The healthcare system in Greece

Overview of the Greek healthcare system

Greece's healthcare system is a combination of public and private health services. The burden of Greek's healthcare needs falls upon the National Health System (ESY), founded in 1983. The ESY ensures all citizens and residents receive good medical services, excluding any bias towards income or social status.

An amalgamation of Social Security contributions, taxes, and a tiny proportion of payments from patients helps fund the ESY, enabling it to function. Under the umbrella of Greece's healthcare system, there are services such as primary care, specialist care, emergency care/hospitalization, and medicines. Once citizens are registered with the health care provider organization, EOPYY, they are given a GP (general practitioner), who can offer treatment accordingly or can recommend specialist care, etc.

The private sector health sector is very active in Greece. Unfortunately, private health is more expensive than the public system, where you are only expected to pay a maximum of 25% of costs (this can be fixed if you have private insurance). Yet, within the private health system, a wide range of medical services are offered, including specialized medical services and personalized care. Furthermore, access to medical services is quick, with no wait times. Several private hospitals, clinics and health care centers are situated in Athens, Thessaloniki and Greece's other cities.

Read also Accidents and emergencies in Greece

Specific features of the healthcare system in Greece

• The standard of care you'll be receiving will vary significantly depending on where you are. In short, if you're on an island or a more remote location, you'll need to be transferred to either Athens or Thessaloniki or the closest regional hub to receive anything more than the basic standard of healthcare.
• It is not uncommon to wait for hours to get proper care, even in the ER. Most hospitals have a significant shortage of beds and supplies — plus they have a policy of only accepting patients on the days they are 'on call', i.e., usually once or twice a week. Check which hospital is on call that day before going.
• The age-old tradition of 'fakelaki' (i.e., a small envelope with bribe money for the doctor to 'take extra care of you') is unfortunately still a thing. Not all hospitals do it, and not all doctors will explicitly ask for it. This practice is certainly outside of the realm of legality.
• Most, if not all, doctors also have a private practice. It is not uncommon for a doctor to see you at a public clinic and try to convince you to visit their private practices instead. More often than not, it's a good idea since they'll probably have better equipment and resources in their private practice.
• On that note, private clinics, practices and hospitals may be your best bet if there's an emergency or you need to get your test results fast.
• Finally, and this is very sad, you may have to lie about what happened to you or your loved one. Although, according to the British Medical Journal, the overall suicide rate in Greece has risen by 35% since the crisis hit in 2010, suicide attempts are frowned upon by medical personnel in public hospitals. People brought in will probably not get the same quality of care if they admit what happened to them was not an accident. You'd be advised to choose a private hospital in delicate situations like that.

All the above may sound overwhelming, but there are some very positive things about healthcare in Greece. For instance, you don't need a GP to refer you to a specialized practitioner — you can book an appointment directly. You can also get your medicine with a maximum 25% contribution on your behalf if your social insurance covers it. In fact, even if you don't have insurance or even an AMKA, you can usually buy most meds over the counter for reasonable prices.

You can use a website like doctoranytime to find a practitioner to suit your medical requirements. You can also see if your doctor speaks English for a hassle-free appointment.

Read also Pregnancy in Greece

Pharmacies and medicines in Greece

Regarding pharmacies in Greece, most pharmacists speak English and are capable diagnosticians, so if you explain your symptoms, they may save you from a trip to the doctor. Conversely, pharmacies are very accessible and reachable in Greece, owing to the high number you can find. On a single street, you might encounter over five pharmacies, and they are easy to spot with their characteristic flashing neon cross signs.

Greece has a large pharmaceutical industry. Lots of medicines are available, including prescription drugs and over-the-counter medication. Most of the treatments you were used to in your home country are available in Greece, such as anti-inflammatories, general painkillers, allergy medicine, etc.

Greece's National Organisation for Medicines (EOF) is the regulatory body for medicines in the country, and they decide which medicines and drugs can be used, including the availability of them. There might be some differences in the availability of medications because of regulations. You also will notice that Greece does not offer brand-name drugs, such as Nurofen and Advil. Instead, they offer alternatives in the form of generic drugs, which are essentially the same drug in basic form, which is done to bring down medication costs.

How to benefit from healthcare in Greece?

If you're an EU national, all you need is your ID, passport and European Health Card (EHIC) to access the ESY. It's worth noting that the EHIC is also valid in your home country if you have made two full years of social security contributions, and it entitles you to public health coverage for a limited period. If you're a retiree, receiving a pension from your home country, and looking to settle in Greece, you are also entitled to state health benefits. Non-EU nationals can also get healthcare benefits if they provide their Global Health Card (GHIC). Expats from the UK need to produce an S1 form (showing your healthcare is being paid for by the UK when you are in the EU countries or Switzerland).

However, the aforementioned health cards (EHIC & GHIC) are a short-term solution. If you intend to live in Greece, you will need to access healthcare.

Firstly, you will need to get an AMKA number, which is a social insurance number. Previously, it was recommended that you apply for your AMKA through your nearest Citizens Service Centre (KEP), or KEP Office — this is still possible. Increasingly though, foreigners can submit their application through their local Social Security Organisation Office (EFKA or ΕΦΚΑ); they have to book an appointment through the EFKA window on Taxisnet.

What documents are needed to apply for an AMKA?

Unfortunately, the process of getting AMKA can be quite long. Moreover, the dedicated website is outdated regarding what documents you need. Currently, the documents you will require to get an AMKA are as follows:

• A valid passport or valid European ID card
• A Greek Residence permit card or document
• Birth certificate, translated if not in Greek
• Family status certificate (where applicable)
• Employment contract, in Greek. Your employer has to be a Greek or an international company with an entity in Greece. Keep in mind that as a third-country national, it is challenging to get an AMKA social insurance number without employment, being self-employed, or being a business owner in Greece. The reason for this is that Greek authorities need to see that you are making a financial contribution to the economy in Greece for you to be a beneficiary of the social insurance system. So although you are working, you are obliged to make social insurance contributions.
• An AFM or ΑΦΜ, (Tax Identification Number). This document is an exception because it is not typically requested by the authorities. However, your AFM number, along with your credentials, are needed to make an appointment, so keep this in mind.

After receiving your AMKA, you must register with the Greek National Health Insurance Provision (EOPYY). The process can be completed through the EOPYY website, where you must complete an online form and create login credentials to register.

If you get a job in Greece (with a Greek employer or with a company that has an entity in Greece), then in some cases, the employer will help their employee get insurance. This includes assistance with the application for national health insurance through Social Insurance Organisation EFKA. Similarly, the issuing of the AMKA (social insurance number) is usually a speedier and more efficient process if this is done by the employer, and especially if they employ some Non-Greek citizens — they will usually be experienced in the procedures of setting up national insurance, along with AMKA for foreign employee.

Keep in mind that your employer is bound by law to insure you. Many companies may offer private health insurance, which will be much more useful for you, especially regarding accessibility and wait times for health services.

How to get private health insurance in Greece

You may also opt for medical coverage at your own expense. There are many health insurance companies to choose from in Greece, according to your needs and budget, and as an expat, here are some steps you can consider in selecting the best medical insurance:

• What are your medical needs? Think about any medical conditions you might have and your daily life. From there, you can size up what type of coverage will work best for you regarding medicines, care and emergency treatment.
• Next, scope the insurance companies. Try and search, especially for expat insurance providers or those who provide insurance coverage from Greece. Moreover, you can easily compare insurance providers and coverage on the Internet.
• It is a good idea to consider international coverage. This is important if you want to explore outside Greece but want to be protected while traveling.
• Are there any local requirements? When apply or renewing your residence permit in Greece, you need to provide evidence of health insurance, which has to meet certain coverage criteria. Thus, it is recommended to check with your local Central Administration that you have sufficient insurance coverage for your residence permit as an expat.
• Seek help from an insurance professional. Depending on the type of coverage you need, or the purpose that you need it for, there are many insurance companies and agents that can assist you in Greece, who will help tailor an insurance package to your needs and budget and make sure it is compatible with the health care system.

Some of the international health insurance providers covering Greece are:

• Allianz Care
• Regency for expats
• Cigna

You can also consider local health insurance providers, such as:

• Intersalonika
• Generali Insurance
• Ethniki Asfalistiki

Consider having a look at their offers according to your needs and get a free quote on Expat.com's Health Insurance for Expatriates in Greece page.

The quality of care in hospitals and clinics in Greece

Patients who are insured, pensioners, and family members in Greece are entitled to treatments in IKA hospitals, state hospitals, and privately run clinics that have an agreement with IKA.

Depending on where you are in Greece, the standard of hospitals and clinics and the care and services they provide are primarily related to the region. Hospitals of the National Health Service (ESY), i.e., public hospitals, are modern, have good equipment and facilities, as well qualified and experienced medical practitioners. However, there are real shortcomings when it comes to hospitals, such as long waiting periods, coupled with congestion of patients and understaffing. If an overnight stay at the hospital is needed, then the patient's family or friends usually need to bring essentials, bedding and toiletries.

On the flip side, Greece has many private hospitals and clinics that are well equipped and offer many specialist services, with short waiting times, but they are more costly than the ESY. These private hospitals and clinics are spacious, with comfortable and modern rooms for patients. They have the latest treatments available, as well as many other healthcare services on offer.

The better hospitals and clinics are situated in Greece's two largest cities, Athens and Thessaloniki. They have many hospitals, clinics and medical centers that provide a wide range of specialized medical services, from IVF to hip replacements and anything in between. As an expat in Greece, you are likely to have medical needs met, with facilities available and the staff.

Again, those in rural areas struggle for access and quality health, so they are sometimes forced to travel to regional hubs to be treated. To fix this imbalance, the Greek government has increased funding and schemes to increase the presence of medical centers and mobile health units in rural areas such as Epirus and Macedonia.

Greece spends 1/3 less per capita on healthcare compared to the EU average. Still, the Greek healthcare system provides a generally good service in terms of hospitals and clinics. Still, issues remain concerning low-income people with affordability and access and the communities living in rural Greece.