Healthcare for Expatriates in Monaco

Published on January 14, 2026 and written by Cyril Jarnias

Moving to the Principality as an expat is a dream for its quality of life, safety, and tax climate. But behind the luxurious facades and yachts, a very down-to-earth question quickly arises: how does the healthcare system actually work for foreigners living in Monaco, and how much does it cost in practice?

A compact yet ultra-efficient healthcare system

For a tiny territory, Monaco boasts impressive health indicators. The medical density is close to 8.9 doctors per 1,000 inhabitants – one of the highest in Europe – and life expectancy far exceeds the European average, around 86 years for men and over 93 for women according to studied cohorts. The population is often described as among the healthiest on the continent.

The medical infrastructure is modern, well-equipped, and oriented towards high technology: cutting-edge cardiology, thoracic surgery, oncology, geriatrics, sports medicine, dialysis… The Principality also attracts a significant number of foreign patients, to the point that, according to some estimates, about 20% of patients are medical tourists.

The other key characteristic that expats must keep in mind: Monaco is not part of the European Union. This means that European Health Insurance Cards (EHIC) or their British equivalents (GHIC) are not valid here. Similarly, the famous French carte vitale does not work in the Principality.

Monaco Social Security Funds: the public pillar

For any resident who works in Monaco, the gateway to the healthcare system is the CSM. Membership is mandatory for all employees and self-employed workers authorized to work in the Principality, whether they are Monégasque, cross-border commuters, or expatriates.

Funding is based on a system of social contributions. In terms of numbers, the figures mentioned in various documents are as follows: the employer bears a significant share of the social charges (about a quarter of the payroll for all risks), while the employee’s contribution for health insurance is around 15% of gross salary, via the payslip. In practice, when broken down to individual cost, public coverage averages between €100 and €300 per month depending on the situation.

Registration is not automatic from the employee’s perspective: the employer must register each new employee with the CSM. Once enrolled, the insured person is assigned a Monaco Social Security number and card, which will be used for all reimbursements.

Who is eligible for public coverage?

The philosophy is close to that of the French system, but with important particularities for foreigners.

Those entitled to coverage by the social security funds are:

Dependents are also covered: non-working spouse without independent rights, dependent children, up to the set age limit (21 years old, or 28 for higher education, under conditions of household dependency). A useful particularity for some cross-border expats: children can be residents either in Monaco or in the French Alpes‑Maritimes, as long as the insured person remains head of household.

French and Italian nationals benefit from bilateral agreements: they can access public coverage in the Principality, provided they prove they are regularly contributing to the mandatory scheme in their country of origin. Conversely, an uninsured visitor will have to pay for their care in full, even in the public sector.

Scope of covered care

The basket of care covered by the social security funds is broad. It notably includes:

The system operates on a reimbursement basis. In the vast majority of cases, the patient first pays the bill to the doctor, lab, or pharmacy, and then gets reimbursed in whole or in part by the CSM. The standard rate is 80% of the reference fee, leaving the insured person with a 20% co-payment.

This rate can, however, reach 100% in several situations: certain beneficiaries (civil servants meeting seniority conditions, resident retired civil servants, etc.), major procedures exceeding a certain amount, hospitalization for severe pathologies, pregnancy from the sixth month, care related to work accidents, coverage of certain disabilities, specific orthodontic treatments, vaccines (flu for those over 65), ambulance transport for recognized care, etc.

Green, pink, and “bubble” cards: tiered fees

For expats, the most confusing notion is often that of the health cards issued by the CCSS. These are not different levels of reimbursement, but levels of authorized fees with contracted practitioners.

There are three main types of cards, assigned based on income, family situation, and age:

Card Type	Fee Policy with Practitioner	Example GP Consultation Price	Example Specialist Consultation Price
Green card	Mandatory conventional fees	€34.10	€45.60
Pink card	Up to +20% above the fee	€40.92	€54.72
“Bubble” card	Free fees	Variable, free	Variable, free

In all cases, reimbursement is calculated as a percentage of the reference fee, not the extra charges. The card therefore mainly affects the patient’s out-of-pocket expenses. This mechanism explains the importance, for expats, of combining CSM coverage with a solid supplemental insurance.

Hospitalization: third-party payment, co-payment, and exceptions

In case of hospitalization in the public sector in Monaco or in public hospitals in the Alpes‑Maritimes (Nice, for example), the system is more flexible: for stays of less than 30 days, the patient does not pay the full cost upfront. They generally only pay the co-payment and, if they wish, a supplement for a private room. Green card holders may even be exempt from this co-payment for certain stays.

As soon as one switches to the private sector, the logic changes: outside of third-party payment agreements, the clinic requires full upfront payment – medical fees, nights, operating room – and then the insured person seeks reimbursement themselves from the CSM and their supplemental insurance. Since clinic fees can be well above the reimbursement bases, the final bill for an underinsured patient can be spectacular.

The public hospital: Princess Grace Hospital Center

At the heart of the system is the Princess Grace Hospital Center (CHPG), the only major public hospital in the Principality. This facility, founded in the early 20th century, is today an ultramodern general hospital with about 600 beds, equipped with a complete technical platform:

– 24/7, 7 days a week emergency department,

– intensive care and resuscitation,

– general and specialized surgery,

– cardiology and cardiac surgery (in connection with the Cardio-Thoracic Center),

– obstetrics and maternity,

– pediatrics and neonatology,

– oncology and radiotherapy,

– geriatrics (with the Rainier III Center),

– sports medicine, advanced imaging (MRI, CT scan, interventional radiology), etc.

The facility also houses a very popular VIP check‑up service with an international clientele. Comprehensive health assessments are offered, with prices around €2,000 to €4,000 depending on the package, and highly personalized service.

The CHPG works in close collaboration with major centers in Nice and Marseille; the hospital’s restructuring indeed aims to strengthen these complementarities, for example for certain types of surgery or cancer treatment.

A dense network of high-end private clinics

For wealthy expats accustomed to the standards of the best international clinics, Monaco offers a particularly developed private network given its size. Several iconic establishments are found here:

These structures generally offer:

But this level of service comes at a price. Some approximate figures from various sources give an idea:

Type of procedure / stay	Approximate price in public sector	Approximate price in private sector
General practitioner consultation	€34.10 – €40.92 (CCSS fees)	€50 – €100, sometimes up to ~€85 per 15 min
Specialist consultation	€45.60 – €54.72 (CCSS fees)	€150 – €400
Hospitalization per night	€600 – €1,200 / night	€1,000 – €2,500 / day, > €2,800 sometimes
Childbirth (package)	€5,000 – €10,000	even higher in high-end clinics
Dental consultation	~€150	>€150 depending on procedures
Complete private check‑up	€1,850 – €2,200 (children/adults)	~€4,000 for CHPG VIP assessments

For scheduled surgeries (hip or knee replacement, rotator cuff repair…), estimates can reach between €6,000 and over €11,000 for the procedure alone, not including the stay.

In terms of cosmetic surgery, the Principality concentrates a large number of specialized clinics offering breast implants (€3,300–€3,800), facelifts (€3,900–€4,300), rhinoplasty (€3,000–€3,400), bariatric surgery (€5,200–€6,400), etc. These procedures, not covered by the CSM, rely almost exclusively on private payment or very high-end insurance.

Health insurance: a legal obligation and a financial necessity

For an expat, the first rule is simple: health insurance is mandatory for every resident. It is a requirement of Monégasque law, and also a condition for obtaining a residence permit.

Two main scenarios arise.

Expatriate employees in Monaco

The employee is automatically enrolled in the public system via their employer. Their contributions and those of their company fund the CSM, which entitles them to reimbursements. Their family can be declared as dependents if they are not covered by another scheme.

In practice, a vast majority of these residents supplement this protection with private supplemental insurance – or a “mutuelle”, often included in their salary package. Goal: cover the 20% co-payment, extra fees, private room charges, and, above all, broader access to the private sector.

Expatriates without local employment or wealthy inactive individuals

For people who come to live in Monaco without working locally – rentiers, entrepreneurs managing their business remotely, affluent retirees – the situation is different. Without an employment contract granting affiliation to the CSM, they must prove they have private insurance valid in Monaco to obtain their residence card.

As part of the residence procedure, the authorities require:

– proof of sufficient financial means,

– proof of accommodation (lease of at least 12 months or title deed),

– a clean criminal record,

– and a health insurance certificate covering, at a minimum, essential risks in the Principality.

For these profiles, insurers recommend international health insurance contracts covering:

– hospitalization and surgery,

– routine care (consultations, exams),

– pharmacy,

– sometimes dental and optical,

– medical evacuation and repatriation,

– and, increasingly, mental health coverage.

Premiums vary greatly depending on age, health status, and chosen coverage level. The data gathered indicates ranges of about €200 to over €600 per month for a good-quality private contract, with some basic offers starting around €74 monthly for limited coverage.

Main insurance players for expatriates

The Monégasque market is naturally dominated by international insurance giants. Among the names most frequently mentioned for expats:

– April International (Emergency plans, Basic Formula, Essential, Comfort, Premium),

– AXA (Foundation, Standard, Comprehensive, Prestige, Prestige Plus ranges),

– Allianz Care (Allianz Care, Care Plus, Care Pro),

– IMG (Bronze, Silver, Gold, Platinum levels),

– Mondassur (Gold Nomad Expat, Gold Expat Access, Gold Expat Safe, Gold Expat Premium),

– Bupa Global (Major Medical, Select, Premier, Elite),

– MSH, Foyer Global Health, and others.

Many residents go through specialized brokers like Pacific Prime or Mondassur, who can compare tens of thousands of coverage combinations according to needs (geographic area, deductibles, compensation ceilings, dental/optical options, maternity, etc.).

The major selection criteria for an expat include:

– 100% hospitalization coverage,

– access to the Monégasque private sector,

– medical repatriation option,

– coverage for pre-existing conditions (often excluded or limited),

– ceilings for dental and optical,

– the presence or absence of waiting periods.

Navigating the system day-to-day

Once settled and insured, the main challenge for an expat is to learn to “read” a very efficient but administratively dense system.

Registering and choosing your primary care physician

The first steps are to:

1. obtain your Monaco social security card (via the employer or, for certain profiles, via the SPME or the self-employed fund), 2. choose a primary care physician (“referring doctor”) affiliated with the system.

This general practitioner will be the first point of contact for most health issues. They can:

– provide routine follow-up (minor illnesses, prescription renewals),

– coordinate preventive exams,

– refer to specialists and hospitals when necessary.

In theory, going through this channel optimizes reimbursements, as in France, although the Monégasque system is a bit more flexible regarding care pathways.

Finding doctors can be done via:

– official lists (authorities’ websites, “Monalis” service…),

– the Medical Council directories,

– word of mouth within the expatriate community.

Appointments, emergencies, and on-call doctors

Consultations are booked by phone or via online platforms, depending on the practice. Waiting times are generally shorter than in many European countries, due to the high medical density.

For life-threatening emergencies, the reflex remains the same:

– dial 112 from a mobile phone,

– contact 15 (SAMU/medical emergency), 18 (firefighters), or 17 (police) depending on the situation,

– or go directly to the CHPG emergency department.

The Principality also has an organization of on-call doctors and pharmacies for nights and weekends. A single number, 116 117, allows you to be directed to an available doctor or to find the nearest open pharmacy.

Medications and pharmacies

The pharmacy network is dense for such a small territory: 16 pharmacies, identified by the traditional green cross, cover Monaco. Hours are generous (often 8:30 AM to 12:30 PM then 2:30 PM to 7 PM on weekdays, variable hours on Saturday), with an on-call system ensuring 24/7 opening in rotation.

The operation is similar to that of France:

– some medications are sold over-the-counter,

– others require a prescription from an authorized practitioner,

– prescriptions are generally valid for 6 months,

– the same treatment can only be dispensed for one month’s supply, except in special cases (travel abroad, etc.),

– generics may be substituted for the brand-name drug, unless the doctor specifies otherwise.

To request reimbursement from the CSM, patients must:

– provide the treatment sheet issued by the pharmacist,

– attach the labels from the medication boxes,

– include the prescription,

– then submit or send the whole package to the relevant fund.

In terms of price, Monaco is not necessarily more expensive than the French Riviera for medications: a treatment for a cold is around €11, a box of antibiotics about €17. But again, without insurance, repeated expenses can add up.

In the hospital, medications administered during the stay are, however, covered as part of the hospitalization package.

Cost focus: what to expect as an expat?

Even with good insurance, it is useful to have approximate figures to avoid bad surprises, especially when hesitating between public and private.

The table below summarizes the most frequently cited price ranges for a resident with standard coverage:

Expense Item	Indicative Amount (before reimbursement)
General practitioner consultation (public, green card)	€34.10
General practitioner consultation (public, pink card)	€40.92
General practitioner consultation (private)	€50 – €100, or more depending on reputation
Specialist consultation (public, green card)	€45.60
Specialist consultation (public, pink card)	€54.72
Specialist consultation (private)	€150 – €400
Public hospitalization per night	€600 – €1,200
Private hospitalization per night	€1,000 – €2,500 / day, sometimes > €2,800
Childbirth	€5,000 – €10,000
Dental consultation	Approx. €150
Dental implant	Approx. €2,000
Complete check‑up (adult)	Approx. €2,200
CHPG VIP check‑up	Around €4,000

For an expat not affiliated with the CSM and poorly covered by international insurance, a few-day stay in a private clinic can therefore very quickly amount to several tens of thousands of euros.

Medical specialties and coverage for severe illnesses

Beyond general medicine and routine care, Monaco has an advanced ecosystem for cutting-edge fields that particularly concern older expats or high-level athletes.

Cardiology and cardiac surgery

The Cardiothoracic Center of Monaco and the cardiology departments of the CHPG provide comprehensive care:

– coronary angiography, angioplasty, stenting,

– bypass surgery and valve surgery,

– thoracic aortic surgery,

– treatment of arrhythmias,

– surgery for congenital heart defects in children, in connection with international teams.

This expertise attracts patients from around the world. For an expat, it is hard to imagine covering such procedures without robust insurance: gross costs quickly run into tens of thousands of euros.

Oncology and cancer treatments

The Principality has heavily invested in cancer care: breast, cervical, and colorectal cancer screening programs, hematology, medical oncology and radiotherapy units (including stereotactic radiotherapy), tumor genetics, etc.

Sports medicine and orthopedics

For a population where sports activity and luxury leisure are prominent, orthopedic surgery and sports medicine are pillars of the system, with IM2S as the flagship.

Procedures performed include:

– knee, shoulder, ankle arthroscopy,

– rotator cuff repairs (€6,000–€6,500 for the procedure),

– hip and knee replacements (over €11,000 per intervention),

– care for ligament and tendon injuries in athletes.

These treatments are integrated into insurance systems, but for intensive practitioners, the temptation to use the best surgeons in the private sector is strong, which requires high-end supplemental insurance or the ability to pay directly.

Mental health and psychological well-being

Often overlooked in expatriation preparations, mental health is nevertheless the subject of a structured national strategy in Monaco. The five-year “Psychological Health and Well‑being” plan aims to better prevent, detect, and treat disorders, from adolescence to old age.

Expatriates benefit from:

– psychiatry and psychology services at the CHPG,

– specialized units like La Roseraie (psychiatry and medical psychology),

– private psychological counseling centers,

– helplines (e.g., the CHPG psychological support number),

– associations like the Monaco Red Cross or Fight Aids Monaco offering targeted support.

The language barrier is relatively limited: many therapists consult in English and sometimes other languages, which is crucial for discussing intimate topics.

International insurance contracts now quite often include psychotherapy allowances, but with limits (number of sessions, annual ceilings, need for pre-authorization). A point to check carefully in any contract, especially since expat life, even comfortable, can generate stress, isolation, and social pressure.

Specifics to know to avoid bad surprises

The picture may seem idyllic, but a few technical points deserve to be well understood by every expat.

First, the non-applicability of European cards (EHIC/GHIC): a citizen of the EU or the United Kingdom visiting Monaco cannot rely on the usual reciprocity mechanisms. Without travel insurance covering the Principality, the bill will fall entirely on their shoulders in case of a problem.

Finally, extra charges, especially with the pink card or the “bubble” card. The temptation is great to consult “the best specialist,” but an expat not covered by appropriate supplemental insurance can end up with very significant out-of-pocket expenses.

In all cases, it is recommended:

– to request detailed quotes for any major procedure or scheduled hospitalization,

– to check with your insurance the pre-authorization procedures for important interventions,

– to understand whether coverage is based on actual costs or a fee schedule (with a ceiling).

Expatriation, residence, and health: an inseparable trio

Unlike some countries where health matters can be sorted out after arrival, Monaco integrates it at the very heart of the residence procedure. To obtain a residence permit, one must prove not only:

– stable housing,

– sufficient income or wealth (often materialized by a significant deposit in a Monégasque bank account),

– a clean criminal record,

but also valid health coverage in the territory.

In a context where the cost of living is high (rents, services, food), ignoring this parameter would jeopardize the entire expatriation project. The figures for insurance premiums – from €100–€300 per month for the public system to €200–€600 for private – may seem high, but they must be weighed against the actual pricing of care.

In summary: an exceptional system, to master before moving

Expatriates who choose Monaco benefit from a top-tier medical environment: exceptional doctor density, a high-performing public hospital, high-end private clinics, cutting-edge specialties in cardiology, oncology, orthopedics and geriatrics, not to mention a growing effort on mental health.

For an expat, proper preparation means:

– integrating the health budget (contributions + supplemental insurance) into the financial plan,

– understanding the reimbursement mechanisms, CCSS cards, public/private differences,

– anticipating specific needs (maternity, dental, optical, mental health, chronic illnesses),

– and never relying on the illusion that, because the Principality is wealthy, care will be spontaneously free.

Monaco offers a healthcare system worthy of its reputation for luxury and excellence. Still, to fully benefit from it, one must master its rules and accept that here, more than elsewhere, medical quality goes hand in hand with impeccable health insurance.