthcare means people have access to essential medical services without paying at the time of treatment.   

Is free healthcare actually free?

Not entirely—most health systems are funded through a combination of taxes or social insurance contributions and may include user copays or limited private costs.  

Does Canada have free healthcare?

Yes, Canada provides universal healthcare to residents, funded through taxes. Many residents supplement with private plans to cover services like dental or vision.  

Does Israel have free healthcare?

Yes, Israel provides universal, mandatory coverage that is funded through taxes and premiums. Residents may have copays for certain services and medications.

Do immigrants get free healthcare?

Eligibility depends on residency status and local policies. In many countries, permanent residents and some temporary workers may qualify.  

Does Japan have free healthcare?

Japan has universal healthcare through a mandatory insurance system funded by employers and individuals with government subsidies.

How many countries have free healthcare?

Over 50 countries offer some form of universal or heavily subsidized healthcare coverage.

Skip the healthcare guesswork with Pebl

Figuring out healthcare obligations in one country is complicated enough. Now multiply that by every market where you want to hire. With Pebl as your Employer of Record (EOR), you don't have to become an expert in  185+ countries ' healthcare systems. We already know what coverage you need to offer the right benefits in each location, whether that's supplementing a universal system or providing full private insurance. And while we're handling the healthcare piece, our EOR services also take care of payroll, compliance, and onboarding so you can focus on building the global team you need. Ready to expand without the guesswork? Let's talk.

This information does not, and is not intended to, constitute legal or tax advice and is for general informational purposes only. The intent of this document is solely to provide general and preliminary information for private use. Do not rely on it as an alternative to legal, financial, taxation, or accountancy advice from an appropriately qualified professional. The content in this guide is provided “as is,” and no representations are made that the content is error-free. 

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