Need care while traveling? The latest health insurance statistics in Europe reveal how healthcare coverage, private insurance use, and out-of-pocket costs vary across countries.
Here, we’re breaking down the latest data to explore how health insurance works across Europe, which countries spend the most on coverage, and common barriers to care.
At REVA, we provide life-saving international air ambulance flights to help patients like you reach the right hospitals across Europe and around the world.
Need to arrange an international air ambulance? Contact REVA anytime, day or night, to speak with our team. We’re here to help you breathe easier.
Health Insurance in Europe At A Glance
How large is the health insurance market in Europe?
The health-related insurance market in Europe reached about €263.9 billion in direct written premiums in 2024.
How many people in European OECD countries have voluntary health insurance?
Among 29 OECD countries with recent comparable data, nine had voluntary private health insurance coverage for more than half of the population in 2024.
Belgium had the highest complementary coverage (97%), while Israel and the Netherlands had the largest supplementary private insurance markets, covering over 80% of the population.
How does health insurance coverage vary across European countries?
Health insurance coverage varies across Europe based on each country’s healthcare system:
- Most European OECD countries: Universal or near-universal public or compulsory coverage
- Netherlands and Switzerland: Universal coverage through compulsory private health insurance, supported by subsidies and regulation
- France, Belgium, and Slovenia: Voluntary insurance is mainly complementary, helping cover cost-sharing
- Ireland: Voluntary insurance is often duplicate coverage for faster access or wider provider choice
- Netherlands: Voluntary insurance is often supplementary, covering services not fully included in the main system
Health Insurance Premiums in Europe
How much do Europeans pay in health insurance premiums?
In the EEA, Europeans paid about €263.9 billion in health-related direct written insurance premiums in 2024.
What share of Europe’s insurance premiums comes from health insurance?
Health-related insurance made up about 14.2% of all EEA direct insurance premiums in 2024, with €263.9 billion in health-related premiums out of roughly €1.858 trillion in total life and non-life premiums.
Which European countries have the highest health insurance premiums?
Using EIOPA’s 2024 country-level health-related direct premium data, the largest EEA health insurance markets were:
- France: about €84.9 billion
- Germany: about €72.0 billion
- Netherlands: about €66.2 billion
- Spain: about €13.9 billion
- Italy: about €9.3 billion
Which European countries have the lowest health insurance premiums?
The smallest EEA health insurance markets in 2024 were:
- Iceland: about €106.4 million
- Latvia: about €130.6 million
- Estonia: about €157.5 million
- Cyprus: about €172.5 million
- Lithuania: about €206.9 million
Health Insurance Markets by Country
How do health insurance markets differ across Western, Northern, Southern, and Eastern Europe?
European health insurance markets vary widely by region:
- Western Europe: The largest markets, led by France (€84.9B), Germany (€72.0B), and the Netherlands (€66.2B), which together made up about 84.5% of the EEA health-related premium total in 2024.
- Southern Europe: Smaller but significant markets, led by Spain (€13.9B) and Italy (€9.3B).
- Eastern Europe: Much smaller markets, including Latvia (€130.6M), Estonia (€157.5M), and Lithuania (€206.9M).
- Northern Europe: Private health insurance plays a smaller role because public systems cover most costs. Government schemes pay 80% or more of national health spending in Sweden, Norway, Iceland, Denmark, and the United Kingdom.
Which European countries rely most on compulsory private health insurance?
The Netherlands and Switzerland rely most on compulsory private health insurance.
Both countries have universal healthcare coverage through mandatory private insurance systems supported by public subsidies and strong government regulation.
Which European countries rely most on voluntary private health insurance?
Belgium relies heavily on voluntary private health insurance: 97% of the population is covered by complementary private plans.
The Netherlands also has one of Europe’s largest supplementary private insurance markets, covering more than 80% of the population.
Nine of 29 OECD countries reported voluntary private coverage for over half their population in 2024.
Private Health Insurance Coverage in Europe
What percentage of people have voluntary private health insurance in European countries?
Among 29 OECD countries with recent comparable data, nine had voluntary private health insurance coverage for more than half of the population in 2024.
Which European countries have the highest voluntary private health insurance coverage?
Belgium (97%) and the Netherlands (80%) have the highest reported voluntary private health insurance coverage in Europe.
Which European countries have the lowest voluntary private health insurance coverage?
The European countries with the lowest voluntary private health insurance coverage are:
- Estonia: 4%
- Lithuania: 7%
- Sweden: 7%
- United Kingdom: 12%
- Turkey: 14%
- Spain: 15%
How many health insurance companies operate in Europe?
In 2024, the EEA had 2,309 insurance undertakings operating across all insurance categories, including:
- 368 composite insurers
- 375 life insurers
- 1,260 non-life insurers
- 306 reinsurance companies
Which European countries have the most health insurance companies?
In 2024, the European countries with the most insurance undertakings were:
- France: 443
- Germany: 328
- Luxembourg: 255
- Ireland: 169
- Spain: 13
Who are the largest health insurers in Europe?
Major European groups with large health insurance operations include AXA, Bupa, Allianz, Munich Re/ERGO, and Generali.
AXA reported €17.5 billion in health premiums and other revenues in 2024, while Bupa reported £16.9 billion in 2024 revenue and 60.5 million customers worldwide.
What percentage of healthcare spending is paid by voluntary private health insurance?
Voluntary private health insurance pays for about 5% of total healthcare spending across the OECD, though it exceeds 10% in some countries, including Slovenia and Ireland.
Need To Reach Care Across Europe? Call REVA Anytime
When the care you need isn’t available nearby, REVA helps you reach the right hospital, specialist, or treatment center across Europe and beyond.
Our air ambulance teams provide life-saving, ICU-level care during flight, safely coordinating every step of your transfer.
Reach out to us anytime to arrange your air ambulance. We’re here whenever you need us.
Sources
EIOPA. “European Insurance Overview 2025.”
OECD. “Health at a Glance 2025.” November 13, 2025.
EIOPA. “Insurance Statistics.”
Bupa. “Annual Report 2024.”
AXA. “Full Year 2024 Earnings.” February 27, 2025.