Published on and written by Cyril Jarnias
Settling in Iceland means accepting harsh winters, spectacular landscapes… and a very unique healthcare system, both highly efficient and tightly controlled by the state. For an expatriate, the key challenge is understanding how this system works, who is entitled to it, how much it costs, and what services you can actually access in practice, whether you live in Reykjavik or in a remote fjord.
The Icelandic healthcare system is based on public health centers called Heilsugæsla, supplemented by private clinics. The European Health Insurance Card is useful for EU/EEA nationals. It’s crucial to know emergency numbers, the costs associated with care, and best practices to avoid financial surprises.
A universal, public, and highly efficient system
Iceland has opted for a universal healthcare system, primarily funded through taxes and managed at the national level. Nearly all hospitals are public; there are no private hospitals, and private services are limited to specialized clinics, mainly in Reykjavik and its outskirts.
The effective coverage index of the Icelandic healthcare system, ranking it among the most efficient in the world according to The Lancet.
The country is divided into seven health regions, with approximately 60 local health centers. Two major hospital hubs structure the offerings: Landspítali – the National University Hospital in Reykjavik – and Akureyri Hospital in the north. In addition, there are several regional hospitals and health institutions spread across the country, with a high concentration of services in the capital region, where about 65% of the population lives.
For an expatriate, this context has a direct consequence: everywhere in the country, you will find basic access to public care, but the range of specialties and speed of treatment will be significantly better in the Reykjavik urban area than in rural areas.
Public, private, emergency: who does what in Iceland?
The core of the system is primary care, organized around Heilsugæsla health centers (or Heilsugæslustöð). These facilities, present throughout the country, are equivalent to community health centers or general practitioner offices in other European countries.
In Reykjavik, this network is grouped under the name Heilsugæsla Reykjavíkur, with several centers including Heilsugæslan Miðbær in the city center. This is typically where expatriates living in the capital first register to have a primary care physician.
The table below summarizes the main types of healthcare facilities an expatriate may encounter.
| Type of facility | Primary role | Status | Special considerations for expatriates |
|---|---|---|---|
| Heilsugæsla / Heilsugæslustöð (health centers) | General medicine, basic follow-up, referral to specialists | Public | Main entry point into the public system |
| Landspítali University Hospital (Reykjavik) | University hospital, emergencies, major specialties | Public | Largest hospital in the country, English-speaking staff |
| Regional hospitals (HSS, SAK, HSU, HSA, HVE, HVEST) | Regional hospital care, local emergencies | Public | Staff generally speaks English |
| Læknavaktin (Reykjavik) | Out-of-hours city emergency medicine | Public / contracted | Walk-in, fee-based, English-speaking staff |
| Private clinics (Domus Medica, Laeknasetrid, Miðstöðin, MediCare Iceland…) | Quick consultations, direct access to specialists | Private | Full payment required, often English-speaking service |
In the capital, the density of offerings means that most specialties are accessible either at the university hospital or through private clinics like Domus Medica or Laeknasetrid Medical Center. These private facilities are very popular among expatriates who want to reduce waiting times to see a specialist or receive more personalized care, often entirely in English.
In the countryside, the care pathway typically begins at the local health center and then continues to the regional hospital if needed. All these listed facilities are public and have English-speaking staff.
| Public facility | Address | Phone | Main coverage area |
|---|---|---|---|
| Landspítali (Reykjavik) | Hringbraut, 101 Reykjavík | +354 543 1000 | Capital region, national referral |
| HSS | Skólavegur 6, 230 Reykjanesbær | +354 422 0500 | Southwest (Reykjanesbær, airport) |
| SAK | Eyrarlandsvegur, 600 Akureyri | +354 463 0100 | North (Akureyri and surroundings) |
| HSU | Árvegi, 800 Selfoss | +354 432 2000 | South (Selfoss and region) |
| HSA | Lagarás 17‑19, 700 Egilsstaðir | +354 470 3000 | Eastern region |
| HVE | Merkigata 9, 300 Akranes | +354 432 1000 | West (Akranes and region) |
| HVEST | Torfnesi, 400 Ísafjörður | +354 450 4500 | Westfjords |
This hospital map is valuable to know, especially if you live outside Reykjavik or plan long trips around the country.
How does public health insurance work for expatriates?
The Icelandic national health insurance – Sjúkratryggingar Íslands (often abbreviated as IHI in English) – is at the heart of healthcare financing. The principle is simple: the system covers about 84–85% of costs, with the rest borne by patients through co-payments. But for an expatriate, access to this coverage is neither automatic nor immediate.
The residency principle and the six-month waiting period
To benefit from subsidized public care, you must be a legal resident and have lived continuously in Iceland for six months. This waiting period is the general rule for non-Icelandic nationals arriving from countries outside the EEA.
The process typically involves several steps:
1. Obtain a kennitala, the ten-digit national identification number, essential for everything: employment contract, banking… and healthcare. 2. Register your legal domicile with Registers Iceland. 3. Submit a health insurance application to Sjúkratryggingar Íslands, ideally as soon as your domicile is registered. 4. Wait: processing the application usually takes 4 to 6 weeks, but coverage only begins after six months of continuous residence.
During the waiting period before your Icelandic health insurance takes effect, you are not considered insured. You can still see a doctor or be hospitalized, but you will have to pay the full price without any subsidies.
Partial exemptions for Europeans and Nordics
Nationals of the European Economic Area (EEA), the United Kingdom, Switzerland, Greenland, and the Faroe Islands can, under certain conditions, avoid all or part of the six-month waiting period by transferring their insurance rights from their home country.
Concretely, this involves providing forms issued by the social security institution of the country of departure (e.g., E‑104 or S041), proving they were covered in that country before moving to Iceland. Once these documents are registered with Icelandic insurance, rights can begin without a waiting period.
The conditions for transferring social security rights to Iceland vary by origin. Citizens of Nordic countries (Denmark, Norway, Sweden, Finland) benefit from very flexible rules: they can apply for affiliation upon registering their legal residence, provided they left their home country less than 12 months ago. For expatriates from other countries, such as France, Germany, or Italy, the transfer is also possible, but they must have previously been covered by a public social security system, not just private insurance.
Spouses and children under 18 of an EEA insured person may sometimes also benefit from a waiting period exemption, but these cases are reviewed individually.
Mandatory private insurance for non‑EEA nationals and short stays
For nationals of non‑EEA countries, the six-month waiting period is fixed. Obtaining a residence permit is conditional upon prior purchase of private health insurance valid for at least six months, from an authorized insurer in Iceland, with a minimum coverage level of approximately 2,000,000 ISK for medical expenses.
Digital nomads have specific visas, but they do not become affiliated with the public system: they must remain covered by private insurance throughout their stay.
Tourists and visitors staying less than six months, regardless of nationality (excluding EHIC mechanisms discussed later), cannot access Icelandic insurance. They are considered self-payers and must have travel or international insurance covering local healthcare costs.
The table below roughly summarizes the situation by profile.
| Expatriate / visitor profile | Entitled to public Icelandic insurance | Waiting period / main condition | Private insurance required |
|---|---|---|---|
| EEA / Swiss / UK resident with validated rights transfer | Yes | Possible without waiting, if insured in home country | Recommended initially |
| Nordic citizen moving to Iceland | Yes | Upon registration of residence | Optional |
| Non‑EEA resident (residence permit) | Yes | After 6 months of continuous residence | Mandatory for first 6 months |
| Digital nomad with specific visa | No (unless future changes) | Not eligible as a resident under the law | Mandatory throughout stay |
| Tourist / stay < 6 months | No | No entitlement to public insurance | Strongly recommended |
What Icelandic insurance covers (and doesn’t cover)
Once the waiting period is over, an expatriate affiliated with Icelandic insurance has roughly the same rights as a local citizen. Coverage is broad and includes most routine and major needs.
Covered services
The following services are included in the public coverage scope:
Discover the main healthcare services covered by the insurance system, including consultations, hospitalizations, maternity care, and many other benefits.
General and specialist consultations, as well as hospitalizations and inpatient care.
Prenatal care, childbirth, postnatal care, and imaging exams (X-rays, CT scans, MRIs) and radiation therapy.
Prescribed medications (with patient contribution) and medical transport, including some travel expenses.
Technical aids and medical equipment, as well as physiotherapy and rehabilitation (with limits and co-payments).
Home nursing services, and coverage in nursing homes and for long-term care.
Hospital treatment costs outside the country in some cases, and dental and orthodontic care for children and partially for retirees.
Certain groups benefit from additional exemptions: children under two years old pay no consultation fees, care for those under 18 with a doctor’s referral is free, and people over 67 or with disabilities may be fully exempt from co-payments for consultations.
Areas with little or no coverage
Conversely, several areas remain poorly or not covered, which explains the frequent use of supplementary private insurance:
Some healthcare services are not fully covered by basic health insurance. Here are a few common examples where personal financial contribution is often necessary.
Except for special cases and pensioners, routine dental care for adults (cleanings, fillings) is only partially reimbursed.
Much of the physiotherapy sessions done in private practice receive partial reimbursement from basic insurance.
Glasses, contact lenses, and comfort-related optical care are generally poorly reimbursed, often requiring supplemental health insurance.
Some psychological or psychotherapeutic care may only receive partial reimbursement, depending on the practitioner and type of follow-up.
Purely cosmetic surgery or elective procedures not medically necessary are not covered by mandatory health insurance.
For an expatriate used to a system that heavily covers dental or optical care, the shock can be significant: in Iceland, these areas are more a matter of individual responsibility or private contracts than collective solidarity, except for children and the elderly under certain conditions.
Co-payments, caps, and costs: what to expect?
The Icelandic system is not free at the point of service: every consultation, exam, or procedure involves a patient co-payment. These amounts are generally reasonable for the insured, but they quickly escalate for those not affiliated or using private clinics.
Co-payments and monthly caps
The Icelandic framework is based on the idea of a “cost shield” (kostnaðarþak): beyond a certain cumulative amount of co-payments per month, insurance takes over and the insured person’s share drops significantly.
Exact amounts vary according to regulations and updates, but the following orders of magnitude emerge:
– General monthly cap for an adult: around 25,000 to 35,000 ISK
– Lower cap for children, retirees, and people with disabilities: between 16,700 and 23,000 ISK depending on sources
Annual overall cap on out-of-pocket expenses for an individual in Iceland, limiting financial risk in case of significant healthcare expenses.
For medications, another capping mechanism exists: after a certain spending level over a 12-month period (around 62,000 ISK), state coverage increases and can reach 100% for costly chronic treatments.
Examples of fees for consultations and exams
To get a concrete idea, it’s useful to look at some typical fees, both public and private. Here is an indicative summary of common costs, for a patient covered by Icelandic insurance, unless otherwise noted.
| Common services | Approximate cost (in ISK) | Notes |
|---|---|---|
| Scheduled GP consultation at health center | ≈ 500 to 1,000 | During office hours |
| More complex / urgent daytime consultation | ≈ 3,400 | Higher co-payment |
| Specialist consultation (with GP referral) | ≈ 2,500 | In the public system |
| Laboratory analysis | ≈ 3,591 | Excluding highly specialized tests |
| Pregnancy test | ≈ 904 | At health center |
| Emergency room visit (ER) | ≈ 5,000 | For insured, excluding subsequent hospitalization |
| Private doctor consultation (Míðstöðin, GP) | ≈ 12,000 | Full fee, non-subsidized |
| Consultation at Læknavaktin without insurance | ≈ 15,000 | City emergency care in Reykjavik |
For an expatriate not yet affiliated with Icelandic insurance, these amounts can be significantly higher, especially at the hospital, since there is no subsidy: hence the importance of solid travel or international insurance during the first few months.
Funding and contributions
Beyond co-payments, public insurance is funded by taxes and mandatory social contributions. For employees, the employer automatically deducts a contribution (around 6.10% of salary) for the insurance fund, up to a monthly ceiling (around 25,000 to 35,000 ISK depending on category). Unemployed or retired people must pay their contribution directly within the Icelandic social system.
It is not possible to opt out of the public healthcare system. Every resident and insured person contributes financially, even if they also have parallel international private insurance.
The European Health Insurance Card (EHIC) and its role in Iceland
For nationals of the EU, EEA, UK, and Switzerland, the European Health Insurance Card (EHIC) – or its British equivalent GHIC – is a key tool for temporary stays in Iceland. It does not replace travel insurance, but it allows you to be treated like a local insured person for medically necessary care during your stay.
Concretely, presenting a valid EHIC and a passport at a hospital or office allows you to:
– be billed at the same rate as an Icelandic insured person (same co-payments) rather than the full tourist rate;
– get certain major services covered, such as dialysis, oxygen therapy, or chemotherapy, provided they have been pre-arranged with a public facility.
If you are a European citizen arriving in Iceland with an EHIC, it acts as a safety net during the first few months, even before any transfer of rights to Icelandic insurance. However, it does not cover repatriation, lost luggage, or many ancillary costs: supplemental insurance is still essential.
If you are billed in full despite having a valid EHIC, you can request a retroactive refund either from the Icelandic Health Insurance or from your home country organization, by providing original invoices, proof of payment, EHIC, and ID.
Private insurance: essential at first, useful afterward
For most expatriates, private insurance is not just a comfort: it’s a necessity, at least during the waiting period for public affiliation.
Why private insurance is indispensable
Several reasons make private coverage practically mandatory:
For new non-EEA residents, a six-month waiting period is required before accessing public subsidies. Digital nomads and stays under six months are completely excluded. The system does not fully cover certain care (adult dental, optical, some psychotherapies, comfort procedures). Additionally, waiting times to see a specialist in the public sector are often long, ranging from 1 to 6 months.
Icelandic authorities require that non-EEA nationals have private insurance meeting strict criteria (valid for at least six months, minimum coverage of about 2,000,000 ISK, approved insurer) to be issued a residence permit.
How much does it cost and what does private insurance cover?
Private health insurance plans sold in Iceland generally show the following cost levels: cost level.
– Basic plans: 15,000 to 30,000 ISK per month
– More comprehensive plans including dental, optical, and extended coverage: 40,000 ISK per month or more
Overview of the main health insurance options available for residents and expatriates in Iceland.
Companies like Sjóvá and VÍS dominate the domestic Icelandic market, offering coverage tailored to residents.
Groups like AXA or Cigna Global offer expatriate contracts, including worldwide coverage, maternity options, and medical evacuation.
These expatriate contracts often include advanced services like second medical opinion and teleconsultation.
The typical benefits of these contracts for an expatriate in Iceland include:
– Coverage of high costs before public insurance affiliation
– Reduction of out-of-pocket expenses on public co-payments
– Faster access to specialists through private clinics
– Coverage for little or non-subsidized care (adult dental, glasses, some psychological care)
– Continuity of coverage outside Iceland (business trips, returns home, etc.)
When choosing a policy, closely examine the deductible level, the percentage reimbursed per procedure, exclusions (especially for pre-existing conditions), and assistance services (translation, 24/7 medical hotline…).
Accessing care in practice: steps and useful tools
Once on the ground, access to care is structured around a few essential steps and tools.
Registering at a Heilsugæsla health center
After obtaining your kennitala and, if possible, starting the affiliation process, the first practical step is to register at the health center nearest to your home. That’s where you will request a primary care physician (GP) who will become your main point of contact in the public system.
This doctor issues most prescriptions and referrals to specialists in the public system. Without this referral, many public specialists are not accessible unless you pay a higher fee.
When registering, it is advisable to:
– authorize the center to access your previous medical records if necessary;
– immediately indicate if you need an interpreter for consultations;
– check what languages the doctors speak, especially if you are settling outside Reykjavik.
Heilsuvera: the Icelandic digital health portal
The Heilsuvera platform (website and app) plays a central role in organizing care. For insured persons, it allows you to: manage your medical record, book appointments online, and access information about your treatments and prescriptions.
– book online appointments with your health center;
– send messages to the care team;
– consult some medical information and prescriptions.
To fully use this service, you need an Icelandic e-ID (electronic identity linked to your kennitala) and to be already registered in the system. For a newly arrived expatriate, this tool becomes mainly useful once the initial administrative phase is completed. In the meantime, appointments must be made by phone.
Phone numbers and medical helplines
Besides 112, the single number for all emergencies (police, fire, ambulance, mountain rescue), Iceland has several dedicated lines for medical guidance.
The most useful numbers to keep in your phone are: emergency contacts, doctors, close friends, family, your bank’s customer service, repair services (plumbing, electricity), your family doctor, and assistance numbers for your car.
| Service | Number / access | Primary role |
|---|---|---|
| General emergencies | 112 | Emergency calls, ambulances, rescues |
| General medical advice and guidance | 1700 | 24/7 advice, direction to centers or emergencies |
| Nurse line / Læknavaktin (after hours) | 1770 | Nurse advice, organizing visits or ER referrals |
| Læknavaktin – extended phone reception | 1700 / 1770 | On-call care in the Reykjavik area |
| Pediatric emergency service (phone line) | 563 1010 | Dedicated line for children and adolescents |
Læknavaktin in Reykjavik has fairly extensive hours: on weekdays, from about 5 PM to 10–11 PM, and all day on weekends and public holidays. You can walk in without an appointment, take a ticket, and pay a flat fee.
Teleconsultation and services in English
Telemedicine options are expanding in Iceland: in addition to Heilsuvera’s messaging, several private players offer video consultations, notably MediCare Iceland, which specifically targets English-speaking clients. Additionally, large international platforms like Teladoc can serve expatriates depending on their insurance contract.
For non-Icelandic-speaking expatriates, English proficiency is very common among healthcare professionals, especially in Reykjavik and major towns. At facilities like Landspítali hospital, Læknavaktin, and major private clinics in the capital (Domus Medica, Laeknasetrid Medical Center, etc.), it is rare to find a practitioner who does not speak fluent English.
In rural areas, English levels can be more variable, but most doctors have at least a functional level. When booking an appointment, it is wise to mention you don’t speak Icelandic and ask if an English consultation is possible, or request an interpreter if needed.
Emergencies, after-hours care, and special situations
Even with good insurance, an expatriate may one day face a medical emergency. Knowing who to turn to and how the Icelandic emergency chain works can save valuable time.
In case of a life-threatening situation
In case of immediate danger (loss of consciousness, intense chest pain, severe trauma, respiratory distress), the reflex is the same everywhere in the country: call 112. The dispatch center handles the call, dispatches an ambulance if necessary, and coordinates transport to the nearest emergency department.
In the capital region, Landspítali University Hospital at Fossvogur handles 24-hour emergencies with English-speaking teams. Direct emergency department numbers include +354 525 1700 and +354 543 1000, but in practice, 112 remains the single entry point.
Ambulance is covered by the public system for insured persons; without insurance or EHIC, a flat fee or full cost may be charged for purely tourist status, but this is never a reason to deny care in a life-threatening situation.
For minor emergencies or issues occurring in the evening or on weekends (high fever, painful episode needing prompt advice, acute infection without immediate life threat), the solution is often to go to the Læknavaktin on-call service.
In Reykjavik, this city emergency center is located at Austurver (Háaleitisbraut 68, 103 Reykjavík). Hours vary slightly by source, but in practice:
– Weekdays: late afternoon until late evening (typically 5 PM – 10/11 PM)
– Weekends and public holidays: usually continuous from morning until evening (9 AM – 10/11 PM)
You can walk in without an appointment, take a ticket, and wait your turn. A nurse advice line at 1770 helps triage situations, give first aid advice, schedule an appointment, or recommend going directly to hospital ER.
For children, a specific pediatric facility is located at Orkuhúsið, Urðarhvarf 8, with dedicated hours in the late afternoon and on weekends, accessible via phone referral at 563 1010.
Pre-arranging certain major treatments before arrival
For expatriate patients requiring scheduled major treatments like dialysis or long-term oxygen therapy, it is essential to plan ahead before even setting foot in Iceland. These treatments must be pre-arranged with specialized units at Landspítali in Reykjavik, for example:
– Dialysis unit: Eiríksgata 5, 101 Reykjavik, phone +354 543 6311
– Oxygen therapy unit (3-A): Eiríksgata 5, 101 Reykjavik, phone +354 543 6049
For EHIC holders, these treatments can be covered at local rates, provided they have been booked with a public provider and supporting documents have been submitted in advance.
Living outside Reykjavik: specific considerations and precautions
The vast majority of specialists and private clinics are concentrated in Reykjavik. For an expatriate based in Akureyri, Selfoss, Egilsstaðir, or more remote locations, access to care follows a different logic.
Local health centers provide medical presence, sometimes with limited hours outside towns. Some are only open certain days of the week for general practice consultations. Regional hospitals handle more serious care and emergencies.
The main points to keep in mind if living outside the capital region are as follows:
For effective medical care in Iceland, it is advised to: check the opening hours of the local health center and your doctor’s phone availability; inquire about after-hours solutions (on-call doctor, local call number, referral to 1700 or 1770); plan trips to the nearest regional hospital for specialists or major exams; confirm the possibility of an English consultation when booking; and always keep the contact numbers for 112, 1700, and the regional hospital handy.
The Heilsuvera platform offers a service map that shows health centers, hospitals, and on-call facilities across the country, a particularly useful tool for planning trips or hikes in remote areas.
Care in English and resources for finding a doctor
For a newcomer, quickly finding an English-speaking practitioner can be a challenge if you don’t know where to look. Several resources can be mobilized.
Embassies in Reykjavik, including the British embassy, typically maintain a list of doctors, dentists, and hospitals with fully English-speaking staff. The UK embassy, for example, is located at Laufásvegur 31, 101 Reykjavík and can be contacted at +354 550 5100 or via an online form.
Most major public facilities (Landspítali, HSS, SAK, etc.) clearly state they have English-speaking staff. In private clinics in Reykjavik like Domus Medica, Laeknasetrid, or MediCare Iceland, English is often the common working language with international patients.
Many Icelandic doctors across all specialties (surgery, psychiatry, dermatology, etc.) are listed as able to consult in English. For an expatriate, this is the essential information to remember among the complete lists available.
– communication in English with medical staff generally poses no problem in Reykjavik and major towns;
– in the countryside, it’s useful to check the practitioner’s language skills in advance, especially for specialized consultations or sensitive topics (mental health, pediatrics, gynecology);
– if necessary, health centers can arrange for an interpreter, provided you mention this when booking.
Best practices for expatriates: records, receipts, identity, and medications
Beyond the broad principles, a few simple habits greatly simplify an expatriate’s life in the Icelandic healthcare system.
Always carry your kennitala (or at least the number), your insurance card (Icelandic or EHIC), and a form of ID. These are systematically requested at the reception of health centers, hospitals, and pharmacies.
Always keep invoices and receipts for care. They will be useful for:
A medical invoice can be used for three main reasons: tracking your co-payment caps, for possible reimbursement claims with your international private insurance, and to correct a potential billing error, for instance if your insured status was not properly applied.
For regular medications, inquire in advance about their availability in Iceland, especially for very specific treatments. Pharmacies (Apótek) are well-stocked, but brand names may differ, and some very specific molecules require advance planning or coordination with a specialist.
Finally, for complex or chronic health issues, it’s helpful to arrive in Iceland with a medical summary in English (or Icelandic) prepared by your previous doctor, listing your medical history, current treatments, and allergies. This document will aid your new Icelandic doctor and speed up setting up the right care plan.
Summary
Healthcare for expatriates in Iceland operates within a very structured, efficient framework that is demanding on the administrative side. The public system, built around Heilsugæsla centers and Landspítali University Hospital, offers a quality level among the best in the world, with funding largely pooled through taxes and capped co-payments.
To fully benefit from this protection, an expatriate must go through several steps: obtaining a kennitala, registering your domicile, applying for affiliation, and possibly transferring rights for Europeans. The first six months are a key period, where private insurance – often mandatory – plays a crucial role in avoiding heavy expenses.
Once registered, the expatriate accesses the same system as locals: registration at a health center, follow-up by a general practitioner, referral to specialists if needed. Private clinics are available for faster appointments, and the Heilsuvera online platform handles administrative tasks. Most care can be conducted in English.
By combining good advance preparation, appropriate insurance coverage, and a basic knowledge of key structures and numbers, it is possible to enjoy a very high level of care in Iceland without every medical visit turning into an administrative or financial headache.
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Cyril Jarnias is an independent expert in international wealth management with over 20 years of experience. As an expatriate himself, he is dedicated to helping individuals and business leaders build, protect, and pass on their wealth with complete peace of mind.
On his website, cyriljarnias.com, he shares his expertise on international real estate, offshore company formation, and expatriation.
Thanks to his expertise, he offers sound advice to optimize his clients' wealth management. Cyril Jarnias is also recognized for his appearances in many prestigious media outlets such as BFM Business, les Français de l’étranger, Le Figaro, Les Echos, and Mieux vivre votre argent, where he shares his knowledge and know-how in wealth management.
