Is healthcare free for children in Europe? What parents pay

By Skyler Bissell · November 2, 2026

A Seattle couple on a $150,000 household income pays $9,792 a year for healthcare in our engine. Live on the same salary as a family of four, with children aged 3 and 7, and the bill becomes $14,828. In Berlin the same household goes from €1,220 to €1,340. What the German children add is a little spending outside the exemptions, such as over-the-counter medicine for a child past 12.

So the short answer is yes, mostly. Healthcare is free for children in most of Western Europe in the sense that matters at the clinic: a child pays no premium, no deductible and no copay for ordinary medical care until about 18, and dentistry is free or nearly free for children in many systems. Two big exceptions matter for people moving: in Switzerland children have their own premiums, and in Ireland GP visits are free only for children under 8. Free at the clinic also has a source. Parents fund it through payroll contributions or general taxes, and that money sits in the tax line of any honest comparison.

What two children add to one household's health bill

Every row below is the same household: two earners splitting a $150,000 income 100 to 60, aged 35 to 44, restated in local currency at fixed ratios (EUR 138,000 in Berlin and Amsterdam, GBP 118,501 in London, SEK 1,575,000 in Stockholm, CHF 120,000 in Zurich). We price each city twice, first as a couple without children and then with the two children. Nothing else changes between the two columns.

The figure is what the household pays itself in a typical year: premiums, realized out-of-pocket spending net of reimbursement, and adult dental and vision cover. It leaves out any health contribution taken from gross pay, because that already counts as tax on this site. It also leaves out children's dentistry outside the US, where our model assumes the public system pays for it. That assumption is wrong for Switzerland, as the Zurich section explains.

Read across each row instead of down the columns, because the columns mostly show how each country collects the money, whereas the only thing that changes within a row is the two children. In the three American cities the jump is $4,372 in Austin and $5,036 in Seattle and New York, because the household moves from an employee-plus-spouse premium to a family premium and has two more people running into the deductible. KFF's 2025 Employer Health Benefits Survey is the source behind our US premiums, and it puts the average worker's share of a family premium at $6,850 a year, before any deductible.

In Berlin, London and Stockholm neither column has a premium, so the difference is all out-of-pocket spending. Amsterdam's adults pay their own nominal premiums in both columns, and the children add nothing to them. Zurich is the one European row where children bring premiums of their own. Its CHF 3,180 ($3,855) rise is bigger than the other four European rows combined.

For the 71-country view of the family premium, our healthcare costs by country ranking runs one family of four in every country we cover. This page stays with the question underneath it: which services children get free, and until when.

Where children's free care stops, country by country

"Free" changes meaning from one service to the next. A system can waive the GP fee and still charge for braces, or cover prescriptions to 16 and dentistry to 18. These are the statutory rules we checked against each country's own health ministry or national health service in November 2026.

Germany: free on a parent's membership, with one trap

Under Social Code V, section 10, children are covered through a parent's statutory insurance (Familienversicherung) until 18, until 23 if they are not working, and until 25 while in school or vocational training. The Federal Ministry of Health's copay rules exempt children from copayments until their 18th birthday, transport costs aside. An adult pays 10% of a prescription's price, at least EUR 5 and at most EUR 10. Children under 12 can also get prescribed non-prescription medicines paid for.

There is one trap in it. The same section 10 removes free family cover when the parent outside statutory insurance earns more than the insured parent and above the compulsory-insurance threshold. For 2026 that threshold is EUR 77,400 a year, according to BMAS's 2026 social-insurance limits. In our Berlin household the higher earner sits above that line and is allowed to switch to private insurance. If that parent does, the children leave free family cover and need private policies of their own. Our model assumes both parents stay in statutory insurance.

Germany also adjusts the parents' payroll for children. Under Social Code XI, section 55, childless members over 23 pay a surcharge of 0.6 percentage points on long-term care insurance, and parents get 0.25 points off for each child from the second to the fifth, until the child turns 25. In our engine the childless Berlin couple pays more payroll contribution than the family does.

Netherlands: no premium, no deductible, a registration form

Every Dutch adult buys a basic policy, which is why Amsterdam's adults carry a premium in both columns of the table. Children do not. Rijksoverheid's premium guidance says plainly that no premium is paid for children under 18. Its deductible guidance says children under 18 pay no eigen risico either; for adults it is EUR 385 in 2026 and 2027. Dental care for under-18s is largely covered by the basic package without the deductible. On the child's 18th birthday all of this ends at once: they take out their own policy and start paying both.

The adults' side has a second channel. An income-related health contribution is collected by the Belastingdienst, and for employees it usually comes through the employer. That is part of how the children's cover gets paid for, and it never appears on the insurer's bill.

Sweden and England: free at the counter, with age lines

Swedish regions set their own fees. In Region Stockholm, per 1177, children and young people from 0 to 17 pay no patient fee. An adult pays SEK 275 for an outpatient visit, and outpatient fees stop at SEK 1,450 a year under the high-cost protection. Dental care is free through the calendar year a child turns 19, according to 1177's dental support page. That limit was 23 until the end of 2024, so older guides that promise free dentistry into the early twenties are out of date.

England splits services by age. The NHS dental entitlement rules make NHS dentistry free under 18, or under 19 in full-time education. The NHS Business Services Authority's April 2026 prescriptions booklet makes prescriptions free under 16, and at 16, 17 or 18 for those in full-time education. A 17-year-old apprentice pays for prescriptions and still gets free NHS dentistry. Scotland, Wales and Northern Ireland run their own charging rules.

Switzerland: children pay premiums and dentists

Swiss basic insurance is compulsory for every resident, children included, and each child has a premium. What children get is lighter cost sharing. The Federal Office of Public Health's cost-sharing rules give children no deductible, against CHF 300 for adults, and cap their 10% share of costs at CHF 350 a year, half the adult cap. Children up to 18 also skip the CHF 15 daily hospital charge.

Dentistry is the larger gap. The same office's benefits page says basic insurance does not, as a rule, pay for dental treatment, apart from a short list of severe illnesses. Our Zurich family figure holds no children's dentistry, so the true Zurich cost of two children is higher than the table shows. Swiss families cover it with a supplementary dental policy or pay the dentist directly.

Ireland and France: free in parts

Ireland is the exception closest to the American model inside Europe. The HSE's under-8 GP visit card gives every child under 8 living in Ireland free GP visits, assessments at ages 2 and 5, out-of-hours urgent care and asthma care. From age 8 the card stops, and the GP's fee applies unless the family holds another card. France sits between the two groups. Service-public.fr confirms that under-18s are exempt from the flat medical charges, which rose to EUR 70 a year for each charge from October 1, 2026. The remainder of a doctor's fee still applies, which is why French families add their children to complementary cover.

The US baseline: free preventive visits, priced everything else

American children are not left uncovered, and well-child care is free on most plans. HealthCare.gov's children's preventive care list says most plans must cover well-baby and well-child visits, vaccines, vision screening and fluoride treatments with no copayment or coinsurance, in network, even before the deductible. A sick visit, a specialist, an emergency room or a prescription goes through the family deductible and copays. That is the part a European system removes, and it is most of what the American rows above are pricing.

Who pays for the free part

No system on this list runs children's care for nothing. Germany and the Netherlands collect a health contribution from wages. Sweden and the UK pay through general taxation. The child's bill is spread across every earner, including people without children. That is why the European columns in our table are so small, and why the honest comparison puts health contributions and taxes on one line. The true tax burden once healthcare is counted runs that arithmetic for this household. For a parent, the practical point is narrower. Whether you have one child or three, the payroll contribution stays the same, and in Germany it falls slightly.

Health spending is one of three costs that move a family relocation, alongside childcare and paid leave. The full picture, including daycare and child benefit, is in our guide to the cost of raising kids. The seven-city children's ledger prices this same household's childcare and benefits beside its health spending.

Four checks before you count on free care

First, register the children. Dutch, German and Swiss cover all run through an insurer, and children need to be added to a policy or a parent's membership. Second, in Germany, settle which parent's insurance the children sit under before either of you chooses private cover. Third, write down the birthday that ends each entitlement: 16 for English prescriptions outside education, 18 for Dutch premiums and German copays, 8 for Irish GP visits. Fourth, price orthodontics and, in Switzerland, all dentistry separately, because no table of public cover includes them.

FAQ

Are braces free for children in Europe?

Usually not in full. The Dutch basic package leaves out braces for young people, according to Rijksoverheid. In Germany, statutory insurance pays for orthodontics that meet a medical threshold when treatment starts before 18: the family pays 20% of the cost, 10% for a second child in the same household, and the insurer refunds that share once the treatment is finished as planned, under Social Code V, section 29. Swiss basic insurance pays for almost no dental work at all. Budget for braces as a separate cost in every country on this page.

Does Switzerland help families pay children's health premiums?

Yes, if the family's income qualifies. The Federal Office of Public Health says cantons must cut children's premiums by at least 80% for families with lower and middle incomes, and each canton decides who qualifies. Our Zurich figures apply no reduction, so a family that qualifies would pay less than the table shows.

Are children's prescriptions free in Ireland?

Not under the under-8 GP visit card. The HSE says the card covers free GP visits for children under 8, including assessments at ages 2 and 5 and out-of-hours urgent care, and that medication costs and hospital charges are not covered. Families pay for medicines separately unless they hold another entitlement.

If a move is on the table, the number to bring to the conversation is the one in the table's right-hand column for your destination, set against what your current plan charges for the family tier. Then run your own household through the calculator with your children's ages, and the health line will sit beside rent, taxes and childcare in one comparison.

These figures are annual household healthcare spending from cityparity's engine for two named households, a two-earner couple without children and the same couple with children aged 3 and 7, checked November 2, 2026. Premiums, realized out-of-pocket spending and adult dental and vision are included; statutory health contributions taken from wages are counted as tax and left out. US premiums follow KFF's employer survey. No income-tested premium reduction, private insurance switch or children's dentistry outside the US is modeled. Statutory rules are linked beside each claim and describe the national authority's published position on the date checked. Calculation methodology.