Cyprus vs. Malta: Social Security and Health Insurance for Entrepreneurs Compared – The Complete Healthcare Guide for EU Expats

Why Cyprus or Malta at all? An overview of the EU advantages

Before diving into the details of the social security systems, let’s clarify: Why are these two island states so attractive for EU entrepreneurs?

EU membership as a game changer

Both countries are full EU members. For you as an entrepreneur, this means: freedom of movement, EU-wide recognition of your qualifications and—crucially—coordinated social security systems under EU law.

Specifically: Your social security periods from Germany, Austria, or other EU countries are credited. You don’t lose any pension entitlements and can easily switch between systems.

Tax conditions at a glance

Here are the key figures relevant for your social security planning:

• Cyprus: 12.5% corporate tax rate, Non-Dom status possible for individuals
• Malta: 35% nominal, but with refund system effectively 5% for EU holding structures
• Both: No inheritance tax, attractive double-taxation agreements

These tax advantages make both locations appealing. But here’s what many overlook: Social security contributions can seriously reduce—or even increase—these benefits.

Cost of living and infrastructure

Malta scores points for its compact size and English-speaking administration. Cyprus offers more space, lower living costs, and a more relaxed pace.

When it comes to your healthcare decision: Both countries offer good medical infrastructure, but different systems of financing and organization.

Cyprus Social Security: The GESY system for entrepreneurs

Since 2019, Cyprus has introduced a revolutionary healthcare system. GESY (General Healthcare System) is a unified, tax-funded system covering all residents.

Structure of the Cypriot social security system

The Cypriot system is built on multiple pillars:

1. GESY (Health Insurance): Comprehensive medical care
2. Pension Insurance: State-provided retirement security
3. Unemployment Insurance: Protection in case of unemployment
4. Accident Insurance: Occupational risks

As an entrepreneur, you pay into all areas. The key point: Contributions are capped and comparatively low within the EU.

GESY contributions for the self-employed and entrepreneurs

Here’s where it gets concrete. GESY contributions are income-based and progressive:

This means: Even with a very high income, you pay a maximum of €4,770 per year for full health coverage. That’s remarkably affordable.

Further social security contributions in Cyprus

In addition to GESY, further contributions apply:

• Pension Insurance: 7.8% (employees) or 15.6% (self-employed)
• Unemployment Insurance: 1.2% (employees only)
• Accident Insurance: Variable rates depending on the sector
• Social Cohesion: 2.65% on interest and dividends

As a self-employed person, your total burden is about 19.6% of your income—but here too, there are contribution caps.

GESY system benefits

What do you get for your contributions? GESY offers comprehensive benefits:

• Free choice of doctor within a wide network
• Free basic healthcare and emergency treatment
• Specialist care with low co-payments (€1-6 per visit)
• Medicines with 10% co-pay (capped at €10 per prescription)
• Dental care (with restrictions)
• Physiotherapy and rehabilitation

The system is considered one of the most modern in Europe. Waiting times are short, quality is high.

Malta Social Security: Structure and contribution scheme

Malta takes a different approach. Its social security system is more traditional and similar to the German or Austrian model.

The Maltese social security system at a glance

Malta draws clear lines between the different types of insurance:

1. National Insurance (NI): Pension, unemployment, and sickness benefit
2. Health Insurance: Via the state healthcare system
3. Occupational Accident Insurance: Separate coverage

Notable: Malta has a dual healthcare system. Public care for all plus a well-developed private sector.

Contributions to Maltese social security

Contribution rates in Malta are structured differently to Cyprus:

Here’s a fundamental difference: Malta uses flat rates, not percentage contributions. With higher incomes, this can be very advantageous.

Healthcare in Malta: Public vs. private

Malta’s healthcare offers two paths:

Public System:

• Free basic care for all residents
• Mater Dei Hospital as the central clinic
• Longer waiting lists for non-urgent treatments
• Limited choice for specialists

Private System:

• Short waiting times and greater comfort
• Free choice of doctor, state-of-the-art facilities
• Additional costs of €1,000-3,000 per year for full private cover
• Many international doctors and English-speaking service

Most entrepreneurs combine both systems: public basic care, plus private top-up insurance for comfort and flexibility.

Special regulations for EU entrepreneurs in Malta

Malta offers special rules for EU citizens:

• Immediate eligibility: EU citizens get instant access to the public system
• Flexible payments: Various categories based on employment status
• International recognition: Maltese social security periods are recognized EU-wide
• Private options: Easy access to private health insurance

A practical advantage: In Malta, the self-employed can choose between contribution categories depending on income and desired benefits.

Health Insurance Cyprus vs Malta: A direct comparison

Now it gets interesting. Let’s compare the two systems side by side and pinpoint the real differences.

Contribution comparison at different income levels

Here’s a realistic calculation for various entrepreneur profiles:

This seems clearly in favour of Malta at first glance. But beware: This calculation only takes the public system into account. In Malta, you will almost certainly need additional private health insurance.

Comparison with private top-up insurance in Malta

Realistic costs with private health insurance in Malta:

Malta remains cheaper, but the difference shrinks significantly when matching benefits.

Benefit comparison: What do you get for your money?

Cyprus GESY advantages:

• All-inclusive system without extra charges
• Modern, digital administration
• Short waiting times and high quality
• Easy billing with no paperwork hassle
• Comprehensive preventive care included

Malta’s hybrid system advantages:

• Flexibility between public and private care
• Very low base costs
• International doctors, English as the working language
• Premium service in the private sector
• Possibility to customize your cover

Quality of medical care

Both countries offer good standards, but with different emphases:

Cyprus:

• Very good basic and emergency care
• Strong specialisms in cardiology and oncology
• Modern facilities in public hospitals
• Challenge: Limited number of specialists on the island

Malta:

• International medical standards
• Strong private health sector
• Good links for treatment in other EU countries
• Mater Dei Hospital with state-of-the-art technology

For serious or rare illnesses, both countries have agreements with clinics in Germany, Italy or the UK.

Practical aspects: Registration, contributions and benefits

Theory is great, but what does it look like in practice? Here are the key steps for both countries.

Registering in the Cypriot system

Registration in Cyprus is surprisingly straightforward:

1. Apply for residence permit: As an EU citizen, registering at the Civil Registry (MEU1 form) is sufficient
2. GESY registration: Online via the HIO portal or in person
3. Receive social security number: Automatically upon registration
4. Apply for health card: Sent by post

Timeframe: Around 2-4 weeks for the full process. You can access medical services from day one of registration.

Registering in the Maltese system

Malta is a bit more traditional, but things move quickly here too:

1. Visit Identity Malta: Personal registration is required
2. Apply for eResidence Card: Replaces the classic residence permit
3. Register for social security: At Jobsplus or online
4. Receive health card: Issued immediately upon registration

Timeframe: 1-2 weeks, but emergency care can be used immediately.

Paying contributions and deadlines

Cyprus:

• Monthly billing via tax return
• Automatic calculation based on your income
• Online payments via JCC Smart or bank transfer
• No proof required for benefits

Malta:

• Weekly or annual payments possible
• Various categories depending on employment
• Online payments via the Jobsplus portal
• Keep receipts for private top-up insurance (tax-deductible)

Dealing with pre-existing conditions

An important aspect many forget:

Cyprus GESY:

• No exclusions for pre-existing conditions
• Full coverage immediately after registration
• Chronic illnesses fully covered
• No waiting periods for ongoing treatments

Malta:

• Public system: No exclusions
• Private top-up: Often waiting periods or exclusions
• Ongoing treatments still possible through the EU health insurance card
• Normal waiting period of 6 months for private full insurance

This is a clear advantage for Cyprus if you have chronic conditions or ongoing treatments.

Medication access and costs

Day-to-day practicalities: How do you get your medication?

Cyprus:

• Electronic prescriptions via GESY
• 10% co-pay, max €10 per prescription
• Wide range of medicines in the GESY catalogue
• Import of special medications possible

Malta:

• Public: Basic meds free or very cheap
• Private: Variable costs depending on insurer
• Good availability of European medicines
• Online pharmacies and home delivery available

Which is better for whom? Your personal decision matrix

Here comes the moment of truth. Which system fits your profile? Here’s an honest assessment for various types of entrepreneurs.

Cyprus is better for you if…

• You value planning security: One system, one cost, no surprises
• You have chronic illnesses: Full coverage without exclusions
• Your income is moderate (€30,000-80,000): Great value
• You prefer digital solutions: Modern, paperless system
• You plan to stay long-term: GESY is constantly expanding
• You prioritise prevention: Comprehensive check-ups included

Malta is better for you if…

• Your income is high (over €100,000): Massive savings on contributions
• You want flexibility: Customisable insurance solutions
• You appreciate premium service: First-class private healthcare
• You work in English: The whole system operates in English
• You’re internationally mobile: Insurance is highly portable
• You’re healthy and want to stay that way: Minimal contributions if low risk

Decision matrix by income bracket

Special cases and exceptions

Families with children:

Cyprus has the edge. Children are automatically covered at no extra cost. In Malta, you’ll need separate contributions or private top-up cover for comprehensive child benefits.

Chronic illness:

Clearly Cyprus. GESY covers virtually everything from day one, no waiting or exclusions. In Malta, private insurance with pre-existing conditions can become very expensive.

Digital nomads:

Malta is more flexible. You can pause your social security and just pay the minimum base fee if you spend longer periods abroad.

Older entrepreneurs (50+):

Cyprus offers better planning security for retirement and comprehensive health cover with no age surcharges.

The hybrid solution: Malta + private EU insurance

Here’s an insider tip for high earners: In Malta, you can pay the minimum contribution and take out a private EU-wide health insurance policy.

Benefits:

• Minimal Maltese social contributions (€1,040/year)
• First-class healthcare coverage Europe-wide
• Insurance contributions tax-deductible
• Flexibility if you relocate

Costs: €3,000–8,000 per year depending on age and cover level. Still cheaper than the Cypriot system for high incomes.

Pitfalls and common mistakes when moving abroad

Time to get honest. Here are the typical stumbling blocks I see for entrepreneurs relocating to Cyprus or Malta.

The tax only mistake

I see this all the time: Entrepreneurs only calculate corporate tax, ignoring social contributions. Classic example:

Thomas, an online marketer, earns €120,000 a year. He compares:

• Germany: 30% total = €36,000
• Malta: 5% corporate tax = €6,000

His mistake: Ignoring Maltese social security and private health insurance. Real Malta costs: €12,000-15,000. Still better, but not as dramatic as it first appeared.

The health insurance gap

This happens a lot in Malta: Entrepreneurs trust the public system, only to find later that waiting times or benefits don’t meet their expectations.

Solution: Budget for private top-up insurance from the outset. The costs are manageable; the surprises later, not so much.

Underestimating the transition period

Both countries have waiting periods or restrictions in the first few months:

Cyprus:

• GESY starts immediately, but some specialists have waiting lists
• Transfer of ongoing treatment may take 2-3 months

Malta:

• Private insurance often has 6-12 months waiting period
• Certain benefits only available after a year

My advice: Keep your German/Austrian health insurance for 6 months in parallel. It costs more, but gives you peace of mind.

Language barriers in Cyprus

Even though English is widely spoken, much administration is conducted in Greek. For more complex applications, this can become a hurdle.

Pro tip: Hire a local tax advisor or lawyer for your first years. The cost pays off in avoided mistakes.

Underestimating EU coordination

Many entrepreneurs worry they’ll lose their German pension entitlements. Not true:

• EU coordination rules protect all entitlements
• Periods are credited between countries
• You can switch back later without loss

But: The coordination only works if you deregister and register correctly. Mistakes here can be costly.

Tax pitfalls in social security

Not all social contributions are automatically tax-deductible:

Cyprus:

• GESY contributions are tax-deductible
• Pension contributions too
• But: Make sure you stay within the caps

Malta:

• Social security contributions are fully deductible
• Private health insurance only up to €233 per year
• Further health expenses may sometimes be deducted

Factor these into your overall calculations.

Conclusion and concrete recommendations for action

After this deep dive you have all the info you need for an informed decision. Let me summarise the key points.

The golden rule for your decision

There’s no such thing as the better system. There’s only the system that fits you best. Your choice depends on four things:

1. Your income: Above €80,000, much speaks for Malta
2. Your health: Chronic conditions favour Cyprus
3. Your preferences: Security vs. flexibility
4. Your plans: Long-term vs. experimental

Concrete next steps

If you opt for Cyprus:

1. Check the latest GESY updates on the HIO website
2. Allow 2-3 months for full registration
3. Find a local tax advisor for the first years
4. Check if your current doctors have partnerships in Cyprus

If you opt for Malta:

1. Budget realistically for private top-up insurance
2. Research the various social insurance categories
3. Contact private health insurers before moving
4. Plan for waiting periods for private benefits

My personal recommendation

If you asked me directly, I’d say:

For most entrepreneurs with annual incomes of €50,000–100,000, Cyprus is the better choice. The system is transparent, benefits are comprehensive and costs are predictable.

For high earners above €150,000, Malta is unbeatable. The savings on contributions can add up to €10,000+ each year.

For everyone else: Do your own calculation. The differences are often less than expected once you include all the factors.

The most important tip at the end

Whichever system you choose: Get it right from the start. Mistakes in registration or incomplete deregistration in Germany can cost you dearly years later.

Invest in professional advice for your first steps. It’ll set you back a few hundred euros, but can save you thousands in the long run.

And remember: Both choices are reversible. You’re an EU citizen and can switch at any time. That takes the pressure off and lets you experiment.

The world’s your oyster. With the right health insurance in your pocket, you’re ready to start your journey with peace of mind.

Yours, RMS

Frequently Asked Questions

Can I transfer my German pension entitlements to Cyprus or Malta?

Yes, under the EU coordination regulation all pension entitlements are preserved. Your working years are credited between countries, and you’ll later receive pension payments from each country you worked in – in proportion.

What if I only use Malta’s public system and develop a serious illness?

The Maltese public system covers all necessary treatments, including serious illnesses. However, waiting times can be longer and comfort lower compared to private care. Life-threatening emergencies are treated immediately.

Are private top-up policies in Malta tax-deductible?

Yes, but only up to €233 per year. Additional amounts cannot be set off for tax. Further medical expenses may be deductible in certain cases.

How soon does GESY insurance in Cyprus kick in after registration?

Your GESY entitlement begins on the day you officially register as a resident. You can access medical services immediately, even if your health card hasn’t arrived yet.

Can I switch between social insurance categories in Malta?

Yes, you can switch between categories every year, depending on your current work situation. You need to declare your choice by 31 December for the following year.

What does good private health insurance in Malta cost for a family?

For a family of two adults and two children, expect to pay €4,000–8,000 per year, depending on the cover and level of excess. International policies are usually more expensive but provide EU-wide cover.

Are my German preventive care check-ups recognized in Cyprus or Malta?

Yes, with the European Health Insurance Card or by transferring your medical records. In Cyprus, integration into the GESY system is simpler; in Malta it depends on your chosen insurance.

As a self-employed person in Malta, can I make higher voluntary payments for better benefits?

Yes, you can join category 3 (voluntary insurance) and pay up to €40 per week. This increases future pension entitlements but doesn’t affect the benefits under the public health system.

What if there’s an emergency right after I move?

Emergency treatment is immediately and freely available for all EU citizens in both countries. Your European Health Insurance Card is valid until your new insurance is fully active.

Are there differences in dental care between Cyprus and Malta?

Yes, significant ones. Cyprus’s GESY includes basic dental care with low co-payments. Malta only covers emergency dental treatment in the public system. For full dental care, you’ll need an additional private policy in Malta.