An issue of discrimination has to be overcome before the island can sign a reciprocal health agreement with the UK, Guernsey's health department says.
The department said if Guernsey had an agreement like the one signed by the Isle of Man and the UK it would disadvantage islanders.
It said it would mean islanders paying for services that UK visitors would get for free.
The department said negotiations over a future agreement would continue.
It said: "This issue would need to be taken into account in deciding the most appropriate way forward for Guernsey."
Bailiwick of Guernsey residents pay for ambulances, accident and emergency visits and doctor's appointments, whilst residents of the Isle of Man, Jersey and the UK do not.
The Health and Social Services Department said: "To provide these services 'free of charge' to non-local residents would discriminate against our own people."
The previous reciprocal agreement between Guernsey and the UK ended in April 2009.
It meant islanders could receive free healthcare under the National Health Service while on visits to the UK, and the same would apply to UK residents when they visited the island.
Similar agreements with the Isle of Man and Jersey also stopped in April 2009.
The UK signed a new agreement with the Isle of Man in September and Jersey authorities have said they are close to following suit.